6 ways you can avoid Medicare scams

Medicare scams are nothing new, and there was a lot of this kind of activity in recent years. In April 2020, the Centers for Medicare and Medicaid Services reported that scammers might use the pandemic to try stealing everything from people’s Medicare numbers and banking information to personal details like birthdates and Social Security numbers.

The U.S. Department of Justice has been busy keeping online crooks at bay. In September 2021, it charged 138 people in the United States with healthcare fraud. The crimes resulted in $1.4 billion in alleged losses.²

Silas Jessup, a licensed insurance agent based in Middlebury, Indiana, says these crimes affected some of his clients. “In several situations, scammers were able to convince the beneficiaries to take action by phone,” he says. “Sometimes, the actions that were taken over the phone were not in the consumer’s best interest, and they were difficult, if not impossible, to unravel.”

It is unlikely for Medicare representatives to call you unless you ask

Government agencies like the one that manages Medicare will hardly ever call you. And if they do, they won’t ask you to confirm sensitive information.³ Phone scams can be particularly dangerous because the scammer could sweet-talk you into giving them your Medicare card number or credit card information. That can lead to identity theft, which is when someone uses your personal information to commit fraud, like spending your money on things without asking you.

These are the only times Medicare, or someone representing Medicare, will call to ask for your personal information:

• If you’re already a member of a Medicare plan; the agent who helped you join can also call
• If you’ve called and left a message (or a representative said that someone would call you back); in that case, a customer service representative from 1-800-MEDICARE can call
• If you already filed a report of suspected fraud

You never want to give out your personal information. And know that a representative from Medicare will rarely call you. Most of the time, they’ll send you information through the mail. If you’re concerned that you might be the target of a future Medicare scam, here are 7 tips to help you protect yourself and your loved ones.

If you need help navigating Medicare, a great place to start is with a licensed insurance agent. Call one at (800) 488-7621, or explore plans online for more information.

Medicare scam prevention tip #1: Find an insurance agent you can trust

Finding the right licensed insurance agent to help guide you through the process of applying for Medicare or switching Medicare plans can be difficult. There are so many choices in the phonebook and online that the process can be overwhelming.

Jessup suggests staying local. “Doing business with a local insurance agent who you can meet in person, or appropriately research and vet, can be one way to avoid scams,” he says. “Local agents who have a local presence and an established practice will often have more concern for placing the client into the right product — and also servicing that client on an ongoing basis.”  HealthMarkets provides you with an online agent finder tool that can connect you with a local licensed insurance agent who can help.

Medicare scam prevention tip #2: If it sounds too good to be true, it probably is

If a stranger is offering you something for nothing, it’s probably too good to be true. Whether you get a call, see a post on social media, or get a letter in the mail promising free gifts, it’s probably a scam — especially if they ask you to share your personal information in order to get the free gift.

“If you have to give any personal information out, including your Medicare number, to receive the free item, it’s a scam,” says Lindmier. Lindmier points out that some licensed Medicare insurance agents can offer gifts of small value ($15 or less) to entice individuals to come to a sales seminar.

“But in those cases, you get the gift regardless of whether you enroll, and you are not required to give any of your information out,” says Lindmier. “Do not give anyone your information for the promise of an iPad or other really enticing gift. They are stealing your personal information, and you will never see that iPad.”

Medicare scam prevention tip #3: Use caution when opening emails with Medicare promotions

Email is one of the easiest ways Medicare scammers can trick you. “In many cases, the sender will mask their true email address with a fake one,” says Lindmier. “The fake email address will look legitimate. But if you hover over the email address from the sender with your mouse, it will show the true email of the sender. If they do not match up, be wary.”

He notes that scammers will often replace the letter “O” with the number “0,” or the letter “I” with “!,” making it hard to spot. “Keep a keen eye out,” says Lindmier. “Again, Medicare will not email you asking for your information. They will send a letter with instructions on how to get them the information they need.”

Medicare scam prevention tip #4: Do not respond or reply to strange phone calls

If you’ve set up an appointment with a licensed insurance agent for a specific day at a specific time and they’re calling you, pick up. You’re good to go. If you get a phone call at any other time from a stranger claiming to be a Medicare insurance agent, just hang up the phone.

“Legitimate insurance agents who abide by the federal regulations cannot typically call a Medicare beneficiary who has not formally requested information or provided permission to contact,” says Jessup. “Consumers should always be very wary of unsolicited incoming phone calls, as they could easily be a scammer.”

Medicare scam prevention tip #5: Never assume that a caller is who they say they are

If your grandson, who has a job with the U.S. government, calls to tell you he’s coming by, he’s worth talking to. But if a stranger calls and tells you they’re from the government and starts asking you personal questions about Medicare, they’re not worth your time.

“We have talked to beneficiaries who thought they were being called by their current insurance company, and they felt comfortable disclosing a lot of personal information because the caller used the name of their current insurance carrier,” says Jessup. “Be skeptical of any incoming call and be careful not to provide personal information until after confirming that the caller is who they say they are.”

You can certainly hang up on them. But if you’re still unsure, you can ask them to verify their National Producer Number, or NPN, which is how you’ll know they’re legitimate. If they can’t provide it to you right away, the best thing to do is hang up.

“Scammers have become very proficient at extracting information from consumers with the questions that they ask and the order that they ask them,” says Jessup. “Keep in mind that some scammers might already have a piece or two of your information that they will use to get you to provide additional private or personal information.”

Report suspected Medicare scams anytime you think you are being targeted

There are a number of ways you can report suspected fraud:

• You can call 1-800-MEDICARE (1-800-633-4227)
• You can call the the Department of Health and Human Services Office of the Inspector General’s fraud hotline at 1-800-HHS-TIPS (1-800-447-8477)
• You can visit tips.oig.hhs.gov to file a complaint online
• If you suspect that you have been the target of email fraud, you can contact the Federal Bureau of Investigation’s Internet Crime Complaint Center at ic3.gov

“Reporting suspected scams is important, as it can help the authorities zero in on the offenders and allow them to take action against these scammers,” says Jessup. Whichever way you do it, you’re doing the right thing.