Medicare will never call you unsolicited to ask for your Medicare number, Social Security number, bank information, or other personal, financial, or health information. Legitimate Medicare representatives do not call to sell products, offer "free" equipment/services, or demand payment over the phone. Hang up immediately if a caller asks for these details.
Medicare does not call you uninvited and ask you for personal or private information. You will usually get a written statement in the mail before you get a phone call from a government agency. Calls requesting health insurance information should not be trusted.
Here are some of the biggest Medicare mistakes to avoid:
By phone, we will always identify ourselves by name and the department we're calling from. We may ask for limited personal information (like your date of birth or address) to confirm your identity. We will never ask for your full Social Security number or any passwords.
Medicare will NEVER contact you (unless you ask them to) to ask for your Medicare number or other personal information or to send you a new card. Medicare already has your information. Don't ever let anyone borrow or pay to use your Medicare number.
You know you're being scammed on the phone if the caller uses high-pressure tactics, demands immediate payment via gift cards or wire transfers, asks for sensitive personal info (SSN, bank details), threatens arrest or fines, or offers "too-good-to-be-true" deals, as legitimate organizations won't use these aggressive, unusual methods. Real agencies won't threaten you, demand instant payment, or ask for passwords; they'll let you verify information independently.
Tips to avoid Medicare fraud
Never give your personal information to someone who calls you and asks for it. Thieves can try to trick you into giving them all or part of your number online or on the phone.
The Medicare "3-Day Rule" requires a beneficiary to have a qualifying 3-day inpatient hospital stay (admission day counts, discharge day doesn't) before Medicare will cover services in a Skilled Nursing Facility (SNF) for rehabilitation or skilled care, though this rule can be waived in certain Medicare Advantage plans or through specific Accountable Care Organization (ACO) initiatives. Time spent in observation or the Emergency Department doesn't count towards these 3 days, but new demonstration projects and waivers are emerging to offer more flexibility for patients needing SNF care.
Remember that Medicare will never call you to sell you anything or visit you at your home.
DO I HAVE TO RECORD ALL MY MEDICARE CLIENT CALLS? Yes, you must record all calls with beneficiaries (including clients) in their entirety, including enrollments.
Yes, you can opt out of Medicare (Parts A & B) by formally requesting termination through the Social Security Administration (SSA) or by a provider opting out of the system, but doing so for yourself can lead to significant late enrollment penalties and gaps in coverage, while a provider opting out allows them to see Medicare patients privately under strict contract rules. For individuals, opting out usually means losing valuable benefits, while for doctors, "opting out" is a specific process to avoid Medicare reimbursement rules and charge patients directly, requiring a formal affidavit.
If you know your Social Security information has been compromised, you can request to Block Electronic Access. This is done by calling our National 800 number (Toll Free 1-800-772-1213 or at our TTY number at 1-800-325-0778).
Medicare fraud happens in many ways. It most commonly occurs in: Billing for institutional facilities such as nursing homes, residential facilities, hospitals, home health, and hospice. Billing for physician visits and services not rendered or not medically necessary.
Block individual numbers on Android
If you're with T-Mobile, you can also use #662# to block all suspected spam calls on your Android.
People leave Medicare Advantage (MA) plans due to difficulty accessing needed care (especially with worsening health), restrictive provider networks, complex prior authorization rules, and dissatisfaction with care quality, often feeling trapped as their health needs grow despite initial low costs and extra perks that become limiting. Issues with provider availability, network changes, and sometimes misleading marketing also drive disenrollment, pushing people back to Traditional Medicare for greater freedom, notes KFF.
Scammers use phrases that create urgency, fear, or excitement, demanding immediate action like "Act now!" or "Don't hang up," and often involve requests for gift cards or Bitcoin, combined with threats of account compromise or promises of huge rewards (e.g., "You've won!") to bypass logic. Key tactics include isolation ("Don't tell anyone"), emotional manipulation (love bombing, family emergencies), and unusual requests to move money in specific ways (Bitcoin ATMs, secret accounts).
No, you can't get instantly hacked just by replying to a scammer's text, but you do confirm your number is active, making you a prime target for more sophisticated phishing, malware links, or social engineering attacks that can lead to a hack or identity theft later. Engaging opens the door for scammers to use basic info like your name to build trust and trick you into clicking dangerous links or revealing sensitive data, escalating the threat from a simple message to a full-blown security risk.