In February 2025, the U.S. Attorney’s Office charged a North Carolina man with conspiracy to launder $3 million as part of a shocking Medicare scam. Together with his “business partner,” the man submitted over $100 million in false medical equipment claims during the course of just four months. Separately, a federal grand jury indicted two Texas residents who conspired to file more than $359 million in fraudulent genetic testing claims to Medicare.

Sadly, this is just the tip of the iceberg. In 2024 alone, the U.S. Department of Justice identified and charged dozens of criminals with Medicare fraud totaling billions of dollars.

What is a Medicare scam?

“In a Medicare scam, one or more criminals pretend to be from Medicare or another known organization. Their goal is to trick people into sharing their Medicare or Social Security number,” said Ryan Ramsey, Associate Director of Health Care and Benefits at NCOA. “Most often, scammers use this information to commit identity theft. They submit bogus Medicare claims in the beneficiary’s name to obtain health care services, supplies, or even prescription drugs.”

Medicare scammers often use the phone to find their targets, but they may also reach out via email, text messages, and postal mail. Fraudulent activity tends to ramp up during the yearly Medicare Open Enrollment Period (Oct. 15 - Dec. 7), when beneficiaries are encouraged to review their health care coverage and make any necessary changes.

The Administration for Community Living reports that Medicare fraud and other abuse costs the U.S. government and taxpayers around $60 billion each year. But scams can be hard to pinpoint in real time, Ramsey explained. That means the real figure is likely much higher.

That includes the very real costs for older adults who find themselves on the hook for fraudulent claims made against their stolen Medicare numbers. These enrollees hit their benefits cap sooner than planned, and also incur copayments for services they didn’t receive or didn’t need. Plus, when these fake treatments show up on a person’s Medicare records, their providers can have trouble understanding the patient’s true medical history.

What are the warning signs of a Medicare scam?

First, know this: Medicare scammers can sound very professional over the phone. They often use technology to create convincing websites, emails, and print materials that appear to be from a trustworthy organization. That’s why it’s essential to learn all you can about Medicare scams. Be vigilant and know what red flags to look for to keep you and others safe.

Telltale warning signs of a Medicare scam

1. Promises of free items or services: Be suspicious of any offers involving no-cost medical supplies, medical care, or prescription medications. Many scammers will offer older adults valuable medical equipment, persuade them to share their Medicare number, and then use that information to file high-cost Medicare claims in the beneficiary’s name. Also, beware of offers for free genetic testing or screenings that were not ordered by your physician. This is a known Medicare scam.
2. Pressure to switch your Medicare plan: A scammer, often claiming to be from Medicare, may say you're “pre-approved” for a new health care plan or drug plan with lower premiums or better benefits. They may tell you there’s a fee to enroll in this new plan.
3. Notices to renew or upgrade your Medicare card: A fraudster may call and say you need to activate, renew, or upgrade your Medicare card. They may ask for your Medicare number to “verify” your account, or they may request that you pay a processing fee.
4. Threats to cancel your coverage: You may receive a call stating there’s a problem with your Medicare account, such as fraudulent activity. The caller says your benefits will be canceled if you don’t immediately verify your personal information or join a new plan.
5. Claims you’re eligible for a refund: Another common Medicare scam tactic is telling older adults they qualify for a refund due to changes in their plan. The scammer may ask for your Medicare number—and even your bank account details.

How can I protect myself from Medicare scams?

Scammers are everywhere, and Medicare scams can happen to anyone. The tips below can help you keep your personal information safe.

• Avoid sharing your Medicare number with people who contact you out of the blue: Do not provide your Medicare card, Medicare number, Social Security card, or Social Security number to anyone but your doctor, pharmacy, or people who work with Medicare to assist beneficiaries. Protect these numbers just like you would protect your credit card, debit card, or bank account information. It’s important to know that Medicare will not call you unless you’ve specifically asked for help. And if they do call you in response to a request, they will not need your information since they’ll already have it on file.
  
  Does your caller ID show a legitimate-looking phone number? Don’t be fooled. Scammers can spoof (or fake) their number to make it look like the call is coming from a government agency or other known organization. Also, don’t be surprised if the caller has some basic information about you. With the internet, those details are easy to find today. If someone unfamiliar calls asking you for personal details, simply hang up.
• Do not click on suspicious links: Criminals create fake email addresses to make it seem like their messages are coming directly from Medicare. These emails may send you to a website that looks authentic. Do not respond to unexpected emails or text messages or click on any links they contain—even if the communication looks real.
  
  If you need to update your information, log in to your Medicare account at Medicare.gov, call 1-800-MEDICARE (1-800-633-4227), or talk to a trusted advisor.
• Do not be afraid of threats to terminate benefits: If you qualify for Medicare, your benefits will not be taken away for reasons scammers typically use: like not signing up for a certain plan.
• Do not speak to anyone who tries to persuade you to choose a certain plan: Ignore claims that any policy is “preferred by Medicare." This is not true. Medicare does not endorse a specific plan.
• Destroy your old Medicare card: Some scammers may claim you need to return your old card. They are lying to you. If you receive a new card from Medicare, destroy your old one immediately. Medicare does not need it. Cut it up with scissors or a shredder and start using your new one right away.
• Protect your medical records: Do not allow anyone but your doctor or other health care providers to review your personal medical information.
• Do not accept unauthorized genetic testing kits: If you receive a genetic testing kit in the mail, and your doctor didn't order it, refuse the delivery outright or return it to the sender.

How do I report Medicare scams?

If you or someone you know is a victim of a Medicare scam, take action by reporting it:

• Call Medicare directly at 1-800-MEDICARE (800-633-4227).
• Contact the Senior Medicare Patrol Resource Center by calling 1-877-808-2468 or use their online contact form.
• Submit a report online to the Federal Trade Commission (FTC).

How can you get unbiased Medicare advice?

Medicare enrollment choices can be tough to make—and if you don't take time to ensure you’re not overpaying or missing out on important services, it could cost you. That's where your State Health Insurance Assistance Program (SHIP) can help. These organizations offer expert, unbiased counseling to Medicare-eligible people as well as their families and caregivers. Best of all, this service is 100% free. Find your local SHIP now.