Medicare Fraud: What Is It and How You Can Help Protect Yourself

Medicare fraud is a significant issue. It is estimated the loss is over $60 billion annually, although the exact figure is impossible to know.¹ Examples of Medicare fraud include:² 

• A provider bills Medicare for services or supplies they never provided you.
• A provider charges Medicare twice for a service you received once.
• An individual steals your Medicare Number and submits fraudulent claims.
• A company attempts to sell you a Medicare drug plan that has not been approved by Medicare.

If You are Billed for a Service You Never Received

Watch for billing statements from a medical provider stating you received services or supplies that you never actually received. A scammer may have charged Medicare for a service you didn’t receive, and you may be charged for additional costs.

A Medical Provider Charges for a Service Twice

If you notice a provider has charged Medicare more than once for a service that you only received once, contact the provider and ask if they charged incorrectly.³ If you suspect potential Medicare fraud, call Medicare at 1-800-633-4227 or submit a complaint online. 

Your Medicare Number is Stolen and Used

Finding out a person has stolen your Medicare Number and used it to submit fraudulent claims is a shocking and perhaps unsettling experience. It is important to guard your Medicare card and your Medicare Number. If you suspect your Medicare Number has been stolen, contact Medicare at 1-800-633-4227 to report the stolen number.

How to Help Protect Yourself from Medicare Fraud

One example of Medicare fraud is when a company attempts to sell you a Medicare drug plan that hasn't been approved by Medicare. Before you join a Medicare health or drug plan online or over the phone, contact Medicare to confirm it has been approved.

How to Spot Potential Medicare Fraud

If you receive a text message, phone call, or email asking for your Social Security Number or your Medicare Number, it is likely fraudulent.⁴

It is a good idea to routinely:

1. Compare the statements you receive from Medicare with your personal records to confirm the dates and services listed are correct.
2. Check your claims as soon as you receive them.
3. Review the statements you receive from your healthcare providers. If you believe the charges are incorrect or a mistake has been made, call the provider to report the error and have it corrected.

Helping Protect Yourself from Medical Identity Theft

Medicare will never visit you in your home or call you to sell a service.² A Medicare representative will only call you for limited and specific reasons, including:³

• If you are a member of a Medicare health or drug plan, the provider of the plan, or the agent who helped enroll you in the plan, may call you.
• If you reached out to Medicare at 1-800-633-4227 and left a message, a customer service representative may return your call.
• If you called Medicare at 1-800-633-4227 to report possible fraud, a representative may return your call in the course of their investigation.

Medicare Fraud Strike Force

In March 2007, the U.S. Department of Health and Human Services created Medicare Fraud Strike Force Teams to “harness data, analytics, and the combined resources of Federal, State, and local law enforcement entities to prevent and combat health care fraud, waste, and abuse.”⁴
 
Medicare Fraud Strike Force Teams are currently at work in many major cities of the U.S. These teams bring together the forces of the Office of Inspector General, the Department of Justice, Offices of the United States Attorneys, the Federal Bureau of Investigation, local law enforcement, and others to “quickly identify fraud and bring prosecutions”.⁵ 

Contact Information

If you suspect Medicare fraud, call Medicare at 1-800-633-4227 or submit a complaint online.

Sources:

1. Senior Medicare Patrol, Medicare Fraud by the Numbers, Accessed 2025
2. Medicare.gov, Reporting Medicare Fraud and Abuse, Accessed 2024
3. CMS.gov, Frequently Asked Questions (FAQs): Medicare & Medicaid Fraud, Waste, and Abuse Prevention, Accessed 2024
4. LifeLock.Norton.com, What is a Medicare Scam, Accessed 2025
5. US Department of Health and Human Services, https://oig.hhs.gov/fraud/strike-force/, Accessed 2024

Other Sources:
Fall 2023 Semiannual report to Congress Health and Human Services – Inspector General, https://oig.hhs.gov/documents/sar/1275/OIG-SAR-FALL-2023-Complete%20Report.pd, Issued December 1, 2023.