Why Agents Should Talk to Clients About Medicare Scams

Clients may already view you as a trusted source of Medicare information.

That trust gives you an opportunity to educate them before a suspicious call, email, advertisement, or text arrives.

Helping clients recognize fraud can:

• Protect their personal information
• Reduce confusion during AEP
• Strengthen their confidence in legitimate communications
• Protect the trust you have built
• Help them know where to turn when something feels wrong

Education over selling matters here.

You do not need to make clients fearful. Give them clear warning signs, simple protective steps, and a trusted process for verifying unexpected requests.

Common Medicare Scams Agents Should Recognize

Scams change over time, but many rely on the same tactics.

The “New Medicare Card” Scam

A caller claims the client needs a new, updated, or replacement Medicare card.

They may say the current card is expiring or that coverage will be canceled unless the client confirms their Medicare number, Social Security number, or payment information.

Medicare cards are provided at no cost. The FTC advises that legitimate Medicare representatives will not unexpectedly call, text, or email someone to request sensitive information or payment for a new card.

What agents can tell clients:

Never provide a Medicare number, banking information, or credit card number to an unexpected caller. Hang up and contact Medicare through an official number.

“Free” Medical Products or Services

A caller, advertisement, or online form may offer free:

• Medical braces
• Testing kits
• Durable medical equipment
• Genetic testing
• Prescription products
• Wellness services

The person may claim that Medicare will cover everything. They then ask for the client’s Medicare number or other personal information.

An offer should not be considered legitimate simply because the person says there is no out-of-pocket cost.

Encourage clients to speak with their healthcare provider and confirm that the product or service is medically necessary before sharing information.

Medicare Impersonation Scams

Scammers may claim to represent:

• Medicare
• A government agency
• A health plan
• A doctor’s office
• A pharmacy
• A licensed  agent
• A familiar insurance company

They may already know the client’s name, address, or other details. That does not make the communication legitimate.

Caller ID is not reliable proof. Scammers can manipulate the name or number that appears on a phone. The FTC recommends hanging up and calling 1-800-MEDICARE directly when someone is unsure whether a Medicare-related call is legitimate.

High-Pressure Enrollment Claims

A client may be told:

• “You have to enroll today.”
• “Your current coverage is being canceled.”
• “This is your last chance to receive your benefits.”
• “Everyone in your area is being moved to a new plan.”
• “You will lose Medicare if you do not act now.”

Urgency is one of the most common tools used by scammers.

Plan availability, benefits, costs, and eligibility can vary. Clients should verify claims before providing information or agreeing to an enrollment.

Phishing Emails and Text Messages

A message may appear to come from a carrier, government agency, pharmacy, or other trusted organization.

It may ask the recipient to:

• Click a link
• Open an attachment
• Verify an account
• Update payment information
• Confirm a Medicare number
• Respond immediately to avoid losing coverage

Unexpected links and attachments should be treated carefully.

Agents should follow the same advice in their own businesses. Do not enter login credentials through an unexpected message. Open the organization’s official website independently or contact a known representative.

Red Flags Clients Can Learn to Spot

Scams can sound professional. Some use familiar logos, convincing scripts, and personal information gathered from public sources or previous data breaches.

Teach clients to pause when someone:

• Contacts them unexpectedly
• Creates fear or urgency
• Requests a Medicare or Social Security number
• Asks for banking or credit card information
• Demands payment by gift card, cryptocurrency, or money transfer
• Promises guaranteed benefits or savings
• Refuses to provide information in writing
• Discourages them from speaking with a trusted family member or agent
• Requests remote access to their computer or mobile device

One warning sign may not prove fraud.

It is still a reason to stop, verify, and avoid sharing information until the request is confirmed.

Help Clients Use a Simple “Pause and Verify” Process

Give clients an easy process they can remember.

Pause

Do not provide information or make a decision during an unexpected call, email, or text.

End the Conversation

Hang up, close the message, or leave the website.

Clients should not use the phone number or link supplied by the person contacting them.

Verify Independently

Contact the organization using a phone number from an official website, membership card, plan document, or previous verified communication.

Report Suspicious Activity

Suspected Medicare fraud can be reported to 1-800-MEDICARE. Medicare also directs people to review their claims and report services, supplies, or equipment they do not recognize.

Clients can also contact their local Senior Medicare Patrol for help identifying and reporting potential fraud, errors, and abuse.

Use AEP to Start the Conversation

AEP is a natural time to remind clients about fraud prevention.

You can include a short scam-awareness reminder in:

• AEP preparation emails
• Appointment confirmations
• Client newsletters
• Educational events
• Social media content
• Annual review conversations
• Follow-up messages

Keep the message direct.

For example:

Medicare-related scams may increase during busy enrollment seasons. Do not provide your Medicare number, financial information, or payment to an unexpected caller. Contact me or Medicare through a verified number when something does not feel right.

Be careful not to turn scam education into fear-based marketing.

The purpose is to help clients feel informed and prepared, not frightened or pressured.

As you prepare your client communications, use our AEP checklist to make sure the rest of your busy-season strategy is ready.

Protect Your Own Business From Fraud

Clients are not the only targets.

Licensed insurance agents should also watch for fake carrier emails, fraudulent login pages, questionable lead vendors, altered commission communications, and messages requesting credentials or payments.

Protect your business by:

• Using multifactor authentication
• Creating unique passwords
• Verifying unexpected requests independently
• Limiting access to sensitive client information
• Keeping software and devices updated
• Reviewing lead sources carefully
• Documenting client consent
• Reporting suspected security incidents promptly

Agents and agencies may be responsible for vendors that perform lead generation, marketing, sales, or enrollment-related functions on their behalf. Lead vendors should follow applicable Medicare marketing rules, consent requirements, and data-sharing restrictions.

A cheap or fast lead is not valuable when the source cannot document how the client’s information was collected and shared.

Compliance always matters.

What Should an Agent Do When a Client Reports a Scam?

Stay calm and avoid making promises about the outcome.

Start by documenting:

• What happened
• When the contact occurred
• How the person made contact
• What information was requested
• What information the client provided
• Whether an enrollment, purchase, or payment occurred

Encourage the client to contact Medicare, their plan, their financial institution, or the appropriate authority based on what was compromised.

Agents should also follow their organization’s reporting procedures and contact their compliance officer when the situation may involve unauthorized enrollment, misuse of beneficiary information, questionable marketing, or another compliance concern.

Scam Education Builds Long-Term Trust

Fraud prevention is not only an AEP topic.

A suspicious call can happen in March. A phishing email can arrive in June. A misleading advertisement can appear at any time.

Continue educating clients throughout the year.

A brief reminder in a newsletter, appointment, or social post can help someone recognize a scam before they share personal information.

That is what trusted agents do.

They make complicated information easier to understand.

They help clients slow down when someone creates pressure.

They provide education without using fear.

And they remain a reliable resource long after an enrollment decision is made.

See how education, consistency, and service can also help you build a personal brand clients remember and trust.

Frequently Asked Questions About Medicare Scams

Are Medicare scams more common during AEP?

Scammers may increase Medicare-related activity when open enrollment is receiving more attention. However, scams can occur throughout the year, so ongoing education is important.

Will Medicare call and ask for a Medicare number?

Medicare representatives generally will not call unexpectedly to request a Medicare number, banking information, credit card number, or payment. Clients should end suspicious calls and contact 1-800-MEDICARE directly through a verified number.

What information should clients protect?

Clients should protect their Medicare number, Social Security number, banking information, credit card details, health information, passwords, and other identifying information.

How can someone report suspected Medicare fraud?

Suspected Medicare fraud or abuse can be reported by calling 1-800-MEDICARE. People should also review Medicare statements and report claims for services, supplies, or equipment they do not recognize.

How can agents help prevent Medicare scams?

Agents can provide clear education, teach clients to recognize warning signs, encourage independent verification, use compliant communication practices, protect client data, and report suspicious activity through the appropriate channels.