Medicare and Health Insurance Scams: How to Protect Your Benefits
Quick Answer
Medicare fraud costs the federal government tens of billions of dollars annually and directly harms beneficiaries through corrupted records and depleted benefits. Most scams in this category involve either stealing your Medicare number to submit fraudulent billing or pressuring you into accepting services you do not need so the provider can bill Medicare.
How Medicare Scams Target Beneficiaries
Free equipment or supplies scams. A caller offers free braces, diabetic supplies, cancer screenings, or other equipment, you just need to provide your Medicare number for billing. The equipment may arrive (and may be low quality or unnecessary), but the real goal is to bill Medicare for items far more expensive than what was sent, or for items never delivered at all.
Unsolicited calls about your Medicare card. Callers claim Medicare is issuing new cards and you must verify your current number to receive the replacement. Your Medicare number is the target.
Fake health insurance marketplace calls. Callers claim to be from Medicare or the Health Insurance Marketplace and offer to enroll you in a plan or update your coverage. They collect personal and financial information for identity theft.
COVID-era and ongoing testing scams. Scammers set up tents or booths offering free tests, screenings, or genetic testing, requiring your Medicare number. The results may be fabricated, and Medicare is billed for tests or consultations that never occurred.
Prescription drug fraud. Someone uses your Medicare Part D information to fill prescriptions you never requested, depleting your drug benefit.
What Medicare Will and Will Not Do
| Medicare Does | Medicare Does Not |
|---|---|
| Send your Medicare card by mail | Call asking for your Medicare number |
| Send Explanation of Benefits summaries | Offer free items in exchange for your number |
| Contact you through mymedicare.gov | Threaten to cancel benefits if you do not comply |
| Accept questions at 1-800-MEDICARE | Require you to confirm information to keep coverage |
How to Protect Your Medicare Benefits
- Treat your Medicare card number like a bank account number, only share it with your own doctor, pharmacist, or trusted healthcare provider
- Review your Medicare Summary Notice (mailed quarterly) or check mymedicare.gov for claims filed in your name
- Never accept free medical items or services from anyone who solicits you, legitimate providers do not work this way
- Hang up on any unsolicited call from someone claiming to be from Medicare
How to Report Medicare Fraud
Medicare: 1-800-MEDICARE (1-800-633-4227), available 24 hours, 7 days a week
HHS Office of Inspector General: oig.hhs.gov, 1-800-HHS-TIPS (1-800-447-8477)
Senior Medicare Patrol (SMP): A federally funded programme that helps beneficiaries prevent, detect, and report Medicare fraud. Find your local SMP at smpresource.org.
FTC: ReportFraud.ftc.gov, 1-877-382-4357
What to expect: HHS OIG investigates Medicare fraud and can refer cases for criminal prosecution. Reporting fraudulent billing can also protect your personal benefits record.
For Non-Medicare Health Insurance Scams
If you have private health insurance and suspect fraud:
- Contact your insurer's fraud hotline (the number is on your insurance card)
- File a complaint with your state insurance commissioner (find yours at usa.gov/state-consumer)
- Report to the FTC at ReportFraud.ftc.gov