Medicare Scam Alerts — Know the Warning Signs

Medicare Fraud Is a Serious and Growing Problem

The FBI and the Centers for Medicare & Medicaid Services identify Medicare fraud as one of the most prevalent forms of financial crime targeting older Americans. Fraudsters target Medicare beneficiaries with sophisticated schemes designed to steal your Medicare number, bill Medicare for equipment or services you never received, and enroll you in plans without your knowledge or consent.

Knowing how legitimate Medicare agents and government representatives behave — and how scammers behave — is your best protection.

What Medicare Will Never Do

• Medicare will never call you unsolicited to sell you a plan or offer you benefits
• Medicare will never ask for your Medicare number over the phone in exchange for anything
• Medicare will never send someone to your home to discuss your coverage without a prior appointment you arranged
• Medicare will never threaten to cancel your coverage if you do not act immediately
• Medicare will never offer you equipment, tests, or services in exchange for your Medicare number

Common Medicare Scam Tactics

• The "Your Plan Is Changing" Call: Caller claims your Medicare plan is being cancelled or changing and you must act immediately to avoid losing coverage. This creates false urgency. Real plan changes are communicated by mail well in advance.
• The Equipment Scam: Someone offers braces, diabetic supplies, or other equipment "covered by Medicare" in exchange for your Medicare number. They bill Medicare for equipment you may never receive — or did not request.
• The Fake Insurance Agent: Someone contacts you posing as an insurance agent, often using official-sounding names or fake credentials. A legitimate licensed agent will always provide their full name, their license number, and their agency affiliation when asked — and will never pressure you to enroll on the spot.
• The Health Fair or Community Event: Complimentary screenings or community health fairs that are actually lead-generation events designed to collect your Medicare number. CMS rules prohibit agents from conducting sales at educational events without prior consent.
• The "Special Enrollment" Call: Caller claims you have a special enrollment opportunity that expires today and you must act now. Real Special Enrollment Periods are communicated in writing, not through unsolicited calls.

What a Legitimate Licensed Agent Will Always Do

• Provide their full name, state license number, and agency affiliation when asked
• Give you time to think, compare, and decide — never pressure you to enroll on the spot
• Conduct sales calls only with your prior consent and complete a Scope of Appointment form before discussing specific plan details
• Record all sales and enrollment calls — as required by CMS regulations
• Provide you with a Summary of Benefits and Evidence of Coverage for any plan they recommend
• Never ask for your Medicare number to "check your benefits" before you have agreed to work with them

How to Report Medicare Fraud

If you believe you have been the victim of Medicare fraud, or if you receive suspicious communications, contact the following:

• Medicare fraud hotline: 1-800-MEDICARE (1-800-633-4227)
• HHS Office of Inspector General: 1-800-HHS-TIPS (1-800-447-8477)
• Your local Senior Medicare Patrol (SMP) — a federally funded program that helps Medicare beneficiaries protect themselves from fraud
• Your state insurance commissioner's office for complaints about specific agents or companies

Working With a Trusted Local Agent

The best defense against Medicare fraud is having a licensed, vetted, local agent who knows you and your situation. When you have a trusted agent relationship, you have someone to call when something suspicious arrives — and someone who can quickly verify whether a communication is legitimate. Our network agents are fully licensed, CMS-compliant, and background-checked.