What Are Medicare Scams? How Seniors Are Targeted by Fraudsters

What Are Medicare Scams? How Seniors Are Targeted by Fraudsters

What Are Medicare Scams? How Seniors Are Targeted by Fraudsters

Kim Porter
Updated June 22, 2020

There’s a scam for everything these days, including those that target Medicare recipients.

While these scams often spike during open enrollment in the fall, Medicare scams can happen at any time of the year.

Crooks who go after this population will typically pose as someone who represents Medicare, which is the federal health insurance program for people 65 or older. The goal is to squeeze financial information from someone and either fraudulently use their Medicare benefits or steal their money. But knowing how Medicare scams work can help you try to avoid this con.

What are Medicare scams?

In an effective Medicare scam, someone fraudulently uses your Medicare benefits or takes your personal information to access your financial accounts. These scams come in many forms, but “ultimately, it results in money lost by a Medicare beneficiary or the Medicare system itself,” said Danielle K. Roberts, Medicare expert and co-founder of Boomer Benefits, a Medicare insurance agency. “That raises premiums for current Medicare beneficiaries and, in the end game, taxpayers.”

Scams targeting the elderly have been around for a while, but they picked up in the ’90s with the introduction of the internet. As people began handling their personal finances and health insurance online, scammers smelled opportunity.

While consumers 60 and older are less likely to report being scammed than younger people, they lost more money to fraud in 2018, according to a report by the Federal Trade Commission. The oldest segment of the population reported the largest median losses of $1,700 and the largest increase compared to 2017.

Related: BeenVerified Spam Call Monitor: The Rise of Social Security Phone Scams

How do Medicare scams work?

Scammers target elderly people assuming they’re more naive than the rest of the population or more willing to listen to someone on the phone. “Through the normal aging process, you might not be as sharp or able to catch on to something than you would have 20 years earlier,” Roberts said.

On top of that, Medicare can be a confusing program, which means people don’t know what to believe when they get a tempting offer via email or phone. Here’s how some Medicare scams work:

Types of medicare scams

Bad actors are constantly changing up their tactics to try and defraud victims. Common medicare scams fraudsters have used include:

Back and knee brace scam

In this scam, someone contacts Medicare recipients and offers free or low-cost medical services or supplies, such as back and knee braces. Once you offer up your Medicare number and information, they’ll use it to fraudulently bill Medicare for services, equipment and appointments—for themselves. This drains your medical benefits, which means you might not be able to use them later, and you’re left to cover any shared costs.

Medicare number scam

Medicare recently issued each beneficiary a new card that contains 11 unique characters instead of their Social Security number. While it’s helped decrease identity theft, new phishing attempts and other types of Medicare scams are surging. With that Medicare number, a scammer can use a beneficiary’s information to fill prescriptions, file fraudulent claims or sell the number on the dark web.

Criminals call Medicare recipients, possibly using spoofed caller IDs, and use different methods to get that number. For example, they may say you need to activate your Medicare number, pay a processing fee for your new card or send in your old one.

You may also receive a suspicious email, which may be spoofed to look like it came from Medicare. The email sender may claim there’s something wrong with your account and you’ll need to click on a link or open an attachment to fix the problem. Don’t fall for it; a link or attachment may contain malware, which is software that can take control of your computer or track and steal your information.

Related: Identity theft check: Uncover if your data may have been compromised

Medicare enrollment scams

“The annual election period in the fall is a really hot time for scammers to beef up their efforts,” Roberts said. During this time frame, scammers call Medicare recipients and try to sell fake insurance policies, lie about services you need to buy, tell you you’re due a refund, or attempt to steal your personal information. While there are many legit policies on the market, not all are right for you. Before signing up for a Medicare plan, you should understand where you can buy Medicare plans, compare policies, and know what Medicare professionals can and can’t do.

How can I protect myself from Medicare scams?

Here’s how to try and stay ahead of the con artists:

  • Medicare employees will never initiate a phone call. If you answer a call and it feels suspicious, “hang up,” Roberts said. “You don’t owe that person anything.” Call Medicare’s customer service line directly at 800-633-4227 to see if they contacted you. You may also use a phone lookup service to potentially find out who’s on the other end of the call.
  • The new Medicare card is free, so don’t give money to someone who says you must pay for it. Imposters may also claim you need to return your old card, but Medicare doesn’t require it. Destroy your old Medicare card so no one can steal that info.
  • Don’t click links, open attachments or respond to requests for information in an email, unless you’re sure you know the sender. You can use an email lookup tool to potentially find out more about the sender.
  • Protect your Medicare number and Social Security number and only give it to people you trust.
  • Record all of your medical appointments and tests on a calendar. Review every explanation of benefits and every bill. If you see something you don’t recognize, compare it with your records.
  • Don’t accept offers of money or gifts for free medical care. “Nothing is free,” Roberts said.
  • Only your doctor or other licensed Medicare providers should review your medical information. Don’t allow anyone else to review them, or recommend services.

You can report Medicare fraud by calling 1-800-MEDICARE. The Federal Trade Commission also gathers complaints on other types of scams, too, which may ultimately help investigators solve the broader issues. “If everybody did that every time they had one of these calls,” Roberts said, “they would give federal law enforcement so much information to work with to help track down the impersonators.”

Disclaimer: The above is solely intended for informational purposes and in no way constitutes legal advice or specific recommendations.