Medicare fraud costs taxpayers approximately $60 billion annually, but the financial damage to individual beneficiaries goes far beyond those shocking statistics. When scammers steal your Medicare information, you could hit your benefits cap early, face unexpected copayments for services you never received, and even have trouble getting proper medical care when doctors can’t distinguish between your real medical history and fraudulent claims.

With over 67 million Americans enrolled in Medicare, fraudsters have an enormous target-rich environment. Recent data shows that 1-800-MEDICARE receives over 700 fraud-related calls daily, highlighting just how pervasive these schemes have become.

The Most Common Medicare Scams in 2025

Medicare Card Replacement Scam: Fraudsters call claiming you need a “newer, more secure” Medicare card and request your Social Security number, Medicare ID, or other personal information for “verification.” This scam persists despite Medicare cards being redesigned in 2018 to remove Social Security numbers.

Fake Medical Equipment Offers: Scammers offer “free” or deeply discounted medical equipment like knee braces, mobility aids, or genetic testing kits. They claim Medicare covers everything and no doctor authorization is needed, then bill Medicare for expensive equipment you never ordered or received.

Open Enrollment Imposters: During Medicare’s annual Open Enrollment period (October 15 to December 7), scammers ramp up fake insurance offers, create counterfeit enrollment websites, and send official-looking mailers promoting nonexistent plans at “unbeatable rates.”

Medical Records Phishing: Fraudsters impersonate Medicare officials and contact healthcare providers via fax or email requesting medical records or payment of alleged Medicare debts, claiming to be conducting “audits” or “debt collection efforts.”

Recent Major Medicare Security Breaches

In May 2025, Medicare.gov experienced a significant data incident affecting approximately 103,000 beneficiaries. Bad actors used personal information obtained from unknown external sources to fraudulently create Medicare.gov accounts between 2023 and 2025. Once these unauthorized accounts were established, scammers potentially accessed additional beneficiary data including addresses, phone numbers, and health plan information.

As a result, the Centers for Medicare & Medicaid Services (CMS) immediately deactivated all fraudulently created accounts, disabled new account creation from foreign IP addresses, and began replacing Medicare Beneficiary Identifiers (MBIs) for affected individuals. This incident demonstrates how sophisticated Medicare fraud has become and why vigilance is essential.

Your Defense Strategy

Protect Your Medicare Information Like a Credit Card: Never give your Medicare number to unsolicited callers, even if they claim to be from Medicare or a trusted organization. Medicare will only call you in very limited circumstances, such as when returning your call after you’ve contacted them first.

Verify All Medicare Communications: Medicare doesn’t typically initiate contact via phone, email, or unscheduled visits. If someone claims to represent Medicare, hang up and call 1-800-MEDICARE directly to verify the legitimacy of any request.

Review Your Medicare Statements Carefully: Your Medicare Summary Notice (MSN) arrives every three months and shows all services billed to Medicare on your behalf. Medicare Advantage and Part D plan members receive monthly Explanation of Benefits (EOB) statements. Compare these documents with your personal health records and question any unfamiliar charges, dates, or services.

Create a Secure Medicare.gov Account: Establishing your own online Medicare account prevents scammers from creating fraudulent accounts in your name. You can access your most recent statements, track claims, and monitor suspicious activity within 24 hours of services being billed.

Red Flags That Signal Medicare Fraud

Unsolicited Contact: Legitimate Medicare representatives don’t make cold calls offering services, requesting personal information, or claiming you need to “update your file.” Any unexpected contact claiming to be from Medicare should be viewed with extreme suspicion.

Pressure Tactics: Scammers often create artificial urgency, claiming your benefits will be suspended, your card will expire, or you’ll lose coverage unless you act immediately. Medicare doesn’t operate this way.

Requests for Payment: Medicare never asks beneficiaries to pay for new cards, account verification, or to maintain benefits. Any request for money, gift cards, or wire transfers is fraudulent.

Too-Good-to-Be-True Offers: “Free” medical equipment, services not requiring doctor approval, or promises of benefits beyond your actual coverage are classic fraud indicators.

What to Do If You’re Targeted

Document Everything: Keep records of suspicious calls, emails, or mailings. Note phone numbers, caller names, what information was requested, and any claims made about Medicare benefits or services.

Report Suspected Fraud Immediately: Contact Medicare at 1-800-MEDICARE (1-800-633-4227) to report suspected fraud. You can also file reports online at Medicare.gov/fraud or contact your local Senior Medicare Patrol for assistance.

Monitor Your Accounts: Check your Medicare statements regularly and review your credit reports for any unauthorized medical accounts or charges. If you’ve given personal information to suspected scammers, consider placing fraud alerts on your credit reports.

Contact Your Healthcare Providers: If you suspect someone has used your Medicare information fraudulently, notify your doctors and other healthcare providers so they can flag your account and watch for suspicious activity.

Special Considerations for Medicare Advantage and Part D Plans

Medicare Advantage and Part D members receive monthly Explanation of Benefits statements instead of quarterly Medicare Summary Notices. Review these EOBs carefully for any unauthorized services or prescriptions, as fraudulent claims can result in unexpected copayments and affect your coverage calculations.

Building Long-Term Protection

Educate Family Members: Medicare fraud often targets older adults, but family members can help by understanding common scam tactics and regularly checking in about suspicious communications.

Join Community Watch Networks: Many communities have Senior Medicare Patrol programs that provide education about Medicare fraud and help residents identify and report suspicious activity.

Stay Informed About New Threats: Medicare fraud evolves constantly as scammers develop new techniques. Follow updates from Medicare.gov and sign up for fraud alerts from your local Area Agency on Aging.

Medicare fraud represents a serious threat to both your financial security and your healthcare. By understanding common scam tactics, protecting your personal information, and maintaining vigilance about suspicious communications, you can help protect yourself and contribute to the broader fight against Medicare fraud.