Are you unknowingly falling for Medicare scams? Here’s how to protect yourself
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For millions of Americans, Medicare provides critical health coverage and peace of mind in retirement.
But while it’s meant to safeguard your health, it has also become a target for scammers.
Each year, fraudsters steal billions by exploiting the program, putting both your money and your personal information at risk.
Even the most cautious person can be tricked by today’s increasingly sophisticated schemes.
The good news is that by learning the warning signs and taking a few simple steps, you can better protect yourself and your hard-earned benefits.
A real-life wake-up call
Take the case of Jean Bound, who received packages of COVID tests she never ordered.
When she called the company listed on the slip, she was told Medicare had already been billed.
Alarmed, she reported the incident, but more unsolicited packages soon followed—and so did the charges.
Jean’s story is far from unique.
Every year, especially during Medicare’s annual open enrollment period (October 15 to December 7), scammers ramp up their efforts to trick beneficiaries.
Also read: Unwanted medical gear at your door? It could be a dangerous Medicare scam
What exactly is Medicare fraud?
Medicare fraud happens when someone uses your Medicare number or personal details to submit false claims or access services without your consent.
It can be committed by dishonest providers, medical equipment suppliers, or individuals posing as Medicare representatives.
According to government estimates, fraud costs Medicare around $60 billion annually.
That’s money taken from the program meant to help you—and it can directly affect your care.
Also read: Medicare scams are spreading fast—here’s how to protect your benefits before fraudsters strike
The many faces of Medicare scams
Scammers are creative and constantly inventing new tactics.
Some of the most common include:
Also read: Wisconsin Rapids scam costs resident $600,000: What seniors should know
When health care providers commit fraud
While most doctors and providers are trustworthy, some abuse the system.
Fraud can take the form of:
Also read: A new phone scam is targeting seniors with fake health insurance deals—here’s what to know before you pick up
How to protect yourself from Medicare fraud
Here are key steps you can take:
Also read: Medicare grocery allowance: Are you missing out on this food benefit?
What to do if you suspect fraud
If something doesn’t look right, act quickly:
Stay informed and empowered
Medicare scams are widespread, but you’re not powerless.
By protecting your information, reviewing your records, and knowing where to report problems, you can reduce your risk and help protect the program for others.
Medicare fraud isn’t just about dollars—it can endanger your health.
If false records are attached to your file, you could be denied needed care, given the wrong treatment, or prescribed medication that doesn’t suit you.
Fraudulent claims also drive up costs for everyone, potentially leading to higher premiums and out-of-pocket expenses.
Read next:
Have you or someone you know ever been targeted by a Medicare scam? What steps do you take to safeguard your information? Share your experiences in the comments—your story could help protect someone else in our GrayVine community.
But while it’s meant to safeguard your health, it has also become a target for scammers.
Each year, fraudsters steal billions by exploiting the program, putting both your money and your personal information at risk.
Even the most cautious person can be tricked by today’s increasingly sophisticated schemes.
The good news is that by learning the warning signs and taking a few simple steps, you can better protect yourself and your hard-earned benefits.
Fraudsters often target Medicare beneficiaries with phone calls, fake offers, and false billing schemes. Image Source: YouTube / Scripps News.
A real-life wake-up call
Take the case of Jean Bound, who received packages of COVID tests she never ordered.
When she called the company listed on the slip, she was told Medicare had already been billed.
Alarmed, she reported the incident, but more unsolicited packages soon followed—and so did the charges.
Jean’s story is far from unique.
Every year, especially during Medicare’s annual open enrollment period (October 15 to December 7), scammers ramp up their efforts to trick beneficiaries.
Also read: Unwanted medical gear at your door? It could be a dangerous Medicare scam
What exactly is Medicare fraud?
Medicare fraud happens when someone uses your Medicare number or personal details to submit false claims or access services without your consent.
It can be committed by dishonest providers, medical equipment suppliers, or individuals posing as Medicare representatives.
According to government estimates, fraud costs Medicare around $60 billion annually.
That’s money taken from the program meant to help you—and it can directly affect your care.
Also read: Medicare scams are spreading fast—here’s how to protect your benefits before fraudsters strike
The many faces of Medicare scams
Scammers are creative and constantly inventing new tactics.
Some of the most common include:
- Fake enrollment calls: Pretending to be from Medicare and asking for your number.
- Card replacement scams: Claiming you need a new card with a “chip.”
- Plan switching pressure: Threatening loss of coverage unless you provide details.
- Refunds or perks: Offering rebates or “better deals” in exchange for information.
- Free supplies or tests: Sending or offering “free” equipment and billing Medicare.
- Genetic testing schemes: Promoting “at no cost” screenings to capture your data.
- Phony office calls: Impersonating your doctor or a government agency.
- Threats and urgency: Scaring you into acting immediately with fake consequences.
Also read: Wisconsin Rapids scam costs resident $600,000: What seniors should know
When health care providers commit fraud
While most doctors and providers are trustworthy, some abuse the system.
Fraud can take the form of:
- Double billing for the same service.
- Billing for visits that never happened.
- Charging for a more expensive service than you received.
- Ordering unnecessary tests or treatments.
- Falsifying records to justify charges.
- Splitting up services (“unbundling”) to increase billing.
- Accepting kickbacks for patient referrals.
Also read: A new phone scam is targeting seniors with fake health insurance deals—here’s what to know before you pick up
How to protect yourself from Medicare fraud
Here are key steps you can take:
- Guard your information: Treat your Medicare card like a credit card.
- Be cautious of unsolicited contact: Medicare won’t call, text, or email asking for details.
- Review your statements: Regularly check your Medicare Summary Notices for errors.
- Ignore suspicious links: Don’t click on emails or texts requesting your info.
- Hang up on scams: If a call feels wrong, hang up—scammers can fake caller IDs.
- Protect your records: Share health information only with trusted providers.
- Check prescriptions: Always verify your medications and dosages.
Also read: Medicare grocery allowance: Are you missing out on this food benefit?
What to do if you suspect fraud
If something doesn’t look right, act quickly:
- Contact Medicare: Call 1-800-MEDICARE (1-800-633-4227).
- Report fraud: Reach out to the Office of Inspector General (OIG) hotline at 1-800-447-8477.
- Seek help locally: Connect with your state’s Senior Medicare Patrol (SMP) for guidance.
- Keep documentation: Save receipts, notices, and records of suspicious activity.
Stay informed and empowered
Medicare scams are widespread, but you’re not powerless.
By protecting your information, reviewing your records, and knowing where to report problems, you can reduce your risk and help protect the program for others.
Medicare fraud isn’t just about dollars—it can endanger your health.
If false records are attached to your file, you could be denied needed care, given the wrong treatment, or prescribed medication that doesn’t suit you.
Fraudulent claims also drive up costs for everyone, potentially leading to higher premiums and out-of-pocket expenses.
Read next:
- Primary Insurance falling short? Here’s why secondary coverage might be your best move
- How one scam drained a senior’s savings—and what you can do to stay safe
- She lost $57,000 in one day: How a phone scam targeted a woman in Oregon
Have you or someone you know ever been targeted by a Medicare scam? What steps do you take to safeguard your information? Share your experiences in the comments—your story could help protect someone else in our GrayVine community.
