Every scam has its season.
And the scammers are ready to go for the Medicare Open Enrollment period that runs from Oct. 15 through Dec. 7. It is the same time each year when those on Medicare can make changes to their coverage. The changes you make during this window would be effective Jan. 1.
The open enrollment period for the Health Insurance Marketplace under the Affordable Care Act begins Nov. 1. And scammers can target those consumers shopping for coverage, too.
This year, it's essential for many consumers to realize that scams don't always start with just a call out of the blue. Sometimes, you can connect with the bad actors simply by trying to research the best medical plan for you online.
Medicare scammers hope you'll find them online
The Federal Trade Commission put out an alert in
late September warning that consumers shouldn't just simply click on link for a search result.
"Remember: Scammers and dishonest businesses sometimes pay to appear at the top," the FTC stated.
The crooks make themselves appear legitimate by hiding behind keywords and official-looking logos. Their goal, according to the FTC, is to trick you into believing that you’re at the real Healthcare.gov or Medicare.gov. The web address can seem similar to a government website when it's not.
"If you use the link or phone number in the ad, you might end up paying for a scammy plan that’s not health insurance, or expose yourself to medical identity theft," the FTC said.
Scammers play into the uncertainty that surrounds Medicare open enrollment season when Medicare beneficiaries are encouraged to review their health care coverage and make any necessary changes before the Dec. 7 deadline.
During this window, those with Medicare can change their Medicare health insurance plans, such as Medicare Advantage or stand-alone Part D Prescription Drug plans, for 2027. It's also time to compare what's offered under current plans.
Medicare scammers may pose as Medicare representatives, health care providers, medical supply vendors, or insurance agents, according to an online blog written by Ryan Ramsey, the National Council on Aging associate director of health coverage and benefits.
"Scammers can sound very professional and persuasive over the phone," he wrote.
And many fraudsters, he noted, use AI technology to create convincing websites, emails, and print materials that appear to be from trustworthy organizations.
Some scammers might wrongly warn that you'll lose benefits unless you verify information or change plans immediately. Others may claim you're owed a "refund" as a ruse to get your banking information.
What Medicare crooks want beyond your money
Mary Johnson, an independent Social Security and Medicare policy analyst, told the Detroit Free Press that Medicare scam victims face risks that go beyond losing money.
"Scams can cost not only financially but could put one's health care and health at risk," Johnson said.
If your Social Security number and Medicare numbers end up being stolen, she said, you're likely to be a victim of identity theft.
Fraudsters may use stolen or inappropriately obtained information from Medicare beneficiaries to submit fraudulent claims for unneeded or never provided services, according to a report by the U.S. Government Accountability Office.
In 2023 and 2024, for example, the Centers for Medicare & Medicaid Services, which oversees Medicare, suspended payments to 15 providers involved in a scheme that allegedly billed Medicare for more than $4 billion in urinary catheters that were never supplied.
In some cases, fraudulent medical care, even some surgery that you didn't have, can show up on your record. As a result, Johnson said, the ID theft victim could be rejected for some treatment down the line when prior authorizations are required. You also could face longer waits for care, surprise bills and extra stress as you try to correct the record.
According to the FTC, once you give your Medicare number to a scammer, the scammer can use it to order things like neck braces and other medical equipment, which can result in denied benefits later if you need them or unexpected bills.
That Medicare call about a new card – fake
One common scam already being reported to the AARP Fraud Watch Network Helpline involves someone calling and claiming that Medicare is issuing new cards.
"Scammers may say something like, 'Medicare cards are being replaced with hard plastic cards, like credit cards, and we need your Medicare number to send you one," said Amy Nofziger, senior director of victim support for the AARP Fraud Watch Network.
It's not true.
Some claim that Medicare is switching to a card with a chip in it. Or they say you now need a black and white card instead of one that is red, white and blue. Scammers want to trick you into handing over your Medicare number.
"Be extremely cautious of anyone who contacts you unexpectedly and asks for your Medicare number," Nofziger said.
Medicare does not need to call you to verify your Medicare number because they already have that information, she noted.
The AARP Fraud Watch Network Helpline also receives many calls from consumers who lost their wallets or had their wallets stolen, Nofziger said. The senior is at wit's end when their Medicare card is in that missing wallet.
Nofziger said it's best to keep your Medicare card in a secure place at home rather than carrying it in your wallet every day. Bring it with you only when you know you'll need it.
Nofziger warns that consumers need to re-evaluate any information they might receive out of the blue about Medicare coverage, too.
In some cases, consumers complain that someone on the phone called and told them that Medicare would cover their “knee braces” fully.
"However, when Medicare stopped the transaction, the sham company would try and bill the beneficiaries for those braces, often times at prices that far outweighed standard costs," Nofziger said.
Health insurance open enrollment already can be confusing
Much can be confusing when you're dealing with health insurance, and crooks know how to take advantage of the Medicare muddle.
"Scams can seem super legit at the time, and scammers count on confusion and the natural human tendency to choose quick and easy rather than to take time to check things out," Johnson warned.
Johnson said it doesn't help consumers that algorithms enable advertisers and others to track what you are doing online, what you're reading, researching and buying. "We are literally being followed," she said.
As we become more concentrated with digital online tools, she said, older consumers can become easy pickings for scams, Johnson said.
Johnson noted that outright scams aren't the only risks during open enrollment season.
"One danger that older consumers encounter is incomplete information even from established insurers — which can lead to losing Medigap coverage when one leaps into a Medicare Advantage plan without first looking into the details of whether it would be a good match for your needs," Johnson said.
It's possible to get help to compare costs, coverage, and plans through your State Health Insurance Assistance Programat shiphelp.org or call 877-839-2675. Or you can contact the Michigan Senior Medicare Patrol at 844-677-6424 for information about Medicare scams and fraud prevention.
How to avoid scams
- If you did not initiate the call, be extra cautious and do not respond. Block spam calls.
- Type Medicare.govdirectly into the search engine or you can phone 800-633-4227. You can research options for coverage here.
- If searching for coverage under the Affordable Care Act, you'd go to the Health Insurance Marketplace at HealthCare.gov or call 800-318-2596 to compare health insurance plans, including checking out your coverage or finding out if you qualify for extra savings.
- You don't want to be confused and think you're dealing with a government site when you're not. Take a careful look to spot a paid advertisement. Look for small “Ad” or “Sponsored” labels next to search results to identify paid ads.
- Only share your Medicare card and other health care identification cards and numbers with trusted sources such as your health care providers
- Protect your Medicare card like a credit card or banking information. Don't hand it over to someone who simply appears friendly. Do not provide your Medicare number to a stranger who calls, visits or approaches you in a public setting.
- Medicare already has your Medicare number. They will not call you and ask you for it over the phone.
- If you suspect a health insurance scam, you can report it to the FTC at ReportFraud.ftc.gov and your state attorney general. You can reach the Michigan Department of Attorney General's Consumer Protection Division at 517-335-7599 or file a complaint online.
- If the scam involves Medicare, report it at Medicare.govor 800-633-4227. Only share your Medicare card and other health care identification cards and numbers with trusted sources such as your health care providers.
Contact personal finance columnist Susan Tompor: stompor@freepress.com. Follow her on X @tompor.
This article originally appeared on Detroit Free Press: How crooks are setting traps online during insurance open enrollment
