Preventing Medicare Fraud

When Linda turned 65 last spring, she expected the usual birthday cards and family celebration. What she didn’t expect was the phone call that almost cost her thousands of dollars—and her peace of mind.

The caller claimed to be from “the Medicare Benefits Office,” congratulating Linda on her upcoming eligibility. The woman on the line sounded professional and kind. She knew Linda’s name, address, and even the date of her birthday. “We just need to verify your Social Security number and bank account to complete your enrollment,” the caller said.

Something about the request felt off. Linda hung up and called her local Social Security office—where she quickly learned the truth. Medicare would never call to ask for personal or financial information. The “representative” on the phone had been a scammer, attempting to steal her identity and drain her savings.

Unfortunately, Linda’s story isn’t unique. Every year, thousands of people turning 65 are targeted by fraudsters posing as Medicare officials, insurance agents, or government representatives. These scams are becoming more sophisticated and convincing, especially as the first wave of baby boomers reaches Medicare eligibility.

People nearing 65 are a prime target for scammers because they’re navigating new territory. The process of enrolling in Medicare can be confusing—Part A, Part B, Part D, Advantage plans, Medigap policies, deadlines, penalties—and criminals exploit that uncertainty.

Common scams include fake enrollment offers, phony Medicare cards, and fraudulent “discount” plans. Some fraudsters call or text saying your new Medicare card is on the way but requires a fee. Others send emails claiming you need to “activate” coverage by clicking a link (which installs malware).

There are even impostors who pretend to help you compare Medicare Advantage plans, only to steal your personal information or sign you up for a plan you didn’t authorize.

According to the U.S. Department of Health and Human Services, Medicare-related scams cost taxpayers an estimated $60 billion each year. While much of that involves fraudulent billing by unscrupulous providers, individual beneficiaries are often the first line of defense—and the first victims when scammers succeed.

It’s important to remember:

  • Medicare will never call, email, or visit you to sell you anything or ask for your personal information.
  • You don’t need to pay for a Medicare card. New enrollees automatically receive one by mail after signing up.
  • Only Social Security handles initial Medicare enrollment, not private companies or “Medicare agents.”

If someone calls or emails claiming to be from Medicare, hang up immediately. You can verify your status anytime by calling 1-800-MEDICARE (1-800-633-4227) or visiting Medicare.gov.

Here are some steps to stay safe while registering for Medicare:

  1. Guard your Medicare and Social Security numbers. Treat them like credit card information. Share them only with verified government agencies or trusted healthcare providers.
  2. Be skeptical of unsolicited contact. Scammers often use high-pressure tactics—“act now or lose your benefits.” Real government agencies do not operate that way.
  3. Avoid clicking links in emails or texts about Medicare, even if they look official. Go directly to Medicare.gov or SSA.gov instead.
  4. Check your statements. Once you’re enrolled, review your “Medicare Summary Notice” or “Explanation of Benefits.” Report suspicious charges right away.
  5. Report fraud. If you suspect a scam, contact the Senior Medicare Patrol (SMP) at 1-877-808-2468 or visit smpresource.org. These trained volunteers help older adults recognize and report Medicare fraud.

Linda considers herself lucky. “It was scary to realize how easily I could have been fooled,” she said. “They knew so much about me already.” She now warns her friends turning 65 to be on guard, and she keeps a sticky note by her phone with the reminder: ‘Medicare doesn’t call you first.’

For anyone approaching Medicare age, that’s advice worth remembering. Enrolling in Medicare should be a milestone, not a minefield. With awareness and caution, you can protect your benefits—and yourself.

If you suspect Medicare fraud or need help enrolling safely:

  • Visit Medicare.gov
  • Call 1-800-MEDICARE
  • Contact the Senior Medicare Patrol (SMP): 1-877-808-2468

Staying informed is the best protection against scams. For assistance with enrolling in Medicare and making decisions about additional insurance needs, consider meeting with a SHINE Counselor—volunteers certified by the State to advise about Medicare.   SeniorCare offers free SHINE appointments—call 978-281-1750 to book an appointment. In addition, many local hospitals and Councils on Aging also offer SHINE services.