Stop Medicare scams before they stop you

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Medicare is a tempting prize for scammers. Because it’s a public program funded by taxpayers, it has a huge budget to distribute, and that’s what attracts scammers. In 2024, improper payments added up to $54 billion. Some scams involve setting up fake companies to file bogus claims, while others target beneficiaries directly, stealing their personal information and denying them their right to treatment.

If you fall victim to such a scam, the consequences can range from small financial losses to actual health risks. Scammers may trick you into paying fake fees, premiums, or “copays” over the phone or online. They may also go after your personal information or Medicare number to bill for services or equipment you never requested, which could leave you with less coverage when you actually need treatment.

It’s better to know what you’re up against so you don’t accidentally lose your Medicare benefits.

What to look out for to recognize a Medicare scam

Scammers are getting more and more professional these days. With Medicare scams, fraudsters may use spoofed phone numbers, emails, and websites to make their schemes seem more believable. Luckily, there are still some telltale signs to look out for.

Regardless of the communication method, phone, email, mail, or in person, scammers will try to:

• Create fear or urgency
• Pressure you to act quickly
• Threaten you with consequences

Scammers calling you in Medicare’s name to demand payments

Some scammers use spoofed phone numbers to impersonate Medicare representatives. They may try to trick you into paying fake fees or buying unnecessary products.

These often include:

• Fake health insurance upgrades
• “Low-cost” medical equipment
• Fake tests or genetic kits
• Discounted medication

Remember: Medicare will never call you unless you ask them to, and they will never ask for money.

If you ever owe Medicare fees, you will be contacted by mail, not by phone. Furthermore, Medicare insurance itself is free, and you will never be asked to pay fees just to keep it active.

You may only be required to pay in certain circumstances, such as a portion of the cost for a treatment or prescription drugs, but these bills will always be sent to you by mail, never via phone calls or online forms.

 

Scammers try to mimic these payments to steal your money

Scammers may try calling you in Medicare’s name to ask for your Medicare number or card details.

Money isn’t the only thing scammers are after; your Medicare number can be just as valuable, if not more so.

This scam follows a similar scheme: fraudsters call you pretending to be Medicare employees and ask you to provide your Medicare number for fake reasons, such as:

• Upgrading your plan
• Updating your account details
• Offering “free” drugs
• Issuing a new Medicare card
• …and more

Let me be clear: Medicare will never call you, whether it’s about paying fees, updating your account, or anything else.

Scammers want your Medicare information so they can impersonate you and obtain medical supplies, prescription drugs, or treatments in your name.

 

Scammers calling you in Medicare’s name to extort your personal data

Your Social Security number (SSN) can be the final piece scammers need to impersonate you. During these calls, fraudsters may ask not only for your Medicare details but also for other personal information, such as your SSN, date of birth, or similar data.

They often use the same excuses as when trying to obtain Medicare information, such as:

• Upgrading your plan
• Issuing new cards
• Other account-related reasons.

Let me emphasize this again: Medicare will never call you for these reasons.

Even if the phone number looks legitimate and the caller sounds professional, the moment you’re asked for personal details or payments, you know it’s a scam.

 

What to do if you suspect a Medicare scam

If it’s a phone call, just hang up.

You don’t need to explain yourself or engage in a conversation with scammers. If they threaten you with consequences, do not believe them; scammers use fear to pressure you into making poor decisions.

Remember: If Medicare or its service providers had important information to communicate, they would do so by mail, not by phone.

Apart from not letting scammers take advantage of you, you can also help others by:

• Reporting the fraud to Medicare at 1‑800‑MEDICARE (1‑800‑633‑4227)
• Reporting the fraud to the US Department of Health and Human Services
• Reporting the fraud to the Federal Trade Commission (FTC)

How to make yourself less of a target of Medicare scams

You don’t have to sit tight and hope that scammers won’t target you. Instead, you can take some active measures to make such attempts less likely.

Monitor your Medicare statements regularly

Always review your Medicare Summary Notices (MSNs) or Explanation of Benefits (EOBs). These statements show what services have been billed in your name. If you see charges for services, equipment, or prescriptions you never received, report it right away. Quick action can stop fraud before it impacts your care.

 

 

 

Filed under: General Problems