Avoiding Medicare Scams:
Red Flags to Watch Out for During Busy Enrollment Periods
Medicare enrollment periods can be an important time to review your coverage, compare plan options, and make sure your healthcare needs are still being met. Unfortunately, they are also a busy season for scammers who may try to take advantage of Medicare beneficiaries.
Knowing what to watch for can help you protect your Medicare benefits, personal information, and finances.
🚩Red Flag #1: An Unsolicited Call Asking for Your Medicare Number
Be cautious if someone unexpectedly calls and asks for your Medicare number, Social Security number, bank information, or other personal details.
Medicare advises beneficiaries not to share their Medicare number or other personal information with someone who contacts them unless they contacted Medicare or gave the person permission to contact them. Medicare also states that it will never call you to sell you anything.
When in doubt, hang up and contact Medicare directly at 1-800-MEDICARE (1-800-633-4227).
🚩Red Flag #2: “Your Medicare Benefits Are About to Expire!”
Scammers may use urgency or fear to pressure you into giving them information or making an immediate decision.
Statements such as:
- “Your Medicare card is expiring.”
- “You will lose your benefits unless you act today.”
- “You have to give me your Medicare number to keep your coverage.”
- “Your plan is being canceled, and I need your information immediately.”
should raise concerns.
Don't allow pressure or fear to rush an important Medicare decision. Take the time to verify who is contacting you and why.
🚩Red Flag #3: Uninvited Home Visits
A legitimate Medicare plan representative should not simply show up at your home uninvited to sell or endorse a Medicare health or drug plan. Medicare's marketing rules prohibit plans and their representatives from making uninvited visits to your home.
If someone arrives unexpectedly claiming to be from Medicare or an insurance company, you don't have to let them inside.
🚩Red Flag #4: Promises That Sound Too Good to Be True
Be skeptical of advertisements or sales pitches promising things such as:
- “Free money from Medicare”
- Guaranteed gift cards for enrolling
- Benefits that are available to “everyone”
- A plan that will cover everything at no cost
- Special benefits available only if you provide your information immediately
Medicare plan benefits vary based on the specific plan, location, and eligibility requirements. A legitimate Medicare professional should be willing to explain the details rather than pressure you into making a decision.
Medicare also limits the types and value of gifts that plan representatives can offer in connection with Medicare marketing.
🚩Red Flag #5: Being Asked to Pay Immediately
Be cautious if someone demands payment over the phone or online to enroll you in a Medicare plan.
Medicare's marketing rules state that plans cannot ask for payment over the phone or online; the plan must send you a bill.
Never provide your bank account or credit card information simply because someone says you must pay immediately to secure Medicare coverage.
🚩Red Flag #6: Pressure to Enroll Without Reviewing Your Doctors and Prescriptions
A Medicare plan isn't simply about the premium.
Before changing plans, you should consider:
- Whether your doctors and hospitals are in the plan's network
- Your prescription drug coverage
- Drug tiers and costs
- Deductibles and copayments
- Maximum out-of-pocket costs
- Whether your preferred pharmacy is in-network
- Whether referrals or prior authorizations may be required
A trustworthy Medicare professional should help you understand how a plan fits your individual situation, rather than telling you that one plan is automatically best for everyone.
🚩Red Flag #7: Someone Claims to Be “Calling From Medicare”
There's an important distinction between Medicare and a private insurance company that offers Medicare Advantage or Part D coverage.
If someone claims to be calling from Medicare and wants to sell you an insurance plan, ask questions and verify their identity before providing any information.
If you receive a suspicious call, Medicare recommends contacting 1-800-MEDICARE or reporting suspected fraud.
Protect Yourself During Enrollment Season
A few simple habits can make a big difference:
Slow down. You don't have to make an immediate decision because someone says an offer is ending today.
Ask questions. A reputable agent should be comfortable explaining the plan and answering your questions.
Verify information. Check your plan information through trusted sources such as Medicare.gov or directly with your insurance company.
Protect your personal information. Your Medicare number and Social Security number should be treated as sensitive information.
Review your coverage carefully. Don't choose a plan based solely on a television advertisement, mailer, or phone pitch.
When You Need Help, Choose Someone You Trust
Medicare can be complicated, especially during busy enrollment periods when you may receive numerous advertisements, mailers, phone calls, and plan offers.
At Otium Financial Planners, Medicare services are provided as part of the firm's health insurance and Medicare offerings. Otium's Medicare Advisor, Michele Marchiano, helps individuals navigate Medicare enrollment and coverage decisions.
The goal isn't simply to find a plan, it's to help you understand your options and make an informed decision based on your healthcare needs.
If you have questions about Medicare or would like help reviewing your coverage, Otium Financial Planners can be reached at 440-252-2449 or Otium@otiumfinancialplanners.com. The office is located at 34500 Chardon Road, Suite 4, Willoughby Hills, Ohio 44094, and offers both in-person and virtual appointments.
Remember: When in Doubt, Don't Give It Out
During Medicare enrollment season, a little caution can go a long way.
If an unexpected caller, email, text, or visitor makes you feel pressured, asks for sensitive information, or promises benefits that seem too good to be true, stop and verify before taking action.
Your Medicare coverage is important. Take your time, ask questions, and work with trusted resources.
Otium Financial Planners - Helping you navigate Medicare with clarity and confidence.
This article is for educational purposes only and is not a substitute for personalized Medicare insurance, or financial advice. Medicare rules and plan benefits can change. For current Medicare information, visit Medicare.gov or call 1-800-MEDICARE.
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