Medicare and health insurance scams

What is a Medicare scam?

A Medicare scam is any attempt to steal your Medicare number, your money or your benefits by pretending to be Medicare, an insurance plan or a health care provider. Some scams target you directly. Others use your number behind the scenes to bill Medicare for things you never got.

The cost is enormous. The FTC says fraud, errors and abuse cost Medicare about $60 billion a year. It gives examples such as providers charging for a back brace you didn’t get or need, fake Medicare drug plans, and scammers who ask you to “confirm” your Medicare number and then use it for hospice fraud.

Why do scammers want your Medicare number?

Your Medicare number works like a credit card number for health care. With it, a dishonest company can bill Medicare for equipment, tests or services in your name. That can lead to medical identity theft, problems with your benefits and higher costs for you later.

That’s why Medicare.gov says to protect your Medicare number like a credit card. Only give it to your doctors and other providers, your insurance plans and their licensed agents or brokers, or people you trust who work with Medicare, such as your State Health Insurance Assistance Program (SHIP). Don’t share it with anyone who contacts you by phone, email or in person unless you contacted them first.

Typical openers include:

• A “free” back brace, knee brace or other equipment “covered by Medicare.”
• A “new Medicare card” that you must confirm your number to receive.
• A “better plan” or a warning that your coverage is about to end.
• A threat to cancel your benefits unless you act now.

Which Medicare scams are common during Open Enrollment?

Medicare’s Open Enrollment Period runs October 15 to December 7. During that time you can join, drop or switch Medicare Advantage and drug plans, with coverage starting January 1. The FTC warns that health insurance scams pick up during Open Enrollment.

Watch for:

• Fake search results. The FTC says scammers and dishonest businesses sometimes pay to appear at the top of search results, using look-alike web addresses and official-looking logos. Scroll past “Ad” or “Sponsored” results and look for the .gov ending.
• Pushy calls about plans. Medicare.gov advises against joining a plan over the phone unless you called for help.
• Gifts for signing up. Don’t accept money or gifts in exchange for “free” medical care.

To compare plans safely, type Medicare.gov into your browser yourself, call 1-800-MEDICARE, or get free one-on-one help from your local SHIP. If you get a call like this, our alert on what to do in the first five minutes of a “Medicare” call walks you through it.

How can you tell if someone used your Medicare number?

Check every statement. Medicare.gov suggests comparing the dates and services on your Medicare statements with your own calendar to make sure you got each service listed. Look for:

• Equipment or supplies you never ordered.
• Tests, visits or services you didn’t receive.
• Services on days you weren’t at a doctor’s office.
• Providers you’ve never heard of.

If something looks wrong, ask your provider or plan to explain. If it still doesn’t make sense, report it. A secure account on Medicare.gov lets you view Original Medicare claims as soon as they’re processed, so you can spot mistakes sooner.

Where do you report Medicare fraud?

• Medicare: 1-800-MEDICARE (1-800-633-4227), or report online at Medicare.gov.
• Medicare Advantage or drug plan fraud: the Investigations Medicare Drug Integrity Contractor (I-MEDIC) at 1-877-7SAFERX (1-877-772-3379).
• HHS Office of Inspector General: online at oig.hhs.gov or 1-800-HHS-TIPS.
• Senior Medicare Patrol: 1-877-808-2468.
• Medical identity theft: IdentityTheft.gov.
• Other scams: ReportFraud.ftc.gov.

If you already gave out your number or paid, follow our first-hour checklist after a scam, and see where to report a scam for every agency that takes reports. Impostors posing as Social Security often target the same people. See our guide to Social Security scams.

More guides: how to protect your Medicare number from scammers , Medicare Open Enrollment scams, genetic testing and “free” equipment scams and HealthCare.gov and Marketplace scams.