.svg)
.svg)
.svg)
Medicare is a government-funded healthcare insurance program that aids senior citizens all across the US. Unfortunately, like any major system, the program has become a hotspot for scammers and fraudsters to target those who use it.
Medicare scam attempts are fairly common and have led to nearly 3 billion dollars in losses nationwide in 2024 alone. Because of this, it’s important to learn how to identify common Medicare scam calls and how to protect yourself from falling victim to these criminal schemes.
What Is Medicare?
Medicare is a government-funded program that provides health insurance for people 65 and older and some under 65 with qualifying disabilities. There are four parts to Medicare coverage: A, B, C and D.
Part A: Hospital Insurance
Part A of the Medicare plan helps cover hospital expenses, nursing care facility costs, hospice care costs, and some in-home health care. The good thing is that almost all American hospitals will accept Medicare.
Most of the ones that don’t are active military hospitals that are covered under other plans. Still, it’s a good idea to double-check that the hospital takes Medicare before checking in, especially for an extended stay. Click here to find hospitals, nursing homes, and other care facilities that accept Medicare near you.
Medicare typically covers 80% of the full expense of your hospital visit. There are additional Medicare Supplement Plans (Medigap) and other options to help cover the remaining cost.
Part B: Medical Insurance
Part B of the Medicare plan helps cover general medical insurance expenses. This includes things like doctor and healthcare provider services, medical equipment, preventative services (screenings, shots, annual wellness visits), outpatient care, and home health care.
Part C: Medicare Advantage
Part C is a plan called Medicare Advantage, and it’s essentially a premium bundling option. It’s run by a private company but is approved by Medicare and offers an alternative option to the regular coverage included in Plans A, B, and D.
There may be additional benefits included, but the number of doctors covered by this plan is more limited. The cost breakdown is also different and an additional premium may be added.
Part D: Drug Coverage
Part D of the Medicare plan helps cover the cost of prescription drugs including certain recommended shots and vaccines. Medicare drug coverage is technically run by a third-party private insurance company, but it’s regulated by Medicare.
Your Bundle Options
Your first main option is Original Medicare, which includes Part A, B, and the option to add Part D. Your second main option is Medicare Advantage, which is Part C (includes A, B, and typically D). If you’re looking to apply for Medicare, it’s a good idea to do some deeper research into both Medicare Advantage and Original Medicare to find what best fits your needs before deciding.
Medicare Cards and Numbers
Once you sign up for Medicare, as with most health insurance companies, you will receive a physical Medicare card with a unique combination of 11 numbers and letters. Not to be dramatic, but you should protect this card with your life. This is one of the main things scammers will target in Medicare scams, as it gives them access to your account and identity.
What Is a Medicare Scam?
Now that you know more about how Medicare works, it’s time to get into the nature of Medicare scams. The most common Medicare scam works like this: Scammers contact people and trick them into giving up their Social Security Number or Medicare card number.
This is typically how it goes:
Calls and More
They will make a phone call (or send an email, text, or letter) posing as someone from Medicare. Depending on their level of sophistication, the content of the call can sound very legitimate and convincing.
Content of Message
The content of their message can be anything. They might be advertising free medical equipment to eligible members who submit their account information. They might tell you there’s an issue with your account, and you need to send your login information so they can fix it for you.
They might tell you you’ve been approved for an upgraded plan and should send your account number right away so they can switch you. Scammers will try anything that convinces you to send your Medicare number or Social Security Number (which you need to sign up for Medicare).
How Medicare Scammers Use Your Number
Once scammers have your information, they will typically use it to steal your identity and commit fraud on your behalf. This usually happens when scammers submit fraudulent claims under your name. They might hope to obtain actual health care services, prescription drugs (which they can resell at a higher price if they want), or other medical supplies, which again, they can resell.
If they don’t order their own prescriptions, they can redirect the ones you order to a location of their choosing, denying you potentially necessary medication. They can also enroll you in hospice or other similar programs, which can cause you to be denied the treatments you need (since your records will show you’re in hospice).
Every time they order something or sign up for a program, that money comes out of your pocket. A surplus of claims can also lead to you hitting your benefits cap much sooner than anticipated, which could result in difficulties in affording treatments you actually need. Plus, your doctor will be very confused about your chaotic medical history.
Examples of Common Medicare Scams
You’ve seen a general overview of what a Medicare scam is, but now let’s go into some specific examples of common scams so you know what to look out for.
1. New Medicare Card
In 2018, Medicare genuinely released new Medicare cards. This inspired scammers to approach members and convince them they needed an updated card, asking for their SSN or Medicare number to replace it.
2. Canceled Benefits
A scammer will claim to be from Medicare and tell you your benefits are at risk of being canceled unless you send them a direct payment or card information.
3. A Better Coverage Plan
Scammers will claim you’re eligible for a discounted monthly plan or a more comprehensive coverage package if only you send your card number so they can switch the plan for you.
4. Inaccurate or Overcharged Medical Bills
This one is scary because the scammers aren’t obscure criminals hiding behind a computer in a basement — they’re the healthcare providers. They can write up unnecessarily high bills or charge you for services you didn’t use or shouldn't be charged for.
They’ll hope you don’t notice the discrepancy and pay without thinking. Their goal is to get as much money from you as possible and subsequently from Medicare when they help cover the bill.
5. Free Equipment or Refunded Expenses
Scammers will claim you’ve won or are eligible to receive free or discounted medical equipment if only you give up your card number. You may also be offered refunds for previous medical expenses in the same way.
How To Identify Medicare Scams
So, you know what a Medicare scam call entails. But how can you identify these scams before it’s too late?
Ideally, you’ll know you’re being scammed before you give up your SSN or Medicare number. It’s much easier to delete and report an email than to recover hundreds or thousands of dollars in damages from fraud.
Here are a few red flags to look out for when dealing with Medicare:
Offers That Are Too Good to be True
We all love to hear the word “free" next to something we need. But unfortunately, in the world of health insurance, “free” should raise a red flag. Any time you hear about free or extremely discounted medical equipment, prescription drugs, or programs on the phone, it’s probably a scam.
Especially if someone calls you and advertises the deal aggressively on the line. The same thing goes for free services like ancestry DNA testing or blood work, anything not prescribed by your trusted doctor.
Unsolicited Contact From Medicare
Medicare as an institution will never call you or contact you via text, email, or mail on a whim to urge you to do something. The only reason this might occur is if you have outstanding or overdue payments, but in that case, you should be expecting them to contact you.
Because they never reach out unless you ask for help, you should be immediately suspicious if Medicare does contact you out of nowhere. And if they do call, they should never need more than basic personal information because everything’s already in their system.
Pressure To Upgrade or Change Your Plan
Medicare may objectively advertise their premium plans or cards, but you should never receive any form of personalized communication directly from them urging you to switch your plan or card.
Medicare is a government program geared toward low-income seniors and people with disabilities. The point is to find a plan that works for you, not to upsell people to the most premium option. Medicare does not endorse any of their plans more than the others.
If you get a call, text, piece of mail, or email urging you to upgrade (or promising a discounted rate if you do), this is likely a scam.
Threats of Coverage Cancellation
Real Medicare employees will never threaten to cancel your coverage, change your plan, or take away equipment or prescriptions you have. The only reason they would do something in this vein is if you’ve missed payments, which you would be aware of.
Threats to take medical care plans or equipment away is a fear tactic used by scammers to convince you to do what they’re saying, which is usually to hand over your card information.
How To Protect Yourself From Medicare Scams
The biggest thing you can do to help keep yourself safe from Medicare scams is to treat your Medicare card like a credit card. Never give out your card information to anyone who reaches out to you first, and never give it to anyone you don’t know. Only give your Medicare and SSN information to trusted doctors, pharmacists, and verified Medicare employees you call first.
You also want to make sure to verify all information with the official Medicare phone number before responding to ensure the call you’ve received isn’t a scam. This number is:
1-800-MEDICARE (1-800-633-4227)
If a real Medicare employee was trying to call you, they won’t mind verifying the information over the phone via this number.
To better secure your personal information, you can also use a second phone number app like Burner when signing up for programs like Medicare. That way, if you get scammed and the hacker gets into your Medicare account, they will only have access to your second number, which is easily deleted in the Burner phone app.
And of course, if you notice any of the red flags listed in the section above, never respond to the person initiating that contact. Report, block, and delete their call as soon as possible and never click on any links included in emails or texts.
How To Report Medicare Scams
Whether you’ve fallen victim to a Medicare scam and have noticed unauthorized charges or claims in your account or suspect a call is fraudulent, you can use the same Medicare number to report fraud:
1-800-MEDICARE (1-800-633-4227)
You can also submit a complaint online with the US Department of Health and Human Services. Scroll down and click the red button that says “File a Complaint Online.”
What To Remember About Medicare Scam Calls
Medicare scammers will try to convince you they work for Medicare and get you to hand over your Social Security Number or Medicare card number so they can commit fraud under your name. To identify scam calls, look out for aggressive callers urging you to act quickly, people selling free or discounted rates or equipment, and callers pressuring you to give them your personal information over the phone.
To stay safe, never give out your SSN, credit, or Medicare card numbers to people who initiate contact with you first. Remember, Medicare won’t reach out unless you ask for help first. And if you do fall victim to a scam, report it by calling the official Medicare number so they can handle the situation.
Sources:
Do All Hospitals Accept Medicare?
5 Warning Signs of a Medicare Scam—and How to Protect Yourself
8 Medicare scams to avoid in 2025.
