Medicare scams are much more common than any of us would like to believe.
One retired nurse reported someone ordering $12,000 worth of catheters under her name.
Meanwhile, 23 Michigan residents were recently charged with Medicare fraud schemes worth $61.5 million!
That’s why we all have to stay vigilant. Depending on your Medicare plan, you might end up paying hundreds of dollars extra for items and services you didn’t order!
But don’t worry—once you know how these scams work and how to avoid them, it will be much more difficult for scammers and thieves to trick you.
In this article, we’ll go over the different tricks fraudsters use, and ten steps you can take to drastically reduce your chances of getting scammed.
How Medicare Scams Work
Most Medicare scammers are after one thing:
Your Medicare number.
Once they have this, they may be able to make fraudulent claims to Medicare using your name and details.
These fraudsters usually partner up with a registered medical facility. They either own the facility or make a secret quid pro quo agreement with the management.
Using your name and the facility’s Medicare registration, they can claim that you ordered a medical device (such as catheters) or received a medical service that’s covered by Medicare.
Once they submit this claim to Medicare, Medicare will promptly reimburse them – even though you don’t get anything.
To make matters worse, if your Medicare plan has deductibles, copays, or coinsurances, you’ll also typically be responsible for paying for some of the costs of these fraudulent claims.
That’s why it’s critical to keep your Medicare number safe.
This number is precisely what fraudsters need for their scheme to work. Without it, they usually won’t be able to make claims in your name.
How Medicare Scammers Get Your Details: 7 Tactics to Look Out For
Now that you know what Medicare scammers need in order to successfully scam you, let’s take a closer look at the tactics fraudsters use to get your details.
Being aware of these tactics can help you steer clear of them.
- Freebies – One of the most common ways for fraudsters to collect your Medicare number is by calling you and promising you freebies. In these phone calls, they pose as Medicare and tell you you’re entitled to something like a free knee brace. But once you give them your details, they’ll either send you a cheap knee brace or nothing at all (and they can already make claims using your name).
- Plan Upgrades – Another tactic phone scammers use is promising you a free Medicare plan upgrade that has “better” coverage than your current plan. Beware of phrases like “You qualify for a FREE upgrade,” or “You’re entitled to a better Medicare plan.” This is a clear indication you’re being lied to.
- Refunds – Right around the tax season, scammers may call you and say you’re entitled to “Medicare refunds.” They’ll tell you that all you need to do is, you guessed it, give them your Medicare details. They may even ask for your bank account details as well!
- Card Activation – In 2018, Medicare switched from using your Social Security number to giving you a new, separate Medicare number. Since then, many fraudsters have been calling people, asking them to “activate” their new card by giving them the details. News flash: there’s no such thing as activating your Medicare card.
- Threats – Some scammers pretend that your Medicare account has a problem and is at risk for termination. They’ll then ask you to verify your identity by giving them all your details. This is supposed to “restore” your account. In reality, it’s all just a ploy to get your details.
- Phishing Emails – One of the most clever ways scammers can get your details is to send you emails that seem like they’re from Medicare. They have great designers who make the scam emails seem legit, and they try to get you to click on links that lead to clone websites. When you put your login details into a clone site, you’re actually sending the scammers this confidential information.
- Pressure Tactics – Last but not least, scammers will usually pressure you to act immediately. They want to get your details before you realize what’s really going on, so there’s almost always an imminent deadline to their threat or reward. If you notice someone pressing you to act fast, this should set your alarm bells off. Remember, Medicare will never rush you into enrolling!
10 Tips to Avoid Getting Scammed by Medicare Fraudsters
Now that you know how many of the more common scams work and the tactics fraudsters use, here’s some valuable information and tips you should know to avoid them:
- Don’t entertain random calls from “Medicare,”
- Be wary of “official” phone numbers,
- Don’t buy anything “Medicare” advertises,
- Don’t entertain people who show up claiming to be from “Medicare,”
- Don’t accept free gifts from “Medicare,”
- Don’t click on suspicious links,
- Protect your Medicare card,
- Don’t let random people see your medical records,
- Check your receipts for mistakes, and
- Don’t be embarrassed.
Let’s have a closer look.
1. Don’t entertain random calls from “Medicare”
If someone calls you randomly claiming to be Medicare, put the phone down.
Medicare will rarely call you first. Most of the time, you must call them first to report a problem or fraud before an actual Medicare representative will call you.
Now, there may be times when your Medicare plan or licensed insurance agent calls you. However, your Medicare plan should already have your details on file – so they shouldn’t have to ask you for your Medicare number again.
2. Be wary of “official” phone numbers
Hackers know how to spoof phone numbers and make them look official.
That’s why, even if it seems like Medicare is calling you, be alert and avoid giving them your information.
Again, Medicare will rarely call you. They usually only do this if you ask them to.
3. Don’t buy anything “Medicare” advertises
Medicare will never endorse one plan over the other.
If someone from “Medicare” is selling a plan to you, hang up the phone immediately.
That’s either a scammer trying to get your details or a salesperson who is likely untrustworthy.
Either way, no one with good intentions pretends to be Medicare.
4. Don’t entertain people who show up claiming to be from “Medicare”
Sometimes, scammers go the old-school route and actually show up at your house.
This can be more effective for them, especially if they put up a good show of being from Medicare.
However, remember this:
Medicare will NEVER visit your house uninvited.
They especially won’t visit your house to sell you a plan!
5. Don’t accept free gifts from “Medicare”
Medicare will not give you free gifts.
Nor will they “upgrade” your plan for free.
Everything in Medicare is paid for either by your premiums, taxpayer money, or your cost-sharing contributions. Medicare giving out freebies is not something they ever do.
6. Don’t click on suspicious links
To avoid phishing, you never want to click suspicious links and enter your details on unofficial websites.
You might be wondering what “suspicious” links are, and how to tell if a site is unofficial.
One of the easiest ways to tell is by looking at the link address. All official Medicare websites end with “.gov,” so there’s Medicare.gov, SSA.gov, CMS.gov, etc.
Be wary of websites that try to imitate this. They can title their websites something like Medicaregov.com (notice how this ends with a .com, not a .gov).
If you want to be sure, instead of clicking a link someone sent you, you can type out the address manually in your browser.
7. Protect your Medicare card!
A good rule of thumb is to treat your Medicare card like you would your credit card.
Keep it away from as many eyes as possible.
The only people who need to see your card are the doctors and hospitals when you’re paying your bill, insurers working on your behalf, or Medicare workers.
Don’t scammers pose as Medicare workers?
Yes, they do. That’s why whenever you show someone your Medicare card, you should know and understand precisely why you’re doing this (just like you would know exactly what you’re buying when you give someone your credit card).
8. Don’t let random people see your medical records
The only people who should see your medical records or recommended services are your doctor, your Medicare providers, or trusted insurers working on your behalf!
9. Check your receipts for mistakes
You should always check your receipts and statements from your insurance provider.
This is one of the simplest ways to spot if someone has been using your details to commit fraud.
If you see items listed that you didn’t receive or don’t understand, call your insurance company immediately.
Many times, these extra items are simply mistakes that they can correct. Other times, they might be able to explain these charges to you.
However, if it wasn’t a mistake on their end, and they can’t explain these, then it’s possible someone is using your information to commit fraud.
10. Don’t be embarrassed
Last but not least:
Admitting you fell for a scam can sometimes be embarrassing.
Often, when people are embarrassed, they bury their mistake instead of reporting it.
But remember, everyone makes mistakes. It’s far better to report the scam.
This will not only prevent scammers from using your details repeatedly, but you can also help law enforcement catch them and help everyone around you.
Remember, the only people who win when you don’t report a scam are the scammers!
What If Someone Gets Your Medicare Number?
If you suspect someone is using your Medicare number, call Medicare immediately at 1-800-MEDICARE (1-800-633-4227).
They will direct you on the next steps you can take.
If you think you gave your Medicare number to a scammer and they’re using your details for identity theft, you can also contact the FTC.
What to do If You Lose Your Medicare Card
If you lose your Medicare card, you can request a replacement by logging in to Medicare’s official website (remember, look out for the .gov!)
You can also call 1-800-MEDICARE (1-800-633-4227), especially if you suspect that someone might have taken your card.
Other Medicare Scams
Aside from insurance fraud, there are a few other scams relating to Medicare:
- Misleading Sales People – Some insurance sales people use false advertising to get new enrollees. They make huge promises of perks (such as free $3,000 Flex Cards), but once you call them and enroll, you realize that you don’t actually get these perks. CMS has recently been cracking down on these false advertising practices. However, some of these advertisements still slip through the cracks from time to time.
- False AI Endorsements – Another trick scammers use to steal information/get new enrollees is using deep-fake AI endorsements. They use AI to make it seem like famous people (such as Taylor Swift or Joe Rogan) endorse signing up for their plan. Of course, the FTC is cracking down on deep-faked ads. Besides, you probably shouldn’t go to celebrities for Medicare advice.
- Scam Callers – Scam callers, usually from overseas, often pose as government offices to steal your bank information. They frequently say they’re from the IRS, Social Security, Medicare, or a well-known company like Amazon or Microsoft. Government offices will never call you uninvited and ask for your bank information – neither will Amazon or Microsoft.
There are more Medicare scams out there. Fraudsters just love taking advantage of people to fill their pockets.
So be on the lookout!
If something seems suspicious, you can always call Medicare at 1-800-MEDICARE (1-800-633-4227) to ask if it’s legitimate.
Other Helpful Resources
Before we close, here are more helpful resources you can check out regarding Medicare scams!
- Your Medicare Card (Medicare.gov)
- Reporting Fraud and Abuse (Medicare.gov)
- How to Avoid Scams (FTC)
- Report Identity Theft (FTC)
- Protecting Yourself and Medicare From Fraud booklet (Medicare.gov)
Conclusion: Don’t Fall For Medicare Scams!
There’s one more way to avoid scams that you should know:
Understanding exactly how Medicare works.
When you know how Medicare works, your alarm bells will go off immediately when a scammer contacts you because you’ll know right away that their promises don’t align with how Medicare works.
Not only that, but understanding how Medicare works will also help you enroll in the best plans for you, and avoid the costly penalties that Medicare imposes for late enrollment.
So, if you’re looking for a great place to start, check out our FREE Medicare workshop.
In it, we go over all things Medicare—from enrollment periods to how to choose the right plan fit for you, all the way to avoiding fees and potentially saving money!