People on Medicare are targeted deliberately and constantly. The telephone calls are the worst of it, because they arrive in your home, they sound official, and they are designed to make you feel that not co-operating would be the risky choice.
This guide is a short set of rules that will keep you safe without requiring you to work out who is calling.
The one rule that covers almost everything
Medicare does not telephone you out of the blue.
Medicare communicates by post. There are narrow exceptions — if you have an open enquiry, someone may ring you back, and your own plan may call about something you started. But an unexpected call from someone claiming to be from Medicare, asking for information, is not Medicare.
It follows that you never need to identify a caller. You only need to hang up and telephone the number you already have.
The things nobody legitimate will ask for
Nobody from Medicare, and no legitimate agent, will ask an unexpected caller for:
- your Medicare number;
- your Social Security number;
- your bank details or a card number;
- a payment by gift card, wire transfer, cryptocurrency or a payment app.
The payment methods in that last line are conclusive. No government agency and no insurer has ever needed a gift card.
The scripts that come round
“Your Medicare card is expiring and we need to issue a new one.” Medicare cards do not expire. The switch away from Social Security numbers on cards happened years ago and required nothing from anybody.
“You qualify for free braces, a knee brace, or a diabetic supply.” Equipment fraud is one of the largest categories of Medicare fraud, and this is how it starts. The call comes first, the equipment arrives unordered, and the claim goes to Medicare in your name.
“You are eligible for free genetic testing / a free cancer screening kit.” A kit arrives, a swab is taken, and an expensive test is billed. Sometimes the results are never sent.
“We need to verify your details to keep your benefits active.” Benefits are not deactivated for failing to answer the telephone.
“I am calling about your Medicare Advantage plan” — from a company you have never dealt with. Cold calling Medicare beneficiaries to sell plans is against the marketing rules. An agent who does it is telling you what kind of agent they are.
What to do when one arrives
Hang up. You do not owe a stranger the end of a sentence, and there is no version of this where continuing helps you.
Then, if you want to check whether something real is going on, telephone the number on your own card, or 1-800-MEDICARE, or your plan’s number from your own paperwork. Never the number the caller gave you.
If you gave something away, telephone 1-800-MEDICARE and tell them. It is not embarrassing and they hear it every day. These calls are professionally designed and people who are neither foolish nor confused fall for them regularly.
The post is quieter but the same
Envelopes designed to look official arrive constantly, particularly in the autumn. Some are marketing dressed as government correspondence, which is unpleasant but legal. Some are outright fraud.
Genuine correspondence from Medicare or from your own plan refers to your specific coverage and does not demand an urgent telephone call to a number you do not recognise. When in doubt, telephone 1-800-MEDICARE and read them the letter.
Watching the statements
The other half of this is noticing when something has already been billed in your name.
If you are on Original Medicare you receive a Medicare Summary Notice. On an Advantage plan you receive an Explanation of Benefits. Neither is a bill. Both list what was billed for you.
Read them. If there is a service you did not receive, a doctor you have never seen, or equipment you never ordered, report it — to the provider first if it looks like an error, and to 1-800-MEDICARE or the Senior Medicare Patrol if it does not.
Fraud is usually caught by someone reading their own statement. There is a separate guide on how to read one.
Where to report
1-800-MEDICARE for anything to do with your coverage.
The Senior Medicare Patrol in your state — Ohio, Kentucky and Indiana each have one — is a free programme specifically for helping beneficiaries identify and report fraud.
Your State Health Insurance Assistance Program for free counselling from someone with nothing to sell.
What we do about it
We do not cold call. We do not knock on doors. We do not buy lists of names.
If somebody telephones you claiming to be from Clearview and you did not contact us first, it is not us. Hang up and ring our office number from this website.
That is not a marketing line. It is how you can tell.
General information, not advice
This guide describes how Medicare generally works. It is not advice about your situation, and rules, dates and figures change — verify anything that matters to a decision against Medicare.gov,1-800-MEDICARE, or your State Health Insurance Assistance Program, all of which are free.
Rights and rules vary by state; this describes Ohio, Kentucky and Indiana. Clearview Medicare Advisers LLC is not connected with or endorsed by the United States government or the federal Medicare program.
Not sure how this applies to you?
Tell us your birthday and whether you are still working. That is usually enough for us to say which periods apply to you and by when. No charge and no obligation.
