Medicare Open Enrollment Scams: How to Spot Them and What to Do

By the WinDailyGames Editorial Team

Every fall, between October 15 and December 7, Medicare runs its annual Open Enrollment period. It's the window when people with Medicare can change their drug plans, switch between Original Medicare and Medicare Advantage, or pick a new Advantage plan for the coming year. It is also, predictably, the busiest season of the year for Medicare scams.

The reason is simple. Scammers know that during these eight weeks, millions of people are expecting to hear about their Medicare coverage. A call about "your Medicare plan" feels less out of place in November than it would in March. The scammers count on that.

The single fact that defends you against most of these scams is this: Medicare will not call you uninvited. Medicare does not cold-call people to sell plans, verify your number, or offer you free equipment. If someone calls you out of the blue claiming to be from Medicare, you can stop listening.

Why Open Enrollment is scam season

During Open Enrollment, legitimate insurance companies advertise heavily, and licensed agents do make calls — but only to people who have given them permission to call, usually by responding to an ad or asking for information. What's illegal, and what marks a scam or a rule-breaking sales operation, is the unsolicited call.

There are federal rules that licensed Medicare agents must follow. They are not allowed to call you unless you asked them to. They are not allowed to show up at your door uninvited. They are not allowed to enroll you in a plan without your clear permission. An operation that breaks these rules is, at best, a sales outfit you don't want to deal with, and at worst a scam after your money or your identity.

The tactics you'll hear

A few scripts come back year after year. They're worth recognizing by name.

The "verify your number" call. The caller says they need to confirm or "reactivate" your Medicare number, or that you need a new card. They'll ask you to read the number off your card. A real Medicare card carries your Medicare Beneficiary Identifier — a string of numbers and letters that replaced the old Social Security–based numbers years ago. There is no separate number on the back of the card that needs "updating," and Medicare already has your number. Anyone asking you to recite it over the phone is collecting it to commit fraud.

The "free" offer. The caller offers free braces, a free knee brace, free genetic testing, a free back brace, or a "free" medical alert device — all you have to do is give them your Medicare number so they can bill it. This is one of the most common Medicare fraud schemes. The equipment is often worthless or never arrives, and your Medicare number gets billed for thousands of dollars in supplies you never received. That fraudulent billing can also cause real problems later when you need a device and Medicare's records show you already got one.

The pressure switch. The caller insists your current plan is being discontinued, or that you'll lose coverage unless you switch today. They push you to make a decision on the call. No legitimate agent needs you to decide on the spot, and your current plan is not going to vanish because you hung up to think it over.

The fake "Medicare" caller ID. The number on your phone may say "Medicare" or show a Washington, D.C., area code. Caller ID is trivially easy to fake, and scammers fake it constantly. What shows up on your screen is not proof of anything.

Red flags that hold up every time

A handful of patterns identify a Medicare scam no matter how the call is dressed up.

Medicare does not call you to sell a plan or to ask for your Medicare number — it already has it. An unsolicited call claiming to be from Medicare is the clearest single sign of a scam.

Nobody legitimate will tell you that you must decide right now. Urgency is a sales and scam tactic, not a feature of real Medicare coverage. Open Enrollment runs for eight weeks for a reason.

A "free" offer that requires your Medicare number is not free. It's a billing scheme. Guard your Medicare number the way you'd guard your Social Security number or a credit card.

If a caller becomes pushy when you say you want to think about it or check with a family member, that reaction tells you what you need to know. End the call.

What to do

If you get an unsolicited Medicare call, hang up. You don't owe the caller an explanation. You don't need to confirm or deny anything. Just hang up.

If you actually want to review your coverage during Open Enrollment, you have good free tools that don't involve trusting a stranger who called you. Medicare.gov has a Plan Finder that compares plans side by side. The single most useful thing it does is let you enter the specific drugs you take and see what each plan would cost you for those exact medications — which is where the real differences between plans usually live. You can also call Medicare directly at 1-800-MEDICARE (1-800-633-4227), a number you look up yourself, not one a caller gave you.

Every state also has a free State Health Insurance Assistance Program, known as SHIP, staffed by trained counselors who don't sell anything and have no plan to push. They will sit down with you and walk through your options. You can find your state's SHIP through Medicare.gov or by calling 1-800-MEDICARE.

If you think you've given your Medicare number to a scammer, or you spot charges on a Medicare statement for equipment or services you never received, report it. Call 1-800-MEDICARE, and report suspected fraud to the Office of Inspector General at 1-800-HHS-TIPS (1-800-447-8477). Reviewing your Medicare Summary Notices when they arrive is the simplest way to catch fraudulent billing early.

A note for the people who help

If you're the family member who handles a parent's or spouse's affairs, Open Enrollment is a good time to have the conversation directly: Medicare will not call them, no real offer is free in exchange for their Medicare number, and there's never a reason to decide on a single phone call. The unsolicited Medicare call is a cousin of the IRS phone scam and the Social Security suspension scam — same shape, different costume. A trusted authority, manufactured urgency, and a push to act before thinking. Naming the pattern out loud is most of the defense.

Where to learn more

Medicare's official site, including the Plan Finder and information on Open Enrollment: medicare.gov

The Federal Trade Commission's guidance on Medicare scams: consumer.ftc.gov

AARP's Fraud Watch Network helpline, staffed by trained volunteers: 1-877-908-3360

To report suspected Medicare fraud: 1-800-MEDICARE, or the HHS Office of Inspector General at 1-800-HHS-TIPS.