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Common Medicare Scams and What You Can Do to Avoid Them

Scammer with laptop

How to Prevent Medicare Scams

Key Takeaways:

  • There are seemingly limitless ways that criminals can use Medicare as a backdrop to scam you out of your personal and medical information.
  • Learning to identify potential illegal activity is the best method for avoiding scams and keeping your information safe.
  • The bottom line is that if you’re unsure whether or not a caller is part of a scam, the best plan of action is to hang up the phone and contact Medicare directly.

What Are Some Examples of Different Medicare Scams?

There are dozens—if not hundreds—of methods that Medicare scammers use to gain access to your personal and medical information. Below, I’ve compiled some of the most common:

Verifying Your Identity

Scammers will call and try to convince you that you need to hand over your identifying information to update your Medicare card or receive a new one. In some instances, they might request a credit card number under the guise that there’s a charge for your new card.

Free Medical Supplies 

Scammers will try to obtain your Medicare or social security number under the pretense that you qualify for free durable medical equipment (DME) or a medical checkup, but that they need to verify your identity or have you cover the shipping and handling charges.

Eligibility for a Refund 

A caller will tell you that you’re eligible for a refund based on a recent change in your Medicare coverage. They just need your Medicare or bank account number to deposit the funds.

Requiring You to Switch Your Plan 

Scammers will tell you that you need to switch or make changes to your current plan and then request your medical information to discuss your options.

Receiving a New Card 

Someone calls you saying that you need to update your information to receive your Medicare card.

Specially Priced Plans 

Scammers will try to convince you that you qualify for special coverage pricing but that the offer is time-sensitive and you need to commit ASAP. Their goal is to get you to hand over your information without thinking about the too-good-to-be-true offer.

Free Gifts 

Here, scammers will tell you that as long as you sign up and hand over your name and Medicare number, you’ll qualify for a free gift.

Receiving a Call From Your Doctor’s Office or Local Health Agencies

Sometimes, criminals will gain access to some of your medical information before they call. And when they do, they’ll tell you that they represent your doctor’s office or a local health agency in order to gain your trust. Then, they’ll request additional medical or personal information that could lead to fraud or identity theft.

With these common scams in mind, how can you protect yourself and avoid them altogether?

How to Identify and Avoid Medicare Scams

The Role of Spoofing in Medicare Scams

In many instances, your caller ID will identify the person or organization at the other end of the line. However, when it comes to scammers, they will often purposely disguise their identity using “spoofing” techniques, which deliberately falsifies the information transmitted to your caller ID. 

This way, you might think you’re talking with a Medicare representative, a government agency, or your local doctor’s office when you’re actually on the phone with a criminal. Then, after gaining your trust, they’ll use different scripts to try and separate you from your money, personal information, Medicare details, or all of the above.

CMS’s New Medicare Cards

According to the Centers for Medicare and Medicaid Services website:

“In April 2018, CMS began mailing new Medicare cards, each of which features a unique, randomly-assigned Medicare number known as a Medicare Beneficiary Identifier (MBI). The MBI is a combination of letters and numbers that helps protect against personal identity theft and fraud.”

This way, you have an identifier that’s unique to you without relying on your social security number. CMS emphasizes that you should guard this information just like you would with your credit cards and never hand it over to anyone who calls you on the phone, emails you, or approaches you in person (unless you’ve given them permission in advance).

Instead, only hand over your Medicare number to doctors, insurers acting on your behalf, or trusted organizations like your State Health Insurance Assistance Program (SHIP).

Understand When Medicare Will Contact You

The Medicare.gov website explains that “Medicare, or someone representing Medicare, will only call and ask for personal information in these situations:”

  • If you’ve called CMS and left a message, or a customer service representative advised you that someone would call you back.
  • If you’re a member of a Medicare health or drug plan, a representative (or an agent who’s helped you) can call you.

What else can you do?

Hang Up, Call Back, or Contact Medicare Directly

When it comes to avoiding scams, a good rule of thumb to keep in mind is that if it sounds too good to be true, it probably is.

Another vital fact to keep in mind is that the Center for Medicare and Medicaid Services and the Social Security Administration will never call you uninitiated to request personal information, update your profile, or give you a new card.

If alarm bells are going off in your head and you doubt the validity of a call, ask the person on the line for their direct number and tell them you’d like to disconnect and call them back. If you’re on the phone with a scammer, they’ll likely try to convince you not to hang up and keep you on the phone as long as possible.

With these details in mind, it’s a good idea to hang up and call Medicare directly at 1-800-MEDICARE (1-800-633-4227) if someone calls and requests your Medicare number or other personal information or if you suspect that you’ve been a victim of fraud.

Do You Have Additional Questions About Medicare Scams?

Whether related to Medicare or any other personal or financial information, scammers are getting more adept each and every day. That’s why the professional staff at IHS Insurance Group believe it’s essential to get the word out and keep you as informed as possible. Don’t hesitate to reach out if you or your loved ones have any questions!

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  2. If you prefer to fill out a quick form and have an agent get back to you at your convenience, use the GET A FREE QUOTE tool.
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Also, check out our Medicare FAQs here.

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