Common Medicare Scams and How to Avoid Them
Learn how to recognize suspicious Medicare calls, misleading benefit offers, medical-equipment schemes and unfamiliar claims—before your Medicare number or coverage is put at risk.
Your Medicare number can be valuable to a scammer
A stolen Medicare Number can be used for medical identity theft, fraudulent billing or attempts to make unauthorized coverage changes. A scammer may also combine it with your birth date, Social Security number, banking information or online account credentials.
The request may sound routine: “We just need to verify your card,” “You qualify for a free benefit,” or “Your coverage is about to expire.” The goal is often to create urgency before you have time to check the story independently.
Six Medicare scams and misleading tactics to recognize
“You need a new Medicare card”
A caller may claim Medicare is issuing a plastic, chipped, black-and-white or annually updated card. Official replacement Medicare cards are available without a fee. Do not provide your number to “activate” or “verify” a new card.
“Free” braces or medical equipment
Be cautious when an unfamiliar company offers back braces, knee braces, diabetic supplies, catheters or other equipment you did not discuss with your own medical provider. “Medicare-approved” does not prove that the offer is legitimate or medically necessary.
Unrequested genetic testing
Scammers may offer a “free” cheek swab or cancer screening in exchange for a Medicare Number. Genetic testing should be based on an appropriate medical evaluation and ordered through a provider you know—not an unsolicited call, fair, booth or social-media advertisement.
Grocery cards and cash-benefit ads
Some Medicare Advantage plans offer legitimate supplemental benefits, but the amount, eligibility and permitted uses are plan-specific. A generic advertisement does not prove that you qualify, and Medicare itself is not calling to give everyone a spending card.
Fake deadlines and threats
Pressure to “act today” is a warning sign. Your Medicare card does not expire every year, and refusing an unexpected caller will not cancel Medicare. Real enrollment periods have defined rules; review the Annual Notice of Change and official plan documents instead of relying on a threat.
Unauthorized plan changes
A caller may present a conversation as a “benefit review” while attempting to collect the information needed for enrollment. Do not approve a plan change, electronic signature or one-time security code unless you understand the exact plan and intentionally requested the transaction.
An unexpected Medicare call is not automatically legitimate
Caller ID can be spoofed, and a professional-sounding caller may already know personal details gathered from public records, old marketing forms or purchased lead data. Knowing your name or current insurance company does not prove who is calling.
Information may be appropriate when:
- You initiated the call using an official telephone number.
- You are working with a doctor, pharmacy, insurance company or licensed professional you know.
- You requested a callback and can verify who is responding.
- The information is genuinely needed for care, billing, coverage or an enrollment you intentionally requested.
Stop the conversation when:
- The caller contacted you unexpectedly and wants your Medicare Number.
- You are told not to speak with family, your plan, Medicare or your broker.
- The caller demands gift cards, cryptocurrency, wire transfers or immediate payment.
- You are pressured to enroll before your doctors, prescriptions and costs are reviewed.
Simple habits that reduce your risk
- Guard your Medicare card. Carry it when needed, but do not photograph or post it online.
- Do not trust Caller ID by itself. Look up and dial the official number independently.
- Avoid links in unexpected messages. Open Medicare.gov or your plan’s website by typing the address yourself.
- Never share account passwords or one-time security codes. A legitimate representative should not ask you to surrender control of an online account.
- Slow down. A legitimate decision can survive the time needed to confirm doctors, prescriptions, costs and enrollment rules.
- Ask what will change. Before any enrollment, identify the exact plan name, effective date, network, prescriptions and effect on current coverage.
- Use a known resource. Medicare.gov, 1-800-MEDICARE, your plan, SHIP or a licensed professional you trust can help verify a claim.
When choosing professional help, ask which companies the person represents and whether they will remain available after enrollment. Our guide to Medicare agents and independent brokers explains the questions worth asking.
Fraud may first appear on a Medicare statement
People with Original Medicare should review their Medicare Summary Notices. People with Medicare Advantage or Part D coverage should review the Explanation of Benefits and other claim information supplied by the plan.
Check the provider
Do you recognize the doctor, supplier, laboratory, home-health agency or hospice listed?
Check the service
Did you actually receive the test, equipment, visit, prescription or other service on the date shown?
Question mistakes
If you know the provider, ask for an itemized statement. If the provider is unknown or the explanation does not make sense, contact Medicare or the plan.
What to do if you think you were targeted
Do not be embarrassed and do not wait for a fraudulent claim to appear. Quick action can help document the incident and protect your coverage.
End the contact
Stop responding, do not send additional information or money, and do not click more links. Save voicemails, texts, emails, envelopes, telephone numbers and transaction records.
Call Medicare using the official number
Call 1-800-MEDICARE (1-800-633-4227) and explain exactly what was shared. Ask what steps are appropriate for your Medicare Number and claims.
Contact your current plan
If you have Medicare Advantage or Part D, use the member-services number printed on your plan card. Confirm your current enrollment and ask whether any change or unfamiliar request is pending.
Review claims and coverage notices
Check your secure Medicare account, Medicare Summary Notices, plan EOBs and mail for unfamiliar providers, equipment, prescriptions, hospice, home-health services or enrollment confirmations.
Protect other information too
If you also disclosed banking details, a Social Security number, passwords or security codes, contact the affected bank or account provider immediately. Use IdentityTheft.gov for a personal recovery plan when identity theft may be involved.
Match the problem with the right resource
| Situation | Who to contact | What to have ready |
|---|---|---|
| Suspicious Medicare claim, stolen Medicare Number or possible Medicare fraud | 1-800-MEDICARE 1-800-633-4227 |
Your Medicare card, the claim or notice, provider name, service, date and reason for concern |
| Issue involving a Medicare Advantage or Part D plan | Your plan’s member services and, for suspected plan or drug fraud, I-MEDIC at 1-877-7SAFERX (1-877-772-3379) | Your plan card, enrollment or claim information, dates, names and communications |
| Fraud, waste or abuse involving an HHS program | HHS Office of Inspector General 1-800-HHS-TIPS (1-800-447-8477) |
Who was involved, what happened, when it happened and supporting records |
| Help reviewing a suspicious Medicare situation | Senior Medicare Patrol 1-877-808-2468 |
Your notices, advertisements, notes and the details of the contact |
| Impersonation scam, money loss or identity theft | ReportFraud.ftc.gov and IdentityTheft.gov | Messages, payment records, account information and a timeline of events |
Medicare scam questions
Will Medicare call and ask for my Medicare Number?
Do not provide your Medicare Number to an unexpected caller. Medicare or a contractor may contact you in limited circumstances, especially after you initiated a request, but the safest response to an unverified call is to hang up and call 1-800-MEDICARE yourself.
Is Medicare sending everyone a new plastic or chipped card?
No general annual plastic-card or chip-card replacement is required. You do not have to pay or provide your Medicare Number to activate a new card. Order a legitimate replacement through your secure Medicare account or by calling 1-800-MEDICARE.
Are all grocery-card and flex-card advertisements scams?
No. Some Medicare Advantage plans offer legitimate plan-specific benefits. However, advertisements may omit eligibility restrictions, permitted uses, service-area limits or the fact that enrollment in a particular plan is required. Verify the exact benefit in the plan’s official documents before sharing information or changing coverage.
Can someone change my Medicare plan using only my Medicare Number?
Enrollment normally requires additional information and authorization, but a Medicare Number is still sensitive and should be protected. If you suspect an unauthorized enrollment attempt, call 1-800-MEDICARE and your current plan immediately and ask how to protect or restore your coverage.
What if a suspicious claim is simply a billing mistake?
Not every error is fraud. If you recognize the provider, ask for an itemized statement and an explanation. If you did not receive the service, do not recognize the provider or remain concerned after the explanation, report the claim to Medicare or your plan.
Can Thompson Medicare Brokerage investigate Medicare fraud?
No. Thompson Medicare Brokerage is not a law-enforcement agency and cannot make a fraud determination. Benjamin can help clients understand plan documents or identify an appropriate contact, but suspected fraud should be reported to Medicare, the plan, HHS-OIG, Senior Medicare Patrol or law enforcement as appropriate.
Medicare fraud and consumer-protection resources
Not sure whether a Medicare call or offer makes sense?
I can help you understand your current coverage, identify what information a legitimate plan comparison requires and point you toward the appropriate official resource when something appears suspicious.
This article provides general educational information and does not make a legal finding that any particular call, advertisement, billing error or business is fraudulent. Medicare rules, plan benefits and reporting procedures can change. Verify current information with Medicare, your plan or the appropriate government agency. Thompson Medicare Brokerage is an independent insurance agency and is not connected with or endorsed by the United States government or the federal Medicare program.