Medicare Scam Calls Are Getting Smarter—How to Tell What’s Real

Medicare scam calls are fraudulent phone calls where scammers pretend to be representatives of Medicare or related health services. Their goal is to steal your personal, medical, or financial information. Scammers can use this information for identity theft or fraudulent billing. These scams target people who are enrolled in Medicare. Oftentimes, senior citizens are taken advantage of because of health issues that can leave them particularly vulnerable or because of a lack of awareness of developing technology and scams.

If you are a senior citizen or know someone who is, knowing how to recognize a medicare scam can help protect you. In this article, we’ll explain the motives behind medicare scams as well as how to identify them. We’ll also help you recognize real calls so that you don’t miss out on important information regarding your health care.

What Do Medicare Scam Calls Look Like?

There are some common tactics medicare scam callers will use to pressure a victim into action. Recognizing these tactics can help protect yourself and others.

First, scammers will pretend to be from Medicare. They will claim that they are calling from Medicare and need to “verify” your identity. They may use spoofed caller IDs to make it look like the call is from a legitimate government agency.

Once they gain your trust, they will request personal information. They may ask for your Medicare number, social security number (SSN), or bank account information. The caller might pretend that they need the information to issue a new card, verify your eligibility, or update your records.

Some victims can also be fooled by a good deal. Some scams include fake offers for free or low-cost medical equipment or services. For example, they might offer free back braces, COVID tests, genetic testing, medical alert systems, etc. paid for by Medicare. However, these offers are often just a way to elicit your Medicare number to fraudulently bill Medicare.

Finally, victims can be pressured into offering sensitive information over the phone in response to a threat. Some Medicare scam callers will try to scare people into supplying information under the threat of losing their benefits. Fearful that their benefits will be terminated, victims are pressured to comply.

The annual open enrollment period, which typically runs from October 15 to December 7, can see an increase in Medicare scam calls. U.S. adults already on Medicare use this time to evaluate their current coverage. Many actively look for information about the best plan and benefits during this time. Therefore, scammers swoop in and take advantage under the guise of being helpful guides. Really, though, they’re simply in the market for personal details, financial information, and money. 

How Have Medicare Scam Calls Gotten Smarter?

As technology evolves, so do scams. Scammers will always find ways to leverage tools and technology to achieve their malicious goals. Here are some ways Medicare scams have gotten smarter in recent years:

Caller ID Spoofing and Robocall Technology

Scammers now use spoofed numbers that appear local or even display as “Medicare” or a known hospital. Robocalls can use automated systems to mass-dial thousands of numbers per hour, often with AI-generated voice assistants that sound human.

Personalized Information

Some scammers have access to real personal data (like your name, age, address, doctor’s name, etc.) from breaches or the dark web. Access to this information makes their pitch sound legitimate. It allows them to sound like they already know you’re a Medicare beneficiary.

Scripted Empathy and Natural Conversation

Instead of robotic scripts, scammers now use natural-sounding dialogue, sometimes even pausing or responding to your tone. They use emotional manipulation, offering “free help” or acting concerned about your health or benefits.

Medical Device and COVID-Related Offers

Scammers now align their pitches with current health trends. Free COVID-19 tests, at-home genetic testing, pain relief braces, diabetic monitors, etc. are often disguises for Medicare billing fraud.

Fake Follow-Up Calls or Mailings

Some scammers send fake letters or make a second follow-up call pretending to be your doctor’s office or insurance. Others pretend to be from private Medicare Advantage plans or offer assistance enrolling in new benefits.

Impersonating Real Government Programs

Scam callers may reference actual changes to Medicare laws or benefits (like new ID cards, supplemental programs, or open enrollment) to add credibility. Some even impersonate Social Security Administration (SSA) agents and link your benefits together to seem more official.

What Are the Signs of a Real Medicare Call?

While Medicare rarely makes unsolicited calls, there are some exceptions where real calls do happen. However, Medicare will never call you uninvited to ask for personal or financial information. You should also never share your Medicare number or other sensitive information over the phone unless you’re sure you’re speaking with a verified provider. But how can you be sure?

One of the biggest signs of a legitimate call is in response to contact you recently initiated. Medicare or a related agency may call you back if you called them first or if you requested help with an application, appeal, or claim.

Second, the caller should clearly identify him- or herself. A legitimate caller will provide their full name, the agency or company they work for, and why they are calling.

The purpose of legitimate Medicare calls will be specific and relevant. For example, a legitimate call might follow up on a recent claim or appeal. You might receive contact from a Medicare health or drug plan you’re already enrolled in. Or, you might receive a call about scheduling for a pre-arranged Medicare home health or telehealth visit.

Furthermore, a legitimate caller will NOT pressure you. Medicare representatives will never threaten to cancel your benefits, demand immediate action or payment, or ask you to act right away to avoid losing coverage.

Legitimate Medicare callers will also NOT ask for full sensitive information out of nowhere. A real Medicare call may confirm limited details like your ZIP code or the last 4 digits of your Medicare number. However, they will NEVER ask for your full SSN, your banking information, or the purchase of products or “free” items you did not request.

Finally, legitimate callers should offer you a call-back number like 1-800-MEDICARE (1-800-633-4227) or the plan’s official customer service number.

How to Protect Yourself and Others from Medicare Scam Calls

So what should you do if you get a Medicare scam call? Well, hang up immediately. You don’t owe anyone any information or explanation. Besides, it might not even be a human on the other end!

You can report the scam to 1-800-MEDICARE and/or the FTC at reportfraud.ftc.gov. You might also consider alerting your doctor or health insurance provider.

To be safe against any scam, let unknown numbers go to voicemail. You can also sign up for call blocking services or apps. If something doesn’t feel right, hang up and call back. Call the official Medicare number or the number on the back of your Medicare card or plan ID card to confirm whether the call was legitimate.

Most importantly, never give your Medicare number or SSN over the phone unless you initiated the call and trust the provider. 

Phone Validation Tools Against Medicare Scam Calls

Phone validation tools use technology to analyze incoming call data and determine whether a phone number is real and active, trusted or suspicious, or associated with known scams or robocalls. These tools help identify, block, or flag suspicious calls before they reach a potential victim. They are used by phone carriers like AT&T and Verizon, spam blocking apps like Truecaller and RoboKiller, and even healthcare providers and businesses themselves to validate outbound calls.

Phone validation tools are an increasingly important part of the effort to combat Medicare scam calls. They act as a first line of defense, protecting vulnerable populations. 

First, caller ID verification protocols help ensure that the caller ID info is not spoofed. When enabled, your phone may show “Verified” for legitimate numbers or “Spam Risk” for suspicious ones.

Next, real-time scam detection tools cross-reference incoming numbers against global scam databases. Medicare scam calls are often reported quickly, so once a number is flagged, it can be blocked or labeled before it reaches others.

Phone validation tools can also block known robocall sources. Many scam calls originate from auto-dialing systems or recycled VoIP lines. Phone validation tools can detect these patterns and stop them before they ring.

Some tools assign a “reputation score” to a number, too. If a number has a high risk score—based on call volume, complaint reports, or known scam behavior—it can be automatically blocked or silenced. 

Finally, phone validation apps let users report Medicare scam calls directly. These reports are shared across the system and therefore improve the accuracy of scam detection over time.

Phone validation tools can reduce the number of scam calls that make it through. They make it easier to identify and report scams. And they help law enforcement and telecoms trace the origin of fraud.

The More You Know About Medicare Scams

Medicare scam calls have grown increasingly sophisticated. Now, they can use spoofed caller IDs, personalized information, and emotionally manipulative tactics to trick seniors into revealing personal and financial data. While distinguishing legitimate Medicare calls from scams can be challenging, key signs such as caller transparency, specific intent, and a lack of pressure or personal data requests can help identify genuine outreach.

Phone validation tools can play a critical role in combating these evolving threats. Medicare beneficiaries, caregivers, and educators should promote awareness of these technologies and encourage their use to significantly reduce the risk of fraud and protect the vital personal information of vulnerable senior citizens.