Medicare Phone Scams: Protecting Seniors From Healthcare Fraud

Common Medicare Scam Scripts

The most common Medicare scam call starts with: "This is Medicare calling about your benefits. We have an important update about your plan." The caller claims there's a new benefit available — free genetic testing, back braces, diabetic supplies, or prescription discounts — but they need your Medicare number to "activate" the benefit.

During Open Enrollment (October-December), scammers pose as Medicare plan representatives offering "upgraded" coverage at lower costs. They pressure seniors to switch plans immediately, requesting Medicare numbers, Social Security numbers, and bank account information for "automatic enrollment."

Another variant: callers claim there's suspicious activity on your Medicare account, your benefits will be canceled, or your Medicare card needs to be "updated" with a new number. The real Medicare card number never changes once issued.

How Scammers Target Medicare Recipients

Scammers target seniors through Medicare beneficiary lists purchased from data brokers, targeting everyone over age 65. They also harvest information from social media profiles, pharmacy loyalty programs, and health-related website sign-ups.

The timing is strategic: scam volume increases 300-400% during Open Enrollment periods and around major policy announcements. In 2025, a wave of scam calls followed the announcement of new prescription drug coverage changes, exploiting the confusion around evolving benefits.

Senior living communities and hospitals are common hunting grounds for scammer accomplices who collect Medicare numbers in person, which are then used in phone scams. Some operations also use direct mail to establish false credibility before following up with phone calls.

What Medicare Will Never Ask By Phone

Medicare will never: call you unsolicited to sell you a new plan or benefit, ask for your Medicare number to "activate" or "verify" your coverage, request banking information or Social Security number over the phone, threaten to cancel your benefits if you don't comply immediately, or offer free services or products in exchange for your Medicare number.

The only time Medicare calls you is in response to something you initiated — a question you submitted, an appeal you filed, or a callback you requested. Medicare does not employ telemarketers or sales agents who make cold calls.

Legitimate Medicare communications come by mail from CMS (Centers for Medicare & Medicaid Services). Your state SHIP (State Health Insurance Assistance Program) provides free, unbiased counseling about Medicare — find yours at shiphelp.org.

Protecting Medicare Recipients

Help protect elderly family members by: guarding their Medicare number like a credit card (it should not be shared over the phone), reviewing their Explanation of Benefits (EOB) statements for services they didn't receive (a sign of fraud), and registering their number on the Do Not Call Registry.

Consider setting up call blocking on their phone — many carriers offer senior-friendly blocking services. The CPR V100K call blocker is a popular hardware solution for landlines that blocks robocalls at the device level.

If a Medicare recipient has shared their number with a scammer, call 1-800-MEDICARE immediately to report the compromised number. Request a new Medicare number and monitor for fraudulent claims. Also file a report with the HHS Office of Inspector General at oig.hhs.gov.

Reporting Medicare Fraud

Report suspected Medicare fraud to: 1-800-MEDICARE (1-800-633-4227), the HHS OIG Hotline at 1-800-HHS-TIPS (1-800-447-8477) or oig.hhs.gov, your state Senior Medicare Patrol (SMP) at smpresource.org, and the FTC at reportfraud.ftc.gov.

Medicare fraud costs taxpayers an estimated $60 billion annually. Reporting scam calls helps the government track and disrupt these operations. Whistleblowers who report Medicare fraud leading to recovery can receive 15-25% of the recovered amount under the False Claims Act.

Keep records of all suspicious calls including the number displayed, date/time, what was said, and any information you may have shared. This documentation is essential for investigations.