Medicare Annual Enrollment Scams:
Red Flags to Watch For
How to recognize suspicious sales tactics and protect your Medicare information
Medicare’s Annual Enrollment Period runs from October 15 through December 7. During this time, people with Medicare may receive an overwhelming number of phone calls, mailers, emails, and television advertisements. Most communications are marketing – not necessarily scams – but some may be misleading or designed to obtain your personal information. Knowing the warning signs can help you protect your Medicare coverage and identity.
1. Someone Calls Claiming to Be ‘From Medicare’
Medicare will not call you unexpectedly to sell you a health plan, offer additional benefits, or visit your home.
Medicare number
Social Security number
Banking or credit card information
Birth date or other identifying information
There are limited situations when Medicare may return your call, such as when you previously contacted Medicare or reported a concern. If you are unsure, hang up and call 1-800-MEDICARE directly.
2. A Company Makes an Unsolicited Sales Call
Medicare plans, agents, brokers, and third-party marketing organizations are generally prohibited from making unsolicited Medicare sales calls. They may call when you are already a member of the plan, have asked them to contact you, or have otherwise given permission to be contacted.
When a third-party marketing organization collects your information and wants to share it with another marketing organization, CMS requires your prior express written consent. That consent must clearly identify each organization receiving your information. A broad statement allowing unnamed ‘marketing partners’ to call should be treated with caution.
If you do not remember requesting the call or giving permission, do not provide personal information. Ask for the caller’s name and company, hang up, and verify the organization independently.
3. You Are Told Your Benefits Will Be Canceled
A caller may claim that your Medicare coverage will be canceled unless you provide information, pay a fee, or immediately change plans. This is a major red flag.
Your current Medicare Advantage or Part D plan will send you an Annual Notice of Change explaining changes for the upcoming year. Review that official notice and contact the plan directly if you have questions.
4. The Caller Already Knows Something About You
Scammers may know your name, address, doctor’s name, or current insurance company. Having some correct information does not prove that the caller is legitimate. Do not give someone the remaining information they need to complete an enrollment or use your identity.
5. You Are Pressured to Act Immediately
Statements such as these should make you stop and verify the information:
‘This offer expires today.’
‘You must change plans.’
‘You will lose your benefits if you do not enroll now.’
‘Everyone in your area is being moved to this plan.’
‘This is the best plan available.’
A legitimate agent should give you time to review your options, ask questions, and make your own decision. You should never be pressured to sign an enrollment form before you are ready.
6. An Advertisement Promises Benefits Without Explaining Eligibility
Be cautious of advertisements promoting grocery money, utility assistance, dental benefits, or money added to your Social Security check without clearly explaining eligibility requirements.
These benefits are not available through every plan, and some are limited to people who meet specific health or financial qualifications. Availability can also depend on where you live. Always verify an advertised benefit with the specific plan before enrolling.
7. Someone Offers Gifts or Money for Your Medicare Number
Never provide your Medicare number in exchange for cash, gifts, medical equipment, genetic testing, or other special offers.
Protect your Medicare card like a credit card. Share the information only with trusted healthcare providers, insurance companies, licensed agents assisting you with an enrollment, or others you know have a legitimate reason to request it.
8. Medical Supplies or Testing Kits Arrive That You Did Not Order
Fraudulent companies may send braces, diabetic supplies, urinary catheters, genetic testing kits, or other products you did not request and then bill Medicare.
Contact your doctor and Medicare before using unexpected items, and review your Medicare Summary Notices or plan Explanation of Benefits for services or supplies you did not receive.
9. Someone Comes to Your Home Without an Appointment
Medicare plans and agents are not permitted to come to your home uninvited to sell or promote a plan. An agent may meet with you at home when you request and schedule the appointment.
How to Protect Yourself
Ask for the caller’s name, agency, company, and telephone number.
Do not trust caller ID alone because telephone numbers can be disguised.
If you did not request a sales call or give permission to be contacted, hang up.
Contact the insurance company using the number on your plan card or official website.
Review your Medicare Summary Notices and Explanation of Benefits.
Work with a licensed agent you know and trust.
