How to Protect Yourself Against Medicare Scam Calls

Complaints about Medicare-related scam calls have increased sharply over the past year, with reports to the Better Business Bureau rising 40% and some seniors receiving 50 calls a day about improving their Medicare coverage.

The callers often claim to represent Medicare regulators, a health insurer or a doctor's office. Some say your Medicare card is expiring, your coverage is about to be interrupted or you qualify for new benefits. Others offer free products, including medical equipment or smartphones, to get you to divulge your Medicare number and personal information.

With that information, they can steal your identity and leave you in financial ruin. They may also use your information to bill for bogus services, treatments or medical devices.

For example, an 80-year-old Texas woman received a large box of orthopedic support braces she had never ordered. The woman investigated and learned that Medicare had been billed $714.83 for the braces. Her secondary insurer was also charged more than $570, and additional fraudulent claims were filed for diabetes supplies and COVID-19 tests she never requested.

In some cases, fraudulent claims can lead to inaccurate medical records, including diagnoses for conditions the beneficiary does not have.

Here's a look at three types of scams targeting seniors.

Example 1: The "you qualify for more benefits" call

An 80-year-old Pennsylvania man received 50 to 60 Medicare-related calls every weekday during open enrollment, according to an article in The New York Times. The calls often started with a recorded message saying: "We're reaching out to seniors to ensure they receive any unclaimed additional Medicare benefits."

The caller would then ask if he had Medicare Parts A and B and try to transfer him to a live agent, Steven Kurutz told The Times. The goal was to collect personal information or convince him to switch coverage.

Kurutz already had comprehensive retiree health coverage and did not need a new plan, but the callers continued relentlessly. The calls became so frequent that they interfered with his ability to use his phone for legitimate purposes, including communicating with doctors and monitoring his health. 

Example 2: The "Medicare card expiring" call

According to fraud investigators quoted in The Times article, some scammers tell beneficiaries their Medicare card is expiring, or their coverage could be interrupted unless they verify personal information. If victims reveal their Medicare number, Social Security number or other information, scammers can use it to steal their identity or fraudulently bill Medicare or insurers.

Other versions of the scam involve callers impersonating Medicare representatives, health insurers or doctors' offices. Scammers create urgency and fear to pressure seniors into providing information before they have time to think critically.

Example 3: The freebies scam

Fraud investigators frequently warn about offers for "free" medical equipment, gift cards, hearing aids, back braces and even smartphones.

The free item is often bait. Once beneficiaries provide a Medicare number and other identifying information, scammers may use it to submit fraudulent claims or enroll them in products or plans they never wanted.

Protecting yourself

What makes these scams convincing is that criminals may already know your age, address or other personal details and need only a bit more information to start the scam. It's important to be vigilant:

• Be skeptical of unsolicited Medicare calls.

• Never provide your Medicare number, Social Security number or banking information to unexpected callers.

• Medicare generally does not call beneficiaries unexpectedly to ask for Medicare numbers or banking information and typically communicates by mail first.

• Hang up if a caller pressures you to act immediately or claims your coverage is at risk.

• Review your Medicare Summary Notices and Explanation of Benefits statements for unfamiliar charges.

• Report suspicious charges or services promptly.

If you suspect Medicare fraud, contact the Senior Medicare Patrol program in your state, call Medicare at 1-800-MEDICARE or report the incident to the Federal Trade Commission at ReportFraud.ftc.gov.