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 Medicare Scams

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For Medicare beneficiaries, shopping for a new plan can be overwhelming. Choosing a new Medicare Advantage or Prescription Drug Plan can be a difficult and confusing decision to make. Unfortunately, scammers see this time of year as a chance to "con" beneficiaries out of personal information to steal their identity and money. The Annual Medicare Open Enrollment period -- October 15 - December 7 -- is the time when Medicare beneficiaries are taking a look at the cost, coverage, convenience, and customer service for Medicare Part C Advantage Plans and Medicare Part D Prescription Drug Plans and making changes without paying a penalty. For scammers, this is the perfect opportunity to seek out unsuspecting beneficiaries and take advantage by providing misleading information and logos that seek to gain your confidence in a con game designed to take your identity and money.

The Maryland Department of Aging wants all Maryland Medicare beneficiaries to be informed consumers during Medicare Open Enrollment. Please read below and learn how to avoid fraud, theft, and scams.​


What are Medicare Scams:

The act of targeting older adults in which attempts are made to extract personal information, deceive with promises of services, financial benefits that do not exist, were never intended to be provided, or were misrepresented. The types of Medicare scams are widespread and change all the time to take advantage of new technology, current events, and more.​


Here are the top Medicare scams targeting seniors:

      I.        Open Enrollment

1. Bogus Medicare Representatives: This tactic involves an “official Medicare agent” either cold calling a senior or knocking on their door. The phony agent says they’re selling Medicare insurance that can save the senior thousands of dollars in health care costs next year, but the offer is only good during the open enrollment period. Ignore cold calls and be wary of anyone who shows up unannounced at your home offering products or services of any kind. 

2. Threating a Loss of Coverage: This scam usually begins with a senior receiving a call that says they must have a prescription drug coverage plan (also known as Medicare Part D) or they will lose their other Medicare benefits. If the senior doesn’t purchase a plan during enrollment time, then their Medicare benefits will be “terminated.” The Medicare prescription drug benefit is an entirely optional addition to your coverage under Original Medicare (Parts A and B).

3. Fake Rebate Notice: This tactic involves a scammer calling a Medicare beneficiary to notify them that they are owed a substantial refund because they’ve reached the prescription drug coverage gap known as the “donut hole.” Please note that Medicare will NEVER call and ask for a beneficiary’s Medicare number or Social Security number. Guard your personal information.

4. Counterfeit Sales Materials: This scam usually begins with a scammer creating and circulating very official-looking brochures and sales materials for new Medicare products that are available at a “discounted price” during the open enrollment period. If you receive any mail or digital communication about Medicare products that you are interested in acting on, do not use the contact information listed on these materials. Instead, call Medicare directly at 1-800-MEDICARE (1-800-633-4227) or look up and compare available plans in your area using Medicare’s Plan Compare Tool.

5. Predatory Medicare Insurance Sales Tactics:  This tactic involves scammers posing as insurance salespeople using aggressive or deceptive sales practices to lure seniors into buying real Medicare Advantage Plans, Medigap policies, Part D plans or other insurance products. Seniors and their families should be aware of what agents can and can’t do, so they’re able to spot dishonest practices right away. Visit Medicare.gov for a complete list of rules that people representing Medicare plans must follow. ​

     II.        Phone Scams: Medicare phone scams are the most common way that older adults are taken advantage of. In many cases, the scammer will call you and pretend to be from Medicare offering you free services, free medical supplies or personal gifts in exchange for personal information, such as your Medicare ID or SSN. In other cases, the scammer may ask you to validate your personal information to keep you from losing your benefits. It best not to answer any calls from unknown or out-of-town numbers and if you ever doubt the validity of a phone call, say you'd like to call the person back and ask for their direct number. 

   III.        Medicareplans.com: This is an outdated link that scammers used as a fake marketplace for older adults searching for a Medicare plan. It is vital that you be careful in your review of different company websites. It is recommended that you look for websites that start with “https" instead of “http" as the “s" indicates a secure website. If in doubt, completing a simple google search where you type in the following “[Company Name Here] Scam" should show any potential scam information. 

   IV.        Medicare Refunds: False claims that you are entitled to a refund is another devious ploy by a scammer to try and get your personal banking information. If for some reason you are in fact entitled to a Medicare refund, a check will be mailed to you directly. A phone call from a Medicare Representative asking for your bank information will never happen.

 

Who is at risk?

All older adults may be victims of scams regardless of whether they are rich or poor, or undereducated or highly educated. Seniors of all races, cultures, and creeds are victimized. Older adults are primarily the targets of scams because they are considered to be in the naïve segments of the population. Scammers are increasingly targeting older adults because they are perceived to be more likely to have a nest egg and less familiar with technology.

 
What are the signs?

The warning signs of scams can come in many different ways; however, the most common red flag to spot a potential scammer is when you receive a phone call from a contact asking you to provide some personal information, such as your Medicare ID number to verify identity. Of course the call is a scam because Medicare will never contact you for your Medicare ID or other personal information unless you've given them permission in advance. Sharing personal information will only open you up to identity theft.


Here are additional signs that indicate you might be dealing with a scammer. They include contact from someone:

  • Calling or emailing you unsolicited, claiming to be a government representative who can help you navigate your Medicare or Affordable Care Act options.
  • Asking for your personal banking information stating that it is needed to cover shipping costs for free medical supplies.
  • Pressuring you to "act now" or else the deal will go away OR someone who seems to be trying hard to give you a "great deal" without time to answer your questions.  MedicareScams SMP.png

How to report suspected Medicare Scams?

If you suspect a Medicare scam, you should report it right away. Any concerned person who has reason to believe that an alleged older adult has been subjected to a scam or fraud should also report it right away.

The Centers for Medicare & Medicaid Services (CMS), which administers Medicare, is cracking down on these types of activities. CMS is working with beneficiaries, doctors, and federal agencies like the D​epartment of Human Services (HHS) Office of Inspector General, the Federal Bureau of Investigations (FBI), and the Department of Justice​ to fight against Medicare fraud and scams.

When reporting a Medicare scam, gather the following information:
  • ​The provider’s name and any identifying number you may have
  • The item or service you are questioning
  • The date on which the item or service was supposedly furnished
  • The amount approved and paid by Medicare
  • The date of the Medicare Summary Notice
  • The name and Medicare number of the person who supposedly received the item or service
  • The reason you believe Medicare should not have paid
  • Any other information you may have showing that the claim for the item or service should not have been paid by Medicare
And then you can contact any of the following for assistance: 

 
What can you do to help keep Marylander's seniors safe from Medicare Scams?

When it comes to scams and fraud the two biggest deterrents are for older adults to stay up to date with their banking information so to be aware of fraudulent charges and not be afraid to say no to solicitors.

Use these tips below to protect against potential scams and fraud.

  • Recognize scam attempts and end all communication with the perpetrator.
  • Guard your personal information and contact Medicare if you have any questions or concerns.
  • Search online for the contact information (name, email, phone number, addresses) and the proposed offer. Other people have likely posted information online about individuals and businesses trying to run scams.
  • Take precautions to protect your identity if a criminal gains access to your device or account. Immediately contact your financial institutions to place protections on your accounts, and monitor your accounts and personal information for suspicious activity.
  • Never give or send any personally identifiable information, money, jewelry, gift cards, checks, or wire information to unverified people or businesses.
  • Make sure all computer anti-virus and security software and malware protections are up to date. Use reputable anti-virus software and firewalls.
  • Disconnect from the internet and shut down your device if you see a pop-up message or locked screen. Pop-ups are regularly used by perpetrators to spread malicious software. Enable pop-up blockers to avoid accidentally clicking on a pop-up. 

Additional Resources


Additional Articles

 
Contact Person: Leonard Croft, Elder Rights Program Manager, 410-767-4665, leonard.croft@maryland.gov

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