How to Help Protect Yourself From Medicare Scams

Medicare fraud often originates with unscrupulous providers who file falsified Medicare claims, such as billing the government for illegitimate services or supplies or for pricier care than the patient received. However, scammers can also target consumers directly in order to access their benefits or deceive them into paying for fraudulent coverage.

In one common spoofing scam, fraudsters pretending to be from the Centers for Medicare & Medicaid Services claim that a target's coverage will be canceled unless they pay for a new Medicare card. Another tricks an individual into revealing their Medicare number, which criminals use to access care or facilitate further fraud.

These scams can be extremely detrimental on many fronts. For example, your legitimate health care requests can be denied because of bogus claims for comparable services—and fraudulent diagnoses, tests, or other misinformation in your health records can lead to improper care.

So, how can you protect yourself against such scams?

1. Guard your identity: Be proactive in protecting sensitive information. A scammer with your Medicare or Social Security numbers, for example, can leverage them for widespread fraud. If you receive a phone call or text message from someone who says they're from a government agency and they press you for your personal information, that should raise a red flag. When in doubt, hang up and call the government agency's publicly published phone number.
2. Watch your statements: Keep track of the medical equipment, services, prescription drugs, and tests you receive and check them against your Medicare Summary Notices (if you have Original Medicare) or Explanation of Benefits (if you have Medicare Advantage plan or a stand-alone Part D drug plan). Report suspicious activity to your provider or the Centers for Medicare & Medicaid Services at 1-800-MEDICARE (1-800-633-4227) or visit medicare.gov for more information.
3. Get outside helpif you suspect fraud: Senior Medicare Patrol (SMP) is a federal program with trained volunteers who can help detect and avoid scams. Find the SMP in your state.

Another reason to be vigilant? Medicare loses approximately $60 billion a year to abuse, errors, and fraud,¹ and those costs are passed on in the form of higher taxes and insurance premiums. Fighting these scams can help Medicare remain affordable for everyone.