Medicare scams: Warning signs and fraud prevention

What is the Medicare scam?

A Medicare scam is a criminal scheme designed to deceive older Americans by exploiting their healthcare benefits and personal information. Fraudsters impersonate Medicare representatives or healthcare providers, using sophisticated tactics to trick individuals into revealing sensitive details or submitting false claims. Although these scams vary in form, they share a single end goal — to steal money from Medicare, from seniors, or from both.

Medicare scammers begin their operations by gathering information from public databases, social media, data breaches, and purchased data lists. They specifically target contact information like phone numbers, email addresses, and home addresses to make initial contact with potential victims.

Once armed with information, they prepare scripts and choose how to approach their targets. To reach them, scammers rely on phone calls, mail, email, and text messages, often combining multiple channels to appear more convincing.

Medicare call scams

Medicare scam calls are the most prevalent. Fraudsters exploit caller ID spoofing to display official-looking numbers, which makes calls appear to come from a government agency or a trusted health provider. This method is effective because scammers can adjust to your responses in real time and use their voice and a sense of urgency to pressure you.

Typical Medicare telephone scam scenarios include claiming you need a new Medicare card, offering “free” medical equipment, requesting immediate verification of personal information, threatening to suspend benefits, or promising unexpected refunds.

Medicare mail scams

Medicare scams through postal mail exploit older adults’ familiarity with paper documents and comfort with traditional communication methods. Scammers invest heavily in professional printing and design to create convincing replicas of Medicare forms, complete with official seals and formatting.

This channel is particularly dangerous because physical documents feel more legitimate to many seniors. Targets have more time to study and potentially fall for detailed fake documentation.

Medicare email scams

Medicare email scams leverage the immediacy of digital communication while appearing official through sophisticated spoofing techniques. Scammers create email addresses that closely mimic medicare.gov domains and design messages that replicate official Medicare formatting.

The unique danger of email scams lies in embedded malicious links that can install malware or direct seniors to fake websites designed to steal login credentials and personal information.

Medicare text scams

Medicare text scams exploit the perceived urgency and personal nature of mobile messaging. These scams are particularly effective because text messages feel more immediate and personal than emails, and many seniors are less familiar with digital security practices on mobile devices. Scammers use short, alarming messages that create panic and drive immediate action, often including links to fraudulent websites.

How big is the problem?

The scale and sophistication of Medicare fraud continue to grow. According to data from the Better Business Bureau reported in the New York Times, complaints about Medicare scam calls have surged 40% in 2025 compared with 2024 [1]. This dramatic increase reflects a broader pattern of systematic healthcare fraud that affects millions of Americans.

Recent federal investigations also reveal just how extensive this problem has become, with prosecutors charging 193 defendants across 32 federal districts in 2024 for approximately $2.75 billion in intended losses and $1.6 billion in actual losses [2]. These prosecutions are not isolated incidents, but part of organized criminal networks that target the healthcare system and older adults.

Identity theft statistics also add important context: Government benefits fraud is among the most common types of identity theft, which aligns with the increase in scams targeting Medicare beneficiaries and attempts to steal their personal and coverage information [3].

Warning signs of a Medicare scam

Medicare scams often follow predictable patterns designed to create artificial urgency and exploit seniors’ trust in federal agencies and known health providers. By understanding these warning signs, you can protect yourself from potential fraud.

• High-pressure tactics. Scammers create immediate urgency, claiming they will suspend your benefits or you will lose critical medical coverage if you don’t respond instantly. They design these tactics to prevent you from thinking critically about the situation.
• Requests for personal information. Scammers will ask for your Medicare number, Social Security number, bank account details, or other personal identifiers through unsolicited phone calls or other means of communication.

PRO TIP: If someone is calling you out of the blue about Medicare, it’s already a violation of Medicare’s own rules. Even legitimate plan representatives cannot ask for personal information like credit card or bank account numbers over the phone unless it’s needed to process an enrollment request that you initiated.

• Card renewal or upgrade requests. Scammers send unsolicited calls or messages claiming you must upgrade, renew, or replace your Medicare card. Medicare automatically issues cards when needed and mails them to you in your welcome packet once you’re signed up. If your card is lost or damaged, log in to (or create) your secure Medicare account to print or order an official copy of your Medicare card.
• Free offers and unsolicited services. Fraudsters make offers for prescription coverage, complimentary medical equipment, free genetic testing kits, or supplemental insurance. Medicare flex card scams also appear frequently — scammers claim you qualify for a new prepaid “flex card” with free money to spend on groceries or other items, then ask for your Medicare number to “activate” the benefit.

PRO TIP: Scammers deliberately use misleading names like “Medicare flex cards” to confuse seniors. These cards have nothing to do with original Medicare. Original Medicare doesn’t offer a flex card — this benefit is only available through some private Medicare Advantage plans, and only certain eligible members receive them.

• Threats of coverage termination. Fraudsters send messages claiming your Medicare will be canceled unless you verify your information, pay a processing fee, or join a new plan immediately. Medicare doesn’t operate through threats or sudden cancellations. 
• Fake refund claims. Scammers often claim you’re eligible for unexpected Medicare refunds, special benefit adjustments, or one-time financial compensations. These are almost always fraudulent attempts to obtain your personal information.
• Suspicious digital communications. Criminals send emails or texts with malicious links and attachments that lead to fake Medicare pages, phishing forms that collect your information, or malware hidden in a file such as a PDF or Word document.

What happens if a scammer steals your Medicare information

If a scammer steals your Medicare information, they can commit extensive fraud that affects both you and the healthcare system. They might:

• Submit fraudulent medical claims in your name.
• Obtain medical treatment, prescriptions, or equipment billed to your Medicare account.
• Create false medical records that could interfere with your future care.
• Drain your medical benefits.
• Leave you with unexpected or disputed medical bills for services you never received.
• Damage your credit if unpaid fraudulent bills go to collections.
• Put you at risk for broader identity theft.

PRO TIP: Learn the warning signs of identity theft. You can check if someone is using your identity by reviewing your credit reports for new accounts, scanning medical statements for unknown charges, and watching your bills and mail for collection notices or unfamiliar providers.

How to avoid Medicare scams

To avoid Medicare scams, remember that Medicare will never call you unexpectedly to request personal or financial information. Government agencies typically communicate through official written correspondence, so be skeptical of any unsolicited health insurance communication.

Follow these tips to protect yourself from Medicare scams:

• Never share your Medicare or Social Security number through unsolicited phone calls, emails, or text messages.
• Question and verify all communications through official Medicare channels, such as 1-800-MEDICARE or medicare.gov. On the website, go to “Basics” > “Forms, publications, and mailings” > “Find mailings” to check when and what Medicare may mail you and see examples of legitimate documents.
• Monitor your Medicare Summary Notices (MSNs) and other Medicare statements for unfamiliar charges or services.
• Don’t trust the caller ID — scammers can spoof Medicare’s phone number.
• Destroy any old Medicare cards and outdated documents containing personal information (including MSNs) as soon as their replacements arrive.
• Use a credit monitoring service to track suspicious activity or changes in your financial accounts.
• Avoid clicking suspicious links or opening unsolicited attachments.
• Ignore offers of free medical equipment, prescription cards, or genetic testing kits.
• Never sign blank medical or insurance forms.
• Refuse revisions of your medical records or coverage plans from unsolicited sources.
• Resist persuasive tactics pushing you to switch plans or share private data.
• Ignore threats claiming your Medicare benefits will be terminated — these are scare tactics.

PRO TIP: Consider online fraud insurance for added protection. Included in NordProtect’s identity theft protection service, it covers up to $10,000 in reimbursements for losses caused by various online scams.

How to stop Medicare scam calls

If you still get these calls despite taking precautions, here are ways to minimize and prevent unwanted calls that can compromise your personal and financial information:

• Let unknown calls go to voicemail.
• Block suspicious phone numbers.
• Use call-blocking technology.
• Never engage with suspicious callers, just hang up.
• Register your number on the Do Not Call (DNC) list at donotcall.gov. 

NOTE: While the National Do Not Call Registry is intended to reduce unwanted calls, scammers and telemarketers often find ways around these rules. Some of them use offshore call centers to make calls, which helps them evade US oversight and consumer protections.

How to report Medicare scams

Reporting Medicare fraud and abuse is crucial to protecting yourself and others. You can report Medicare scams through:

• Medicare at 1-800-MEDICARE (1-800-633-4227). If you have a Medicare Advantage Plan or Medicare drug plan, you can also call the Investigations Medicare Drug Integrity Contractor (I-MEDIC) at 1-877-7SAFERX (1-877-772-3379).
• Senior Medicare Patrol at smpresource.org or 1-877-808-2468.
• HHS Office of Inspector General at oig.hhs.gov.
• Federal Trade Commission at reportfraud.ftc.gov. 
• Local law enforcement.

References

[1] Nick Keppler, “Medicare Scammers Are Calling Seniors 50 Times a Day, Trying to Trap Them,” The New York Times, 2025. [Online]. Available: https://www.nytimes.com/2025/12/05/business/medicare-scam-calls.html 

[2] U.S. Department of Justice, “National Health Care Fraud Enforcement Action Results in 193 Defendants Charged and Over $2.75 Billion in False Claims,” DOJ Office of Public Affairs, 2024. [Online]. Available: https://www.justice.gov/archives/opa/pr/national-health-care-fraud-enforcement-action-results-193-defendants-charged-and-over-275-0

[3] Federal Trade Commission, “Consumer Sentinel Network: Data Book 2024,” FTC, 2024. [Online]. Available: https://www.ftc.gov/system/files/ftc_gov/pdf/csn-annual-data-book-2024.pdf 

[4] U.S. Department of Justice, “National Health Care Fraud Takedown Results in 324 Defendants Charged in Connection with Over $14.6 Billion in Alleged Fraud,” DOJ Office of Public Affairs, 2025. [Online]. Available: https://www.justice.gov/opa/pr/national-health-care-fraud-takedown-results-324-defendants-charged-connection-over-146