Medicare scam calls are easy to spot if you know what to look for. When a stranger offers you something "free" that "Medicare covers" and asks for your Medicare number, treat it as a scam. Hang up. A test or brace Medicare pays for is ordered by your own doctor, not a stranger on the phone. Medicare itself says it "will never call you to sell you anything or visit you at your home." (Source: Medicare.gov, Reporting Medicare fraud & abuse)
It's tempting to call this Medicare's problem, since Medicare pays for it. But a fake claim filed in your name can prevent you from recieving an real test or medical appliance you actually need.
The Medicare scam playbook: five red flags to watch for
Ruth, 74, gets a call from a "Medicare screening program." She qualifies for a free genetic cancer test, fully covered. They just need her Medicare number. A swab kit arrives. Months later, her statement lists thousands of dollars in genetic tests ordered by a doctor she has never heard of.
Every version of this scheme has the same five steps:
- Someone you don't know reaches out first. A phone call, or a booth at a health fair, church event or senior center. Prosecutors have described "deceptive telemarketing campaigns" aimed at Medicare patients. (Source: U.S. Department of Justice, June 30, 2025; Associated Press via Bay News 9, 2019)
- The offer is "free." In one documented scheme, callers offered "a free orthotic brace." (Source: KFF Health News, 2019)
- They ask for your Medicare number, often with other personal details. In one 2025 federal case, prosecutors said the defendants used artificial intelligence to create fake recordings of Medicare beneficiaries supposedly consenting to receive products. (Source: U.S. Department of Justice, June 30, 2025)
- A doctor you never met signs the order. In one set of federal cases, tests and equipment were "ordered without any patient interaction or with only a brief telephonic conversation." (Source: U.S. Department of Justice, July 20, 2022)
- A box shows up, or just a charge. A kit or brace arrives, or a claim simply appears under your name. Prosecutors describe claims for "products and services the beneficiaries did not request, need, or receive." (Source: U.S. Department of Justice, June 30, 2025)
The product changes, the playbook doesn't
These are examples of the pattern, not a complete list. (For a billing pattern we're watching now, see the dated box below.)
- Cancer genetic tests (2019). Thirty-five defendants were charged over $2.1 billion in alleged fraudulent Medicare charges. (Source: U.S. Department of Justice, September 2019)
- Back, shoulder, wrist and knee braces (2019). Twenty-four people were charged over $1.2 billion in alleged losses. (Source: U.S. Department of Justice, April 2019)
- Heart genetic tests (2022). Telemarketers "lured thousands of elderly and/or disabled patients," in cases that included some of the country's first prosecutions tied to heart genetic testing. (Source: U.S. Department of Justice, July 20, 2022)
- COVID-19 test kits (2022 to 2023). People got at-home tests they never ordered. One beneficiary got 32 in 10 days. (Source: KFF Health News, May 2023)
Why a scam against Medicare ends up costing you
You probably won't get a bill, which is why people shrug these calls off. But a fake claim doesn't vanish once Medicare pays it. It sits in your history.
You can be denied equipment you actually need
At a March 2026 House Energy and Commerce oversight hearing, CMS Deputy Administrator Kimberly Brandt described people talked into a motorized scooter they didn't qualify for. Later, when they truly needed a wheelchair, they couldn't get one. "Those are the types of things that we see all the time," she said. (Source: House Energy and Commerce Committee hearing video, March 2026, at 1:10:22)
For most equipment, Medicare usually won't pay for a second item that does the same job within about five years of the first one's delivery. (Source: 42 CFR 414.210(f)) The main exception is a change in your condition that your doctor documents. (Source: Noridian, Same or Similar Denials)
So a brace you never needed can block the brace you do. It's not a permanent bar, but it's a fight. Your levers are below.
A fake test can block a real one
Genetic tests work the same way. Four of Medicare's regional contractors, which together cover more than half the states, limit each specific inherited-gene test to "one per lifetime" and treat any test that looks at "the same germline genetic content" as duplicative. (Source: CMS, L38351 (Noridian); L38274 (Palmetto GBA); L38288 (CGS); L38429 (WPS)) So a swab you gave a stranger can lead Medicare to deny the test your own doctor orders years later.
A false diagnosis in Medicare's billing records
To get paid, the paper trail has to list a reason, which will usually mean ascribing you a diagnosis that isn't true. That diagnosis now sits in Medicare's billing records that could lead future physicians astray when new medical issues arise.
Being signed up for hospice can block other care
Some schemes enroll people in hospice without their knowledge. Medicare is supposed to keep paying for health problems unrelated to the terminal illness. (Source: Medicare.gov, Hospice care) Once Medicare's records show you in hospice, claims from your other doctors are denied unless they're coded as unrelated, and a doctor who doesn't know about the enrollment won't code them that way. (Source: CMS, Medicare Claims Processing Manual, Chapter 11, §40.2 and §50)
The Associated Press reported on a 71-year-old California woman who found out she'd been enrolled in hospice when a claim for an allergy test was denied. She put off appointments and a colonoscopy. Eight months later, Medicare recognized her as a victim of fraud. (Source: Associated Press via 10News)
Before it happens: how to say no
A caller who wants your Medicare number doesn't need a reason from you. "No" and hanging up is the whole response, and nobody legitimate will be offended by it.
Never give your Medicare number to someone who called you
Medicare's rule: don't share your Medicare number "with anyone who contacts you by phone, email, or in person, unless you contacted them first and gave them permission to contact you." (Source: Medicare.gov, Your Medicare card) Medicare or someone representing it asks for personal information only in limited situations, like returning your call after you've joined a plan, reported fraud or left a message. (Source: Medicare.gov, Reporting Medicare fraud & abuse)
Equipment suppliers have their own rule: a Medicare supplier must agree not to call you about a covered item unless you gave it written permission, it's calling to arrange delivery of an item it has supplied to you, or it has supplied you a covered item in the past 15 months. (Source: 42 CFR 424.57(c)(11)) A "free brace" call from a supplier you've never dealt with breaks that rule.
The same goes for your Social Security number, your bank details and your date of birth. If you need a test or a piece of equipment, your own doctor orders it, and the people who deliver it already have what they need.
Block the calls
Ask your phone carrier what call-blocking tools it offers, and let unknown numbers go to voicemail. A call that matters leaves a message; these calls usually don't.
Already gave your number out, or found something on a statement you didn't order? That's the next section, and the sooner you work through it the less a scammer can bill in your name.
After it happens: what to do if you gave out your Medicare number
Work through the steps below:
Check your Medicare Summary Notice for unordered supplies and tests
If you recieved something you didn't order, don't use it. Keep the box and label as they show who billed under your name.
Your Medicare Summary Notice is mailed every 6 months if you got any services or supplies in that period. (Source: Medicare.gov, Medicare Summary Notice) You don't have to wait for it: you can "create a secure Medicare.gov account to view your Original Medicare claims as soon as they're processed." (Source: Medicare.gov, Reporting Medicare fraud & abuse) With a Medicare Advantage plan, check the statements your plan sends instead.
Look for:
- a lab, supplier or doctor you've never heard of
- several genetic tests on the same date
- braces, kits or supplies you never got
- hospice or home health you never agreed to
Don't skip a line because it says you owe $0. That's how most of these claims look. If you have Medicare Advantage, check out our Medicare Advantage overbilling checklist.
Ask about getting a new Medicare number
Call 1-800-MEDICARE and ask whether your number can be changed. CMS's guidance for providers says beneficiaries "can ask to change their MBIs" (the Medicare number) when it's compromised. (Source: CMS, New Medicare Card: Providers & office managers)
What a new number does and doesn't do:
- It blocks claims for services dated after the change.
- It doesn't stop claims for earlier dates. Those can still be filed under the old number (Source: CMS, New Medicare Card: Providers & office managers), and providers have up to a year after the date of service to file. (Source: 42 CFR 424.44) Keep checking your statements for about a year.
- It doesn't erase your history. Past claims stay with you, not with the number.
- You'll need to give it to your doctors, pharmacy and supplemental insurer.
Report the identity theft at IdentityTheft.gov, too. (Source: Medicare.gov, Reporting Medicare fraud & abuse)
Watch for denials of care you do need
If Medicare denies care you need because of a fake claim, don't accept the first answer.
- Appeal. With Original Medicare, appeal from your Medicare Summary Notice: circle the item, follow the instructions and file by the date printed on it. (Source: Medicare.gov, Appeals in Original Medicare) With a Medicare Advantage plan, appeal through the plan within 65 days of the date on its denial notice. (Source: Medicare.gov, Appeals in Medicare health plans) Include your fraud report and say you never received or needed the earlier item.
- Ask Medicare to reopen the fake claim. We found no published process for you to strike a fraudulent claim from your history. With Original Medicare, you can ask Medicare's contractor to reopen it within a year of its decision, or four years with good cause, but whether it does is up to the contractor, and a no can't be appealed. (Source: 42 CFR 405.980)
- Get your doctor's records. For equipment, documentation of a change in your condition is the most direct way around a denial for already having a similar item. (Source: Noridian, Same or Similar Denials) If a supplier hands you an Advance Beneficiary Notice, read it before signing.
- If you were put in hospice without agreeing to it, know that a valid election requires your signature or your representative's. (Source: 42 CFR 418.24) Call 1-800-MEDICARE, say you never chose hospice, and ask that the election be canceled. Back the request with your own written statement and a letter from your doctor saying you aren't terminally ill, and ask the Senior Medicare Patrol for help. A revocation alone won't fix it: it's filed with the hospice and can't be backdated. (Source: 42 CFR 418.28) Medicare's contractor can cancel an election outright, which is different from a revocation by the patient. (Source: CMS, Medicare Claims Processing Manual, Chapter 11, §30.3) Meanwhile, ask your other doctors to rebill the denied care with the code that marks it as unrelated to the hospice diagnosis. (Source: CMS, Medicare Claims Processing Manual, Chapter 11, §50) Expect months, not days.
- Get help with the appeal. Your State Health Insurance Assistance Program offers one-on-one Medicare counseling at shiphelp.org or 877-839-2675. (Source: SHIP National Technical Assistance Center) If normal channels stall while you need care now, ask your U.S. representative's office for a caseworker.
- Get a lawyer if a supplier or debt collector chases you, you're sued, or an appeal reaches a hearing. See your rights with medical debt collectors.
Where to report a Medicare scam
Reports like yours can feed the investigations behind takedowns like the ones above. But a report doesn't fix your own claims history or get a denied item paid, and you likely won't hear what came of it. If your coverage is affected, keep working the appeal.
Call 1-800-MEDICARE
1-800-MEDICARE (1-800-633-4227); TTY 1-877-486-2048. (Source: Medicare.gov, Your Medicare card) What to say:
"I want to report possible Medicare fraud. On [date], I gave my Medicare number to [a caller / a booth at ___] offering [a free genetic test / a brace]. Can you tell me whether any claims have been filed under my number since then, and by which labs or suppliers? I'd also like to ask about getting a new Medicare number. Can I have a reference number for this call?"
The agent can log the report and read you processed claims, but won't tell you what any investigation finds. If you're in a Medicare Advantage plan, call your plan too and ask the same question. You can also report to the investigations contractor for Medicare Advantage and Part D plans at 1-877-7SAFERX (1-877-772-3379). (Source: Medicare.gov, Reporting Medicare fraud & abuse)
Report to the Office of Inspector General hotline
Report suspected fraud online at tips.oig.hhs.gov, by phone at 1-800-HHS-TIPS (1-800-447-8477), or by mail. The Inspector General says the hotline will not confirm receipt and does not provide complaint status. (Source: HHS Office of Inspector General, Report Fraud) It's a pattern-reporting tool, not a case file on your claims.
Get one-on-one help from the Senior Medicare Patrol
This is where you get a person on your side. The Senior Medicare Patrol is a federal program: the Administration for Community Living, part of the Department of Health and Human Services, funds a project in every state, staffed largely by trained volunteers. (Source: Administration for Community Living, Senior Medicare Patrol) Call 1-877-808-2468 or use the state locator to reach yours. (Source: SMP Resource Center) Its counselors "when needed, serve as consumer advocates to resolve billing disputes," and they refer suspected fraud to state and federal investigators. (Source: Administration for Community Living, Senior Medicare Patrol) What to say:
"I gave my Medicare number to someone who offered me a free [test/brace]. I'd like help checking my Medicare statements and reporting it. I have [the date, the caller's number, anything they mailed]."
The Senior Medicare Patrol doesn't investigate or prosecute, and it can't force Medicare to reverse a claim.
Helping a parent who keeps getting these calls
If you're the daughter or son on the other end of the phone, start with the the two rules above, and read each statement together. Then:
- Get permission to call for them. Ask 1-800-MEDICARE what your parent needs to sign.
- Watch for the box. A brace or kit nobody ordered is your cue to check claims and call the Senior Medicare Patrol.
- If memory is a concern and your parent was signed up for something, especially hospice, contact Adult Protective Services too. APS is a social services program run by state and local governments, not a federal office, so the way in is your state's program: find it in the National Adult Protective Services Association's directory, or call the Eldercare Locator at 1-800-677-1116, a service of the Administration for Community Living. (Sources: APS Technical Assistance Resource Center; Eldercare Locator)
No shame, no lecture. These callers are professionals, and the pitch is built to sound like Medicare.
Why this keeps happening
Medicare mostly pays first and asks questions later. At the March 2026 hearing, Committee Chairman Brett Guthrie described CMS's reliance on a "pay-and-chase model, processing claims first and pursuing fraudulent payments later." (Source: House Energy and Commerce Committee hearing video, March 2026, at 49:44) Asked how much of the stolen money comes back, Brandt said: "We don't have an exact estimate, but I would say probably 10%." (Source: House Energy and Commerce Committee hearing video, March 2026, at 41:15)
Medicare isn't the problem. The gap is, and it leaves the spotting to you, at your kitchen table.
The box below is a different kind of signal: a billing pattern in Medicare's 2024 data with no public enforcement action. It isn't evidence of fraud, and nothing in it shows these tests were sold by phone.