Avoiding Medicare Scams

Medicare beneficiaries are among the most frequently targeted groups for fraud. Knowing what scammers do — and what Medicare will never do — is your first line of defense.

Common Medicare Scams

Fake Medicare Card Replacement Calls

A caller claims your Medicare card is expiring, has been compromised, or needs to be updated. They ask for your Medicare number, Social Security number, or bank account to "process" the new card. Medicare cards don't expire and Medicare won't call you unsolicited to replace one.

Unsolicited Plan-Switching Calls

You receive a call from someone claiming to represent Medicare or a named insurance company, pressuring you to switch plans immediately — often with promises of extra benefits or lower costs. Licensed agents are prohibited from making unsolicited calls to Medicare beneficiaries. Cold calls to switch your plan are illegal.

Genetic Testing / DNA Kit Scams

Scammers offer "free" genetic tests or cancer screenings — often at health fairs, pharmacies, or through door-to-door visits — in exchange for your Medicare number. The tests are billed to Medicare fraudulently, and your personal information is compromised. Medicare only covers genetic testing when ordered by your treating physician for a specific medical need.

Unsolicited Home Visits

Someone claiming to be a nurse, health screener, or Medicare representative shows up at your door offering free services. They use your Medicare number to bill for services never rendered. Medicare does not send representatives to your home unannounced.

Fake Medicare Supplement ("Medigap") Agents

Callers or door-to-door visitors pressure you into signing up for a Medigap policy with very little information, or misrepresent what it covers. Always ask for an agent's National Producer Number (NPN) and verify it at nipr.com before sharing personal information.

Red Flags to Watch For

⚠ You receive an unsolicited call, text, or email asking for your Medicare number
⚠ Someone offers a "free" service or gift in exchange for your Medicare card
⚠ A caller claims to be from Medicare and says your benefits are at risk
⚠ You're pressured to make an immediate decision with no time to think
⚠ Someone shows up at your door offering health services without an appointment
⚠ You're asked to pay for something Medicare "will reimburse later"
⚠ A caller asks for your bank account, Social Security number, or credit card to update Medicare records
⚠ You receive Medicare Explanation of Benefits (EOB) for services you never received

What Medicare Will and Won't Do

Medicare WILL:

✓Send you an annual Medicare & You handbook by mail
✓Send your Medicare card by mail when you first enroll
✓Send Explanation of Benefits (EOB) statements after claims are processed
✓Contact you by mail if there's a billing issue

Medicare will NEVER:

✗Call you unsolicited to sell or enroll you in a plan
✗Send someone to your home uninvited
✗Ask for your Medicare number over the phone to "verify" your account
✗Offer free gifts or equipment in exchange for your Medicare number
✗Ask you to pay anything to get a new Medicare card
✗Require you to give bank account information to continue receiving benefits

How to Report Medicare Fraud

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1-800-MEDICARE (1-800-633-4227)

The main Medicare helpline. Report suspected fraud, billing errors, or suspicious contacts. Available 24/7.

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HHS Office of Inspector General (OIG)

Report Medicare fraud to the OIG at 1-800-HHS-TIPS (1-800-447-8477) or online at oig.hhs.gov. Tips can be submitted anonymously.

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Wisconsin Senior Medicare Patrol (SMP)

Wisconsin's SMP program helps seniors detect, prevent, and report Medicare fraud. Reach them through the Wisconsin Board on Aging and Long Term Care.

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Local Law Enforcement / FTC

For phone scams and identity theft, you can also report to the FTC at ReportFraud.ftc.gov and file a local police report if you've given out financial information.

🔒 Guard Your Medicare Number Like a Credit Card

Your Medicare Beneficiary Identifier (MBI) — the number on your red, white, and blue Medicare card — can be used to submit fraudulent claims. Once billed, those services count toward your coverage limits.

•Only share your Medicare number with your doctor, hospital, or a trusted licensed agent
•Review your Medicare Summary Notice (MSN) or online account for services you didn't receive
•Keep a record of all your medical appointments and compare to EOBs
•Never carry your Medicare card unless you have a medical appointment that day

Work with a Local, Trusted Agent

When you work with a licensed, local Medicare agent — in person or by phone — you know exactly who you're dealing with. No pressure, no cold calls, no surprises.

Talk to an Agent