4 Ways to Identify Medicare Scams and Bad Medicare Agents

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There are a lot of Medicare spammers, scammers, and bad actors trying to take advantage of people aged 64.5 and above. Some of them are outright trying to steal your money. Others are simply breaking the law or breaking the rules of Centers for Medicare and Medicaid Services.

How do you know when you’ve got a good egg or a bad one?

Here are some things to watch out for, and how to handle them.

Some of these can come from people who door-knock (not a bad thing in itself if they respect your boundaries), but more of the scams come from phone calls.

1. The caller or door knocker says they’re “with” or “calling from” Medicare.

No insurance agent is with Medicare. They don’t work for Medicare. No one who works for Medicare will call you. No one who works for Social Security will call you. You can only call them. 

Who are these people, then? They are:

  • Insurance agents who work for an insurance carrier, or
  • Independent Agents, or
  • Call center telemarketers, domestic or foreign.

Now, there’s nothing wrong with those three groups of people, but they are not allowed to pretend they represent Medicare itself. If they’re doing that, they are either uneducated – which is negligent and unprofessional of them – or they are unethical and dishonest.

The real relationship between agents and Medicare is always through an Insurance carrier. So they may be “with” a carrier, or represent a number of carriers, but they are not “with” Medicare.

Either way, someone saying they are from Medicare is a big red flag. Ask them for their National Producer Number and the name of their company. They will hang up quick!

Here’s what Medicare itself says about protecting yourself from Medicare Fraud.

If you’re unsure, just ask the agent what their National Producer Number is, and go here to look them up. You can see if they’re licensed, or if their license has expired or been suspended or terminated.

National Association of Insurance Commissioners lookup search
National Association of Insurance Commissioners lookup search

2. Caller wants to verify your identity, give you free medical equipment, or offer a free refund.

First off, “free” itself is a red flag. No ethical agent who helps people with Medicare ever says the word “free.”  

Second, never give any of your personal information, including your Medicare number, social security number, bank account info, or Medicaid number to anyone you don’t trust. 

Ethical agents can earn your trust with a conversation, and will actually need that info to enroll you in a Medicare plan, but that’s going to be a personal conversation that lasts at least 15-30 minutes before you get to any of that personal info. If a telemarketer is asking for personal info in the first 10 minutes of a call, they’re probably a scammer.

3. You’re not sure if the caller is a telemarketer or not

If ever in doubt, say you need to call them back and ask for their direct number. They may just hang up. If they volunteer to call you at a better time, refuse. Tell them you need their direct number, or no dice!

4. The premium they offer seem low, or too good to be true

This used to be a more sure sign of a scam. However, with the advent of Medicare Advantage plans, there is often at least one in each county that has a zero dollar premium.

Again, agents are still not allowed to call them “free,” and that is still a sign of an agent who doesn’t pay attention to the rules. That’s a bad sign for you, because the agent that will help you the most over the years is the one that pays attention and has the most accurate information.

If you’re not sure about the plans they are offering you, you can check on plans yourself here.

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One more note- if the agent talks to you about Medicare Advantage without having you sign a Scope of Appointment (paper or electronic), they don’t know what they’re doing, and your enrollment could be held up because they didn’t follow proper procedure. Find a different agent!

If you ever have any questions or need help, reach out to Brian at PandaCare!

Brian Carter

Brian Carter

Brian Carter has been in the health field since 1999, and was a medical terminology teacher at the Master's degree level. He's also a marketer, stand up comedian, and an abstract painter. Brian has a lot going on, but his passion is Medicare and helping seniors with their Medicare and other health insurance. Brian learned from his grandma that how you live your senior years matter, because you may live a lot more of them than you expect... she lived to be 105 years old, and despite being a farmer and school teacher, she lived frugally enough to be able to give to others. She also received a Governor's award for volunteer service at her local Kokomo, Indiana hospital. His mom was a special education teacher, so he had plenty of good role models for living a life of service to others. Brian grew up in Ohio, lived in San Diego, but loves Charleston, SC the best. It's his favorite city in the world. He has a deep love of the land, the rivers, and the people who call this area home. When asked how he feels about seniors, Brian says, "I love old people... I married one! Don't tell my wife I said that."