Medicare does not call you uninvited and ask for your Medicare number, Social Security number, banking details, or any personal information. Medicare communicates through official written correspondence. If anyone calls claiming to be from Medicare — regardless of what they know about you or what their caller ID shows — it is a scam. Hang up and call 1-800-MEDICARE (1-800-633-4227) yourself if you have questions about your coverage.
Medicare fraud takes two forms that affect you directly. The first is scammers calling or visiting to steal your Medicare number — then using it to bill the program for services you never received, or selling your number to others who do. The second is fraudulent providers submitting false claims to Medicare — inflating bills, billing for services never rendered, or prescribing unnecessary equipment. Both forms cost the Medicare program an estimated $60 billion annually in fraud, waste, and abuse combined, according to the National Health Care Anti-Fraud Association and corroborated by Senior Medicare Patrol. Your Medicare number is as valuable as your Social Security number: Medicare.gov advises treating it exactly like a credit card and never sharing it in response to unsolicited contact.
Why Medicare Fraud Is a Year-Round Threat
Most seniors know to be cautious during open enrollment season (October 15 – December 7), when scam activity spikes dramatically. What fewer people know is that Medicare fraud never stops — it simply shifts tactics based on the season, current healthcare news, and recent policy changes. In 2026, scammers are exploiting genuine confusion around the $2,100 Part D drug cap, carrier pullbacks from several major Medicare Advantage markets, and the introduction of new supplemental benefits.
The financial stakes are high on both sides. Government impersonation scams — the category that includes Medicare fraud — accounted for $789 million in reported losses in 2024 (FTC Consumer Sentinel Network Data Book 2024), and phone call scams, the most common method used in Medicare fraud, produce the highest median individual loss of any contact method at $2,210 per incident (FTC Consumer Sentinel 2024).
The Most Common Medicare Scams in 2026
1. The Fake Medicare Representative Call
The most prevalent scam. A caller identifies themselves as a Medicare representative, CMS official, or insurance company employee. They claim your benefits are expiring, your card needs updating, a new card is being issued, or there's a problem with your account. They ask for your Medicare number, Social Security number, or banking details to "verify" or "update" your records.
Your Medicare number is equivalent to a credit card number for healthcare fraud. Once a scammer has it, they can bill Medicare for equipment, procedures, and services you never received — and those fraudulent claims can affect your medical records for years.
2. The Medicare Flex Card / Free Grocery Benefit Scam
Advertisements — particularly on Facebook, YouTube, and cable TV — promise seniors a free debit card worth $500–$900 for groceries, utilities, or over-the-counter health items simply by calling a number or switching Medicare plans. Some ads feature official-looking logos and even names of real insurance carriers.
The reality: supplemental grocery and utility benefits are available only to a narrow category of dual-eligible Medicare and Medicaid enrollees in specific plans in specific counties. They are not universally available, and no legitimate plan will advertise them through an unsolicited ad without clearly disclosing eligibility requirements. Clicking these ads can lead to unauthorised plan enrollment or theft of your personal information.
3. The Part D Refund Scam
Callers tell seniors they are owed a "2026 Part D refund" due to overpayment or new drug pricing changes under the Inflation Reduction Act, and ask for bank routing and account numbers to "direct deposit" the funds. The $2,100 Part D cap is real — but refunds from it are processed automatically through Medicare, never through a phone call requesting your banking details.
4. Fake Free Medical Equipment or Genetic Testing
Callers or door-to-door visitors offer "free" medical equipment (braces, CPAP machines, wheelchairs, glucose monitors) covered by Medicare, or free genetic cancer screening tests. They collect your Medicare number to bill for equipment or tests you didn't need, may never receive, and didn't authorise — racking up thousands in fraudulent charges to the system and potentially cluttering your medical records with diagnoses you don't have.
Legitimate Medicare-covered medical equipment always requires a physician's order and is arranged through your doctor or a supplier your doctor recommends. If anyone contacts you offering free equipment without mentioning a referral from your physician, it is fraud.
5. The Fake Medicare Website
Professionally designed websites with URLs that are one letter different from Medicare.gov, or that include words like "official," "approved," or "2026," collect login credentials and personal information. Always navigate to Medicare.gov by typing it directly into your browser — never through a link in an email, text, or ad.
6. The Unauthorised Plan Enrollment Scam
During open enrollment, aggressive call centers have enrolled seniors in Medicare Advantage or Part D plans without their clear consent — sometimes after a brief phone call where the caller interpreted vague responses as agreement. Always verify your current plan enrollment through Medicare.gov or by calling 1-800-MEDICARE, not through any number provided by a caller.
Warning Signs
- Unsolicited call, text, or email claiming to be from Medicare. Medicare does not make outbound sales calls or send unsolicited digital messages requesting personal information.
- Any request for your Medicare number, Social Security number, or banking details over the phone. Treat your Medicare number like a financial account number — never give it to anyone who contacts you.
- Offers of free equipment, screenings, or benefits you didn't ask about. Legitimate Medicare benefits are coordinated through your doctor, not through unsolicited offers.
- Pressure to "act now" or make a plan decision immediately. Legitimate insurance representatives give you time to review materials, ask questions, and consult your doctor or family.
- Caller ID showing "Medicare," "CMS," or an 800 number. These can be spoofed. The display means nothing.
- Advertisements promising flex cards or grocery benefits "for all Medicare recipients." These benefits are not universal. If an ad says "call now," it's almost certainly misleading or fraudulent.
How to Verify Whether a Call or Offer Is Legitimate
1-800-MEDICARE (1-800-633-4227): Available 24/7 to confirm your coverage, check plan changes, and verify any claim about your benefits
Medicare.gov: Log in to your account to see your current plan, Part D coverage, and claims history
Your State Health Insurance Assistance Program (SHIP): Free, unbiased Medicare counselling — find your local SHIP at shiphelp.org
Senior Medicare Patrol (SMP): Free assistance identifying and reporting Medicare fraud — smpresource.org or 877-808-2468
If You've Already Given Information or Suspect Fraud
- Call 1-800-MEDICARE immediately. Report that your Medicare number may have been compromised and ask what steps they recommend to protect your account.
- Review your Medicare Summary Notices carefully. Look for claims for services, equipment, or providers you don't recognise. You can also check claims at Medicare.gov.
- Report to the HHS Office of Inspector General at oig.hhs.gov or 1-800-447-8477. This is the primary federal agency for investigating Medicare fraud.
- Report to the FTC at ReportFraud.ftc.gov for any financial loss or personal information theft.
- Contact your local Senior Medicare Patrol at 877-808-2468 for personalised guidance on next steps.
- Place a fraud alert on your credit reports if your Social Security number was shared.
Protecting Yourself Year-Round
- Guard your Medicare card like a credit card — don't carry it in your wallet unless you're going to a medical appointment
- Review every Medicare Summary Notice when it arrives — they are your record of what has been billed in your name
- Create a Medicare.gov account to monitor your claims in real time
- Never give your Medicare number to anyone who contacts you — only to providers you've chosen yourself
- During open enrollment, contact your insurance company or SHIP directly using a number you look up yourself, not one provided by a caller or mailer
By the Numbers — Medicare Fraud Scale
Sources: DOJ 2025 National Health Care Fraud Takedown (June 2025) · CMS Medicare Fraud Overview · HHS OIG Consumer Alerts
Medicare fraud prosecutions distinguish between two types: scammers who contact seniors to steal Medicare numbers (the direct threat to you), and providers who submit fraudulent billing claims (a systemic threat). The 2025 DOJ National Health Care Fraud Takedown charged 324 defendants — including 96 licensed medical professionals — in 50 federal districts for schemes involving over $14.6 billion in intended fraud. The government seized over $245 million in cash, luxury vehicles, and cryptocurrency as part of the action.
For seniors, the most important number is this: the Medicare Fraud Strike Force, since its inception in 2007, has charged more than 5,400 defendants who collectively billed the Medicare program for more than $27 billion in fraudulent claims. Medicare fraud is not rare or marginal — it is a large-scale, organized criminal industry.
| Metric | Figure | Source |
|---|---|---|
| Estimated annual Medicare system-wide fraud | ~$60 billion | National Health Care Anti-Fraud Association |
| 2025 DOJ Takedown — defendants charged | 324 | DOJ June 2025 |
| 2025 DOJ Takedown — intended fraud losses | $14.6 billion | DOJ June 2025 |
| Assets seized in 2025 Takedown | $245 million+ | DOJ June 2025 |
| Medicare Fraud Strike Force — total charged since 2007 | 5,400+ defendants | DOJ/CMS |
| Open enrollment fraud window (peak scam season) | October 15 – December 7 annually | HHS OIG |
| Medicare phone number (official) | 1-800-633-4227 | Medicare.gov |
| Report Medicare fraud (HHS OIG) | 1-800-HHS-TIPS (1-800-447-8477) or oig.hhs.gov | HHS OIG |
Takedown figures from DOJ 2025 National Health Care Fraud Takedown press release. System-wide fraud estimate from the National Health Care Anti-Fraud Association. Note: "intended loss" figures in DOJ press releases represent the amount defendants are alleged to have attempted to bill — actual paid amounts are typically lower.
Sources Used on This Page
All statistics on this page are drawn from primary government sources. "Intended loss" figures represent the amounts defendants are alleged to have attempted to bill; actual paid losses are typically lower. System-wide fraud estimates vary by methodology. This page is reviewed on an ongoing basis as new data becomes available.
Frequently Asked Questions
No. Medicare numbers have been exposed in data breaches and are sold in criminal databases. A caller knowing your Medicare number does not verify they are from Medicare or a legitimate provider. Medicare will never call you unsolicited. Hang up and call Medicare directly at 1-800-633-4227.
Probably not as advertised. While some Medicare Advantage plans offer limited allowance benefits, advertisements for extremely high-value benefits are frequently misleading or outright fraudulent. Verify any plan benefit directly with your plan using the number on your card or at Medicare.gov. Never provide your Medicare number in response to an ad or unsolicited call.
Report it immediately to HHS OIG at 1-800-HHS-TIPS (1-800-447-8477) or at oig.hhs.gov. Also call Medicare at 1-800-633-4227. A service billed that you didn't receive is provider billing fraud. Your report helps investigators identify fraudulent providers — many billing schemes are only uncovered through beneficiary complaints.
Medicare will never call you unsolicited to ask for your Medicare number, bank account information, or payment. Medicare contacts beneficiaries by mail. The only time Medicare may call you first is if you specifically requested a callback. Any unsolicited call claiming to be from Medicare should be treated as a scam attempt — hang up and call 1-800-633-4227 to verify if needed.
Fraudulent use of your Medicare number can affect your coverage limits, create false medical records that could affect future care, and result in incorrect bills or collection notices. Review your Medicare Summary Notice carefully every time one arrives. Report discrepancies to HHS OIG at oig.hhs.gov or 1-800-447-8477 immediately.
Treat your Medicare card like a credit card. Share it only with your doctor, pharmacist, or provider during an appointment — never to anyone who contacts you unsolicited. Do not carry it in your wallet; keep it at home and bring it only when you have an appointment. Medicare.gov provides this guidance directly: your Medicare number is the primary tool used to commit billing fraud against you.
Last updated: April 2026