Protecting Yourself from Medicare Fraud

Jory Cross by Jory Cross | Licensed since 2012
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This article was updated on: 07/06/2018

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There are numerous types of Medicare fraud that can target you, the Medicare beneficiary, directly. But there are some general rules of thumb that you can use to protect yourself from unscrupulous individuals looking to either steal your identity or scam you, and/or Medicare, out of money.

Follow these tips to protect yourself and to save money for both yourself and the Medicare program.

Knowing whom to trust with your Medicare info

There may be times when someone claiming to be from Medicare contacts you. The person might tell you that your new Medicare card has been mailed to you and that, in order to deposit funds into your account, he or she needs your checking account number. Other scams may target you by saying your Medicare card number or information must be updated.  Don’t fall for this type of scam. Only give your Medicare card information to trusted doctors and other health-care providers that have been approved by Medicare; it’s important that you protect your Medicare number. When in doubt, you can always contact the customer service number on the back of your Medicare card (also listed below) for additional help and information.

Spotting fraudulent callers

Not every fraudulent caller is obvious. While some callers may sound suspicious in some way, sometimes the caller may appear much more authentic and professional. In either case, these callers may already have access to some of your most basic information, such as your first and last name and residential address, which creates a sense of legitimacy in the phone call.

Medicare doesn’t often call its beneficiaries and, when it does call, it won’t request you to hand over sensitive information. They already have it. If you join a private Medicare plan, such as Medicare Advantage or Medicare Prescription Drug Plan, you may be able to enroll over the phone and therefore are going to be giving sensitive information over the phone. There is nothing wrong with doing this, but we recommend that you make the call (instead of having someone call you) so that you know you are contacting a reputable source.

Insurance companies that offer Medicare plans are not allowed to do certain things, such as:

  • Offer you money to enroll in a plan
  • Call you to ask you to sign up – in most cases, you need to call the plan
  • Request payment online or over the phone
  • Visit your home when you haven’t invited them
  • Offer to sell you non-health-related insurance, like life insurance

This isn’t a complete list. If you’re suspicious of a caller who claims to be a Medicare representative, hang up and call Medicare at 1-800-MEDICARE (1-800-633-4227). TTY users call 1-877-486-2048. You can call 24 hours a day, 7 days a week.

Other Medicare fraud to watch for

Other examples of Medicare fraud are when a health-care provider bills Medicare for services or products you never got, or tries to push you into getting services that you don’t think you need. Even when it’s the Medicare program that’s being cheated, and not you personally, Medicare fraud costs everyone money because it’s funded by your tax dollars.

You can even get a cash reward in some cases when you report Medicare fraud. For more information, see the Stop Medicare Fraud website.

Reporting possible Medicare fraud and identity theft

To report Medicare fraud, even if you’re not certain that it happened, contact the Department of Health and Human Services (HHS) using the following contact information:

HHS Office of the Inspector General
Phone: 1-800-447-8477 (TTY users call 1-800-377-4950) Monday – Friday 7AM to 8PM EST
Website: Report Fraud Online
Mailing address: HHS Tips Hotline, P.O. Box 23489, Washington, DC 20026-3489

If you believe that you might have handed over sensitive information to a fraudulent caller, or are the victim of identity theft, you can call the Federal Trade Commission to file a report. You can reach its ID Theft hotline at 1-877-438-4338 Monday-Friday, 9AM to 8PM EST (TTY users call 1-866-653-4261).

If you’d like to get more Medicare information, especially about Medicare plan options,  click on the Compare Plans button on this page.

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Jory Cross |
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