With reports of scams in all areas involving consumers of all ages, it is important to reiterate the importance of preventing yourself or your family member from being a victim to Medicare related scams. The following are tips to avoid Medicare related scams:

Guard your personal information

If you receive a call from an individual who identifies themselves as calling from Social Security or Medicare offices, regardless of what they want to discuss, remember that NO ONE from the Social Security or Medicare offices will ever ask for your financial/banking information or credit card information.

Guard your identity. If someone calls from the Social Security office or the Center for Medicare and Medicaid Services (also known as “CMS”), the individual will never ask for your social security information unless you have applied for low-income assistance and the social security number you put on your application for assistance is not correct. The purpose of the call will be solely to obtain the correct information. If you have not applied for low-income assistance, this is an automatic trigger that the call is not valid. If you have applied for low-income assistance, make sure you verify that the individual is actually calling from the Social Security Administration or CMS. Ask them if you can call them back, obtain the telephone number and the name of the individual, and call them back to provide the information.

Guard your personal information from identity thieves posing as sales agents. Legitimate plans may ask for your Social Security number, but only when you are actually enrolling in a particular plan. Legitimate sales agents or representatives of an insurance company who are actually enrolling you in a specific plan may ask for your credit card or bank account information if you are arranging to make automatic payments for your premiums. If you are not comfortable in providing the information then you need to speak up. Ask them if there is an alternative method for providing the information. A legitimate agent or sales representative will offer different options, such as providing a paper application to you for you to provide the information and return to them via electronic delivery (e-mail), facsimile or regular U.S. mail.

If someone says “you must join a certain plan or you will lose your original Medical benefits,” IT IS A SCAM. Enrollment in Medicare supplements (also known as “Medigap”) plans, Medicare Advantage (also known as “MA” or “MAPD”) plans and Prescription Drug Plans (also known as “PDP”) are voluntary and enrollment in these programs is not mandatory for keeping your original Medicare benefits.

Not all drugs plans are Medicare Part D

Do not confuse other types of drug coverage with Medicare Prescription Drug Plans. Only plans approved by Medicare can be marketed as Medicare Prescription Drug Plans. Approved plans will have a seal on their materials with “Medicare Rx” in large letters and “Prescription Drug Coverage” in smaller letters under that. Check with Medicare to make sure that the plan you are considering is approved. Only written material that has been approved by the Center for Medicaid and Medicare Services can be used in soliciting a plan.

Medicare prescription drug plans should come with no strings attached. Companies and organizations can offer modest prizes or gifts with no cash value to promote their Medicare Prescription Drug Plans. It is illegal to require any one to join a Prescription Drug Plan in order to get a prize or gift.

Sales materials that looks like it is from the government

Some sales mailings look like they are from  the Center for Medicare and Medicaid Services. Individuals trying to scam often try to impress consumers with official-looking sales materials that look like they are a government document or from a government agency.

Check the list of Medicare-approved plans available in your area

The list of approved plans and other information about the program are available at www.medicare.gov and by calling toll-free 1-800-633-4227 (TTY users should call 1-877-486-2048.) Medicare Advantage and Prescription Drug Plans, which are offered by private companies and organizations must meet specific federal standards and be approved by the Centers for Medicare and Medicaid Services.

Know the Medicare Rules

Know the law on how Medicare insurance plans can be marketed. It is illegal for companies or organizations marketing Medicare Advantage and Medicare Prescription Drug Plans to come to your door uninvited or to send you unsolicited e-mails. Companies and organizations can call to promote their drug plans, but it is illegal for them to sign people up during those calls. Enrollment into a Medicare Advantage or Prescription Drug Plan can only be done during an inbound call for the sole purpose of enrolling into a specific plan.

Additionally, companies soliciting or selling Medicare Advantage and Medicare Prescription Drug Plans must also obey telemarketing laws. It is illegal for them to call before 8:00 a.m. and after 9:00 p.m. It is also illegal for these companies to call individuals whose telephone numbers are on the state or federal “Do Not Call” registry (with some exceptions), or call people who have asked not to be called. For more information about your telemarketing rights and to put your phone number on the federal “do not call” registry, call 1-888-382-1222.



Medicare Pathways, Inc.  1-866-466-9118

Visit our Medicare News Blog