Medicare guide
How to Avoid Medicare Phone Scams
Medicare phone scams spike around Open Enrollment, when callers pose as Medicare, an insurer, or an agent to get your Medicare number. The simplest defense is knowing what Medicare will and won’t do. Here is the official guidance and where to report a suspicious call.
Blake Insurance Group is an independent agency serving clients by phone, email, and online in states where we are licensed; coverage depends on the insurer, the policy, and underwriting.
Published by Blake Insurance Group LLC · Reviewed October 2026
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What Medicare will and won’t do
Medicare.gov says Medicare will never call you to sell you anything or visit you at your home, and that it calls for personal information only in limited cases, such as returning your call. Don’t join a plan over the phone unless you called and asked for help, and don’t give your Medicare or Social Security number to anyone who contacts you unexpectedly. The FTC adds that Medicare sends new cards automatically and for free.
Report suspected fraud to 1-800-MEDICARE (1-800-633-4227) or the HHS Office of Inspector General at 1-800-HHS-TIPS (1-800-447-8477). Medicare Advantage and Part D members can also call the I-MEDIC at 1-877-772-3379.
Common schemes
- Free genetic or cancer screening: HHS-OIG warns of telemarketing calls, health fairs, and door-to-door offers of “free” cheek swabs used to collect Medicare numbers. If Medicare denies the claim, you could owe thousands.
- New card calls: callers say you need a new card and ask for your number or a fee. The FTC says Medicare sends cards automatically for free.
- Equipment claims you don’t recognize: calls about a back brace, catheter, or other supplies you didn’t order.
- Pressure to switch plans: unsolicited calls urging you to join a plan right away, sometimes using spoofed caller ID.
How to protect yourself
- Hang up on unexpected calls asking for your Medicare number.
- Call 1-800-MEDICARE yourself if you aren’t sure a call is real.
- Read your Medicare Summary Notices and plan statements for services you didn’t get.
- Refuse or return medical kits your doctor didn’t order.
- Join or change plans only when you started the contact or chose the agent.
Where to report
Report suspected Medicare fraud to 1-800-MEDICARE (1-800-633-4227), or to the HHS Office of Inspector General at 1-800-HHS-TIPS (1-800-447-8477) or tips.hhs.gov. Medicare Advantage and Part D members can also call the I-MEDIC at 1-877-772-3379. Report identity theft at identitytheft.gov. Your local Senior Medicare Patrol can also help.
How legitimate agents contact you
Federal rules shape how agents work. Third-party marketing organizations that represent more than one Medicare Advantage organization must give a disclaimer explaining that they don’t offer every plan in your area. Agents must agree with you on a Scope of Appointment, the products you want to discuss, before a sales appointment; a CMS rule effective June 1, 2026 removed the old 48-hour waiting period. And under a 2024 CMS rule, your personal information can be shared with another marketing organization only with your prior express written consent for each recipient.
A legitimate agent will explain which plans they offer, agree on a Scope of Appointment, and won’t pressure you to give your Medicare number before you decide to enroll.
Why scams rise in the fall
| Period | When | What you can do |
|---|---|---|
| Initial Enrollment Period | 7 months around your 65th birthday month | Sign up for Parts A and B, and join a plan |
| Annual Open Enrollment | October 15 – December 7 | Join, switch, or drop Medicare Advantage or drug plans; coverage starts January 1 |
| Medicare Advantage Open Enrollment | January 1 – March 31 | One change: switch MA plans or return to Original Medicare (and add a drug plan) |
| General Enrollment Period | January 1 – March 31 | Sign up for Parts A and B if you missed your IEP; penalties may apply |
| Special Enrollment Periods | After qualifying events | For example, moving or losing employer coverage |
| Medigap Open Enrollment | 6 months from the first month you have Part B and are 65+ | Buy any Medigap policy sold in your state without health questions |
Source: Medicare.gov, October 2026.
Getting honest help
An independent agent appointed with several insurers can compare Medicare Advantage, Medigap, and Part D options available in your area, check your doctors and prescriptions against plan networks and drug lists, and help again each fall during Open Enrollment. Agents are paid by the insurers, so you don’t pay a fee for their help. Medicare.gov, 1-800-MEDICARE, and your State Health Insurance Assistance Program (SHIP) also give free, unbiased help; the national SHIP line is 877-839-2675.
Know your real costs
Scammers often promise savings that don’t exist. Knowing the standard costs helps.
| Item | 2026 amount |
|---|---|
| Part A hospital deductible | $1,736 per benefit period |
| Part A coinsurance, days 61–90 | $434 per day |
| Skilled nursing facility, days 21–100 | $217 per day |
| Part B standard premium | $202.90 per month |
| Part B deductible | $283 per year |
| Part D deductible (maximum) | $615 |
| Part D out-of-pocket cap | $2,100 |
| Insulin | No more than $35 for a month’s supply |
Sources: CMS (Nov. 2025, Apr. 2025) and Medicare.gov. 2027 Part A and B amounts had not been announced as of Oct. 22, 2026; CMS usually publishes them in mid-November. Higher-income beneficiaries pay more for Parts B and D.
Deadlines scammers exploit
Medicare charges late penalties if you delay without other qualifying coverage. Medicare.gov says the Part B penalty is 10% for each full 12-month period you could have had Part B but didn’t, usually for as long as you have Part B. The Part D penalty is 1% of the national base beneficiary premium for each month without creditable drug coverage after a 63-day gap; the base premium is $38.99 in 2026 and $41.33 in 2027. You can generally delay Part B without penalty if you have group coverage from current employment, and sign up within eight months after that coverage or employment ends.
Checking a plan and insurer
- Networks. Confirm your doctors and hospitals are in the plan’s network.
- Drugs. Check each prescription on the plan’s formulary and its tier.
- Costs. Compare premiums, deductibles, copays, and the out-of-pocket maximum.
- Agent license. Confirm the agent is licensed in your state through your state insurance department.
- Star Ratings. Review the plan’s rating on Medicare.gov’s Plan Finder.
What an independent agency does
An independent insurance agency is licensed to sell policies from several insurance companies. Instead of quoting one company's products, an independent agent can compare options from the insurers the agency represents, explain the differences in coverage, and help you re-shop at renewal. The insurance company, not the agent, makes underwriting and claim decisions.
Blake Insurance Group is an independent agency. We work with clients by phone, email, and online in states where we are licensed, and we will tell you which insurers we can quote for your situation.
How we work
Blake Insurance Group serves clients by phone, email, and online in states where we are licensed. The insurers and plans we can offer depend on our appointments and your location; a company named on this page may not be available through us.
How to verify an insurer or agency
Before buying through any website or app, confirm who is selling you the policy and who will issue it:
- Find the licensed agency or insurer named in the site's footer, terms, or license page.
- Look up the agency or producer on your state insurance department's license search, or through the National Insurance Producer Registry (NIPR).
- Look up the insurer on your state insurance department's company search to confirm it is authorized in your state.
- Save the insurer's name and policy number once issued, since that is who handles claims.
A legitimate service will make this information easy to find. Be cautious if you cannot identify the licensed entity.
Sources
We checked the facts on this page against the sources below in October 2026. Plans, prices, and rules change, so confirm current terms before you buy.
- Medicare.gov: Medicare fraud
- Medicare.gov: Reporting Medicare fraud and abuse
- HHS-OIG: Genetic testing scam alert
- FTC: Avoid scams during Medicare open enrollment (Nov. 2024)
- 42 CFR 422.2267: Required materials and content (TPMO disclaimer)
- 42 CFR 423.2264: Beneficiary contact and Scope of Appointment
- 42 CFR 423.2274: Agent and broker requirements (data-sharing consent)
- CMS: Contract Year 2027 Medicare Advantage and Part D final rule (Apr. 2026)
- ACL: State Health Insurance Assistance Program (Mar. 2026)
- Medicare.gov: When does Medicare coverage start?
- Medicare.gov: Joining a health or drug plan
- Medicare.gov: Ready to buy a Medigap policy
- CMS: 2026 Medicare Parts A & B premiums and deductibles (Nov. 2025)
- CMS: Final CY 2026 Part D redesign program instructions
- Medicare.gov: Insulin
- Medicare.gov: Avoid late enrollment penalties
What to have ready for a Medicare review
These details help an agent quote accurately.
- Medicare card. Your Medicare number and Part A and B start dates.
- Doctors. Names of doctors and hospitals you want to keep.
- Prescriptions. Drug names, doses, and pharmacies.
- Current coverage. Any plan, employer, or Medicaid coverage you have.
- ZIP code. Plans differ by county.
Medicare phone scams FAQs
Does Medicare call people?
Medicare.gov says Medicare won’t call to sell you anything and calls for personal information only in limited cases, such as returning your call.
Do I need to pay for a new Medicare card?
No. Medicare sends cards automatically and for free.
What should I do if I gave my Medicare number to a scammer?
Call 1-800-MEDICARE, watch your statements for services you didn’t get, and report the call.
Is a free genetic test from Medicare real?
Be very cautious. HHS-OIG warns that free genetic testing offers are a common scam.
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Important information
Compensation. Links in the partner section of this page are sponsored, and Blake Insurance Group may be paid if you make a purchase. Sponsored placement does not affect the other information on this page.
Independent agency. Blake Insurance Group LLC is an independent insurance agency. Licensed insurance producer NPN 16117464. Licensed states: AZ, AL, TX, CA, NY, OH, FL, NC, VA, GA, OK, NM, IA, KS, MI, NE, SC, SD, WV, IL, NJ, PA, TN, and WA. Which insurance companies we can quote depends on our current appointments, the product, and your state. Mentioning a company on this page does not mean we represent it.
Medicare disclaimer. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov, 1-800-MEDICARE (TTY users 1-877-486-2048), or your local State Health Insurance Assistance Program (SHIP) to get information on all of your options.
Medicare figures. Costs, limits, and rules on this page were checked against CMS, Medicare.gov, and the other listed sources in October 2026. 2027 Part A and B amounts had not been announced. Confirm current figures at Medicare.gov.
Coverage terms. Descriptions are general. The policy contract controls what is covered.
Availability. Coverage, prices, and eligibility vary by company, state, and applicant, and are subject to underwriting. The issued policy controls.
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