Medicare fraud costs the program an estimated $60 billion annually, and scammers are getting more sophisticated. Many of us discover that protecting ourselves means understanding how these schemes work and knowing exactly what to do when suspicious activity occurs. Whether you receive an unexpected call claiming your benefits will be canceled or notice charges for services you never received, recognizing the warning signs can save you from financial loss and identity theft.

Common Medicare Scams to Watch For

Scammers frequently impersonate Medicare representatives, claiming there’s a problem with your account or that you need a new Medicare card. They’ll request your Medicare number, Social Security number, or bank account information to “resolve” issues. Remember: Medicare will never call you unsolicited to ask for personal information or to sell you anything.

Many of us have heard about seniors receiving unsolicited medical equipment like knee braces or diabetic supplies. Scammers contact beneficiaries claiming Medicare covers these items at no cost, then bill Medicare for expensive equipment that was never ordered. If you receive medical equipment you didn’t order, refuse the delivery.

Free genetic testing offers have become increasingly common. Scammers target seniors at health fairs or through direct mail, claiming Medicare covers these tests. After collecting DNA samples, they submit fraudulent claims for thousands of dollars. Only accept genetic testing ordered by your doctor.

Despite the pandemic’s end, COVID-related fraud continues. Scammers offer “special” vaccines or treatments in exchange for Medicare information. All legitimate COVID-19 services are available through authorized healthcare providers without requiring you to share Medicare details over the phone.

Protecting Your Medicare Information

Your Medicare number is as valuable as your Social Security number to identity thieves. Treat your Medicare card like a credit card – never give the number to anyone who contacts you unexpectedly.

Only share your Medicare information with your doctors, pharmacists, and healthcare providers during appointments you scheduled. State Health Insurance Assistance Programs (SHIP) counselors and Senior Medicare Patrol (SMP) volunteers are also authorized to help, but they’ll never contact you first asking for personal information.

Be suspicious of anyone who contacts you claiming to be from Medicare and requests personal information, threatens to cancel your benefits, offers free medical equipment, asks for payment, or pressures you for immediate decisions.

Monitoring Your Medicare Statements

Regular review of your Medicare Summary Notice (MSN) or Explanation of Benefits (EOB) is your best defense against fraud. These quarterly statements detail all services billed to Medicare on your behalf.

Check dates and services against your personal calendar to ensure you actually received each service listed. Look for duplicate charges, services from providers you’ve never seen, medical equipment you didn’t receive, or procedures that seem incorrect for your health conditions.

The SMP Medicare Tracker app can help you keep detailed records of healthcare appointments and compare them against Medicare statements.

How to Report Medicare Fraud

If you suspect fraud, take action immediately. Call Medicare directly at 1-800-MEDICARE (1-800-633-4227) to report suspicious activity. Medicare’s fraud hotline operates 24/7 and can flag your account for monitoring.

Contact your local Senior Medicare Patrol (SMP) program for personalized assistance. SMP counselors can help you understand Medicare statements, identify potential fraud, and guide you through the reporting process.

Submit reports to the Federal Trade Commission (FTC) if you’ve been targeted by identity theft. Report to the Office of Inspector General (OIG) Hotline at 1-800-HHS-TIPS if you suspect a healthcare provider is billing for services you didn’t receive.

For scams targeting seniors specifically, contact the Department of Justice’s National Elder Fraud Hotline at 1-833-FRAUD-11.

If You’ve Been Victimized

Don’t panic if you realize you’ve shared personal information with scammers. Contact Medicare immediately to report the fraud and request a new Medicare number if necessary. Monitor your Medicare statements closely for several months, as fraudulent charges may appear weeks later.

Check your credit reports for suspicious activity and consider placing a fraud alert on your accounts. Contact your bank and credit card companies if you shared financial information. File a report with local law enforcement to create official documentation.

Prevention Strategies

Consider using call-blocking apps like Hiya or Truecaller to filter known scam numbers. Register your phone number with the National Do Not Call Registry and opt out of pre-screened credit offers at OptOutPrescreen.com.

Share fraud information with family members and friends who can help you spot suspicious activity. Many seniors benefit from having a trusted person review unusual communications before responding.

Stay informed by subscribing to fraud alerts from your local SMP program and attending community education sessions when available.

Remember that legitimate Medicare business is conducted through official channels, never through unsolicited contact. When in doubt, hang up, throw away suspicious mail, and contact Medicare directly using the official number on your Medicare card. Your vigilance protects not only your own benefits but helps preserve Medicare for future generations.