Medicare Enrollment: Recognizing Scams and Protecting Yourself
The Medicare Annual Enrollment Period (AEP), which runs from October 15 through December 7, 2025, is a critical time for millions of Americans to review and adjust their health coverage and confirm their 2026 plan aligns with their needs and budget. Unfortunately, this period of heightened activity and important decisions also attracts cybercriminals who want to exploit and defraud beneficiaries.
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Here’s the difficult truth: wherever there’s complexity, bad actors find ways to take advantage. Scammers often target seniors and those new to Medicare because they know you might be less familiar with the official rules and deadlines. Bad actors prey on confusion, urgency, and your desire to get the best deal (or cross one more chore off your “to-do list”).
We want you to feel confident and secure as you make your Medicare choices. So think of this article as your friendly guide to recognizing red flags.
Clayton LiaBraaten, senior executive industry expert at Truecaller, a global caller ID and call blocking app platform, said these are the most common scams and warning signs every Medicare beneficiary and their family should watch for during the enrollment period.
The unsolicited “Medicare Official” call
This tactic is used the most often. You receive an unexpected call, text, or email from someone claiming to be from Medicare, Social Security or another government agency. They might say that your information isn’t complete or that you qualify for a better plan.
Here’s why they call: Scammers know that many older generation folks still answer the phone and that they tend to treat incoming communication as a call to action. These criminals can easily access public information and social media to find “older” targets.
The golden rule: Medicare and Social Security will rarely call you unprompted to sell you a plan or ask for personal information. If you didn’t initiate the contact (you didn’t call them first), treat any calls from someone saying they’re from one of these agencies with extreme suspicion.
Your defense: Don’t engage. Don’t confirm personal details — not even your name or address. Hang up immediately (or, if you’re like my grandmother, hold the receiver to the airhorn you keep next to the phone and activate it). Don’t worry about manners when you’re dealing with someone who’s trying to steal from you.
High-pressure sales tactics and “limited-time” offers
A scammer’s favorite weapon is false urgency. They’ll insist you must enroll in a plan today, often threatening that you’ll lose your current coverage, face penalties, or miss out on a special, limited-time offer.
How they trick you: These high-pressure tactics are designed to make you panic and completely bypass any critical thought and deliberate consideration. Bad actors want you to make a rushed, on-the-spot decision.
The reality: The enrollment period lasts several weeks for a reason — to give you time to do your research, ask questions, and make a thoughtful, well-informed decision. Any legitimate Medicare agent or representative will respect your choice to take the time you need before you commit to a plan and enroll.
Your defense: Don’t make an on-the-spot decision. Ever. State clearly that you need time to review the information and consult with a family member or trusted advisor. If the person on the other end of the phone pushes back, gets aggressive, or refuses to give you more time, it’s a huge red flag that they’re trying to scam you. Just hang up.
The “gift” or “free service” offer in exchange for your Medicare number
Imagine receiving a generous offer for free medical supplies, a no-cost genetic testing kit, or a good-sized gift card. The scammer’s lure? The word “free.” The catch? You must provide your Medicare number to claim your gift or service.
How they trick you: Your Medicare number is just as valuable as your Social Security number or a credit card number. This number is the key they use for fraudulent billing. Once a cybercriminal has it, they can bill Medicare for thousands of dollars in services or equipment you never received.
The reality: There’s no legitimate reason for someone to offer you a retail gift, cash, or unnecessary medical test in exchange for your Medicare ID.
Your defense: Guard your Medicare number carefully. Never give it out to anyone except your trusted healthcare providers or a licensed agent you contacted to assist with enrollment. If a “gift” requires your Medicare ID, walk away.
The bogus “plan representative” at your door
Your doorbell rings unexpectedly, and when you open it, your unannounced visitor introduces themself as a “Medicare representative” or a plan agent. Unfurl a flashing, bright red flag.
The reality: Legitimate Medicare rules strictly prohibit unsolicited door-to-door healthcare plan marketing. While a licensed agent may meet with you if you schedule an appointment first, they’re absolutely not allowed to knock on your door cold-selling a plan.
Your defense: Do not let them into your home. Do not feel obligated to be polite. Do not provide any information whatsoever. Just close the door. If you feel threatened or they become overly aggressive, report the incident to your local law enforcement or the Senior Medical Patrol (SMP).
The fake billing or overpayment scam
If you receive a call or letter stating that you owe money for a Medicare service you never received, or that you’ve been overpaid and need to send the balance in, treat this communication with extreme skepticism.
How it works: Scammers count on your confusion about medical bills. They hope you’ll just pay up without questioning it, or send them money to refund an “overpayment.” These criminals may even try to get your bank account details for a direct deposit refund (which they’ll use to steal your money).
What to remember: Always review your Medicare Summary Notices (MSNs) carefully. If you see a charge for a service you didn’t get, or someone you don’t recognize claims you owe money, contact your doctor’s office and Medicare directly to verify. Never give out your bank details to someone who calls you claiming an overpayment. (Honestly, it’s best practice never to give out bank details over the phone in general.)
Your Safest Bet
Stick to official and approved sources to find and enroll in a Medicare plan:
- Official Medicare Plan Finder website: Medicare.gov
- Call 1-800-MEDICARE (1-800-633-4227)
And if you suspect illegal activity, fraud, or abuse, report it immediately by calling Medicare, contacting your state’s Senior Medicare Patrol (SMP), or filing a complaint with the Office of the Inspector General (OIG) at 1-800-HHS-TIPS.
- Call 1-800-MEDICARE (1-800-633-4227).
- Contact your state’s Senior Medicare Patrol (SMP).
- File a complaint with the Office of the Inspector General (OIG) at 1-800-HHS-TIPS (1-800-447-8477), which is the fraud hotline for the U.S. Department of Health and Human Services.
Proactive steps for safe and secure enrollment
The open enrollment period is your opportunity to take charge of your healthcare. Recognizing these common red flags and taking proactive steps will protect you from becoming a victim of scammers. LiaBraaten suggested following this checklist to enroll safely and safeguard your personal information:
- Be the initiator. When you want to explore plans, you make the call. Start with official, trusted sources like your State Health Insurance Assistance Program (SHIP) for free, unbiased counseling, or contact licensed, reputable brokers that you have vetted yourself.
- Build a digital defense. A simple first step is to register your phone numbers on the Do Not Call Registry. For a more robust defense, consider adding a call-screening service to your phone. These services use technology to work in the background, helping you to distinguish a legitimate call from your doctor versus a cybercriminal, stopping scams before they reach you.
- Verify everything. If an agent contacts you claiming to represent a major insurance company, always ask for their full name, license number, and a direct callback number. Then, hang up and call the insurance carrier’s official public number (found on its website) to verify the agent’s legitimacy.
- Report suspicious activity. Don’t get frustrated. Get empowered. Report fraudulent calls to the FTC and your state’s Attorney General. Also, regularly check your Medicare Summary Notice for any services you didn’t receive, and report those discrepancies immediately.
