How to Avoid Medicare Scams

What is a Medicare scam?

Nowadays, we all receive numerous phone calls labeled “Scam Likely” on the caller ID. There are all sorts of scams out there, and many target seniors.  We have seen reports on the news about scammers who claim to be a grandchild in jail and need money sent for bail.  Or, Emails from people claiming you won a prize and need to send your info to claim the money.  

Scam artists employ various tactics to obtain your personal information, including your Medicare ID number. Once the scammer has your Medicare number, they may use it to commit identity theft and defraud the government and/or the insurance carriers.

The Medicare program paid over $829 billion in 2021 for beneficiary payments.  Scammers see this as a huge opportunity steal individual’s Medicare numbers and personal information to submit fake medical claims to Medicare.  Additionally, doctors or healthcare providers could submit fraudulent claims to Medicare for higher payments on the treatment you did not receive. All of these examples are considered fraud & abuse to the Medicare program.

How to report a scam 

If you believe you’ve been the victim of a scam or fraudulent activity, it is best to stay calm and act quickly and carefully.

If you believe your Medicare number has been lost, stolen or compromised, or you are the victim of fraud & abuse, you should call 1-800-Medicare or report the incident on Medicare's website. 

If you believe you are the victim of credit card fraud, you can dispute a payment as unauthorized with the credit card company or bank you used.  Or if you sent a money wire, you can inform the company of the fraud and request that it be reversed.

• Western Union at 1-800-448-1492
• MoneyGram at 1-800-926-9400

You can always report fraud to the Federal Trade Commission (FTC) using their website.

Preventing scams

Medicare has published a booklet called Protecting Yourself and Medicare from Fraud which can be a helpful resource to learn more about this topic.

Remember, Medicare will never call you unless you called Medicare first and requested a call back.  If you receive a phone call from someone claiming they are from Medicare, please be aware that it is likely a scam.  Protect your Medicare ID number like you do your Social Security number. Never give your Medicare number to anyone you do not know and trust.

Many times, scammers say there is a problem with your account or to have a new ID number mailed, they need to confirm your information.  Unless you requested one, Medicare does not usually issue new ID cards. 

Once a scammer has you on the phone, they pressure you to act.  They try all techniques to get your information, including telling you your benefits may be canceled, that you have a bill that needs to be paid, or even that you will be arrested if you do not give them the information they want to steal.  If you suspect something is wrong, hang up the phone and take time to regroup and research what the person is saying. You may try calling the company directly to confirm if the outreach was legitimate.

Be wary if someone tells you to pay them by wiring money, using cryptocurrency, or with gift cards.

Every 3 months you should receive a Medicare Summary Notice which lists all your healthcare costs and the payments requested/paid.  If you notice a charge on the statement that you don't recognize, you can contact Medicare at 800-633-4227 and the Department of Health and Human Services at 800-447-8477.

New Jersey Medicare Brokers is here to help if you think you
or a loved one has been scammed.