When Medicare Is Calling, Should You Answer?


Health care fraud is a serious crime. Victims can suffer long-lasting emotional and financial effects. Yet every year, scammers ramp up their efforts, especially targeting senior citizens around Medicare’s fall Annual Enrollment Period. However, you should remain vigilant all year.

In addition to disrupting the lives of Medicare beneficiaries, insurance fraud also hurts the economy. According to the National Health Care Anti-Fraud Association, health care scams cost Medicare nearly $70 billion annually.

Sadly, hackers prey on unsuspecting victims over the phone and in person. Their sneaky tactics can go unnoticed unless you know what to look out for. In this article, you’ll learn the facts of Medicare fraud, how to report it, and ways to protect your identity.

Medicare fraud occurs when Medicare gets billed for a service or supplies it never authorized. Fraud is easy to detect once you know the red flags. Receiving a phone call from Medicare is the biggest giveaway that someone is trying to scam you. Medicare will never call you over the phone unless you called first and requested a callback.

It’s also uncommon for the Social Security Administration to contact you unless they need more information for an SSA application. In most cases, if the agency needs to speak with you, they’ll mail you an official letter requesting a phone interview.

If you get a knock on the door from someone who claims to be a Medicare representative, it’s a scam. Medicare never makes house visits to request personal information or sell products and services.

Once enrolled, all beneficiaries receive Medicare cards, also called red, white, and blue cards, in the mail. They don’t expire, so be wary if you’re notified that you need a new one. If you actually need a replacement card, contact the Social Security Administration.

Once hackers take hold of your personal information, it can interrupt your medical care and affect you financially. Consequently, according to the FBI, health care fraud can lead to higher insurance premiums, taxes, and pointless medical procedures.

Always trust your instincts. If an encounter doesn’t seem legitimate, it may not be. Medicare fraud can happen to anyone. Following these simple steps can lower your chances of falling victim to a scam:

  • Keep personal accounts private, including credit card numbers and bank accounts.
  • Keep copies of all your medical payments, claims, and other health care-related records.
  • Never disclose personal or financial information over the phone unless you’ve given that person permission to contact you.
  • Only share personal information with doctors, insurers, and others in your Medicare network.

If you receive a call from Medicare, immediately take down the number, gather the necessary information from above, then hang up. Learn more ways to safeguard your personal information by visiting IdentityTheft.gov.

If you’re getting calls from people claiming to be from Medicare, act immediately. Add your telephone number to the Federal Trade Commission’s Do Not Call List to stop future calls. Call 1-888-382-1222 from the number you’d like to add to the Do Not Call list. If the calls continue, file a complaint online.

You can report suspected Medicare fraud by visiting the FTC Complaint Assistant. You can also call Medicare directly at 1-800-MEDICARE (1-800-633-4227).

Medicare suggests having the following information before you file a claim:

#1: Your Medicare number (you can find it on your red, white, and blue card)

#2: The date and nature of the call if it happened over the phone

#3: The product or service in question

#4: The dollar amount in question if the caller requested compensation

#5: Any other information that could be useful to Medicare

Remember, anyone could be a victim of identity theft. Scammers are always active, especially during the fall Annual Enrollment Period. If you believe you’ve been scammed, file a complaint or contact Medicare right away. You could potentially protect others from having their identity stolen.

Have you been contacted by someone claiming to be a Medicare representative? What did you do? Have you ever reported a scam? Has anyone tried to sell you Medicare coverage over the phone? Please share your experience and stories!

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