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How To Fight

Medicare Fraud


It’s an unfortunate truth, but health care fraud drives up costs for everyone in the health care system.

Fraud schemes often depend on identity thieves getting hold of people’s Medicare numbers. So guard your Medicare number. Treat it as you would a credit card.

What can you do to protect yourself from health care fraud? Here are some tips:


Don’t share your Medicare number or other personal information with anyone who contacts you by phone, email, or by approaching you in person, unless you’ve given them permission in advance. Medicare will NEVER contact you and ask for your Medicare number or other personal information.

Tell your friends and neighbors to guard their Medicare number.

Don’t ever let anyone borrow or pay to use your Medicare number.

Review your Medicare Summary Notice to be sure you and Medicare are only being charged for services you actually received.

Be wary of salespeople who knock on your door or call you uninvited and try to sell you a product or service.

Don’t accept items received through the mail that you didn’t order. You should refuse the delivery and/or return it to the sender. Keep a record of the sender’s name and the date you returned the items.


Fraudsters often surface during Medicare’s open enrollment season, which runs from Oct. 15 to Dec. 7. So if you’re planning to enroll in a Medicare Part C health plan (Medicare Advantage) or Part D prescription drug plan:

Be suspicious of anyone who contacts you about Medicare plans unless you gave them permission.

There are no “early bird discounts” or “limited time offers” for Medicare plans.

Don’t let anyone rush you to enroll by claiming you need to “act now for the best deal.”

Be skeptical of free gifts, free medical services, discount packages, or any offer that sounds too good to be true.

Any promotional items you’re offered to enroll in a Medicare plan must be worth no more than $15. And these items can’t be given on the condition that you enroll in a plan.

A common ploy of identity thieves is to say they can send you your free gift right away – they just need your Medicare number to confirm. Decline politely but firmly. Remember: it’s not rude to be shrewd.

If you suspect a health care fraud, report it by calling 1-800-MEDICARE (1-800-633-4227). You can learn more about protecting yourself from health care fraud by visiting or by contacting your local Senior Medicare Patrol (SMP).

SMP is a wonderful, nonprofit organization. It’s made up of highly-trained volunteers who teach others about health care fraud. SMP volunteers show Medicare and Medicaid recipients how to protect against, detect, and report fraud. The volunteers are seniors and professionals such as doctors, nurses, accountants, investigators, law enforcement personnel, attorneys, and teachers.

SMP is dedicated to the idea that working with healthcare users to prevent fraud will help protect our citizens’ health as well as the Medicare and Medicaid programs.

To find the SMP in your state, go to the SMP Locator at



David Sayen is Medicare’s regional administrator for Arizona, California, Nevada, Hawaii, and the Pacific Territories. You can always get answers to your Medicare questions by calling 1-800-MEDICARE (1-800-633-4227).