Medicare Scams: How They Work & How to Stop Them

What is a Medicare scam?

A Medicare scam is any attempt to obtain your Medicare number, your banking details, or a fraudulent billing authorization by impersonating Medicare, the Social Security Administration, a Medicare Advantage plan, a pharmacy, or a medical equipment supplier. Because Medicare pays claims first and investigates later, a stolen Medicare Beneficiary Identifier can be billed for months before anyone notices — which is why criminals value it more highly than a credit card number that can be cancelled in a single phone call.

The theft rarely feels like theft. It feels like a helpful call about a benefit you did not know you had: a free back brace, a free genetic cancer screening, a new plastic card with a chip, a refund on last year's premium, or a plan review that will 'save you money before the deadline.' Every one of those pitches is a script.

How do Medicare scam calls work?

1. 1The caller opens with authority. They say they are from 'Medicare,' 'the Medicare benefits center,' or 'your plan's verification department,' and they may already know your name, your street, and your approximate age from a purchased marketing list.
2. 2They offer something free. A brace, a knee sleeve, a diabetic supply kit, a DNA swab, a COVID-era test kit, or a new card. Free is the hook, because free feels like it costs nothing to say yes to.
3. 3They ask you to 'verify' your Medicare number. This is the entire point of the call. Everything before it exists to make this question sound routine.
4. 4They add urgency. Your benefit expires today; the shipment goes out tonight; the deadline is Friday; your coverage will lapse without confirmation.
5. 5They bill Medicare. Equipment you never use arrives at your door, or nothing arrives at all, and Medicare is billed thousands of dollars against your record. Sometimes your number is resold to other fraud rings and billed repeatedly for years.

What will Medicare never do?

• Medicare will never call you out of the blue to sell you anything or to ask for your Medicare number.
• Medicare will never charge you a fee for a card, a replacement card, or a 'new chip card.' Replacement cards are free from your Medicare account or 1-800-MEDICARE.
• Medicare will never threaten to cancel your benefits if you do not answer questions immediately.
• Medicare will never ask for payment by gift card, wire transfer, cryptocurrency, Zelle, Venmo, or Cash App.
• Medicare will never send someone to your door to check your card, your health, or your equipment.

What are the red flags in a Medicare scam?

• An unsolicited call, text, or knock offering a free medical device or screening.
• Any request to 'confirm,' 'verify,' 'reactivate,' or 'update' your Medicare number.
• A claim that your card is being replaced with a plastic, chip, or metal version.
• Pressure tied to a deadline, especially during Open Enrollment.
• A caller who will not give you a callback number, or who gives a number that does not match 1-800-MEDICARE (1-800-633-4227).
• Requests for your Social Security number, bank account, or a payment of any size.
• A doctor's name you do not recognize being used to justify equipment or lab work.

What should I do if I already gave out my Medicare number?

1. 1Call 1-800-MEDICARE (1-800-633-4227) and report that your number may be compromised. Ask them to flag your record for suspicious billing.
2. 2Contact your state Senior Medicare Patrol. SMP volunteers review statements with you free of charge and know the local fraud patterns.
3. 3Read every Medicare Summary Notice or Explanation of Benefits for the next twelve months, line by line. Question any service, supplier, or date you do not recognize.
4. 4Report the contact to the FTC at ReportFraud.ftc.gov and, if a Social Security number was shared, place a free fraud alert with Equifax, Experian, or TransUnion.
5. 5If you paid money, call your bank or card issuer the same day and use the word 'fraud' — it triggers a different process than 'dispute.'
6. 6Write down the date, the phone number, and what was said. Investigators use those details to connect cases.

How do I protect a parent who keeps answering these calls?

Do not start with a lecture about being careful — it rarely changes behavior and it makes people hide future calls out of embarrassment. Start with structure: turn on carrier-level spam filtering, register the number on the National Do Not Call Registry, tape a short script by the phone ('I don't give my Medicare number over the phone — I'll call 1-800-MEDICARE myself'), and agree that any medical or financial call gets a call back to a number you both look up together. Then review the Medicare Summary Notice together every quarter so an anomaly gets caught in weeks, not years.