Healthcare scams to avoid and how an advocate protects you

Why this matters

Scammers target people every day by phone, text, email, and mail. Many pretend to be Medicare, a clinic, a charity, or a trusted company. Others try to sell false coverage, bill for services you never received, or push free tests that your doctor did not order. Knowing the signs helps you act early, protect your information, and stop losses before they start. The Federal Trade Commission, the Centers for Medicare and Medicaid Services, and the Office of Inspector General share clear warning signs and reporting steps.

Common healthcare scams to watch for

Government and business impersonation

You get a call, text, or email that looks like it is from Medicare, Social Security, the FTC, a hospital, a pharmacy, or a known company. The message claims an urgent problem or prize and pressures you to act fast. It demands payment by gift card, cryptocurrency, wire, or a payment app. Real government agencies and reputable companies do not ask for payment that way. Hang up. Do not click links. Go directly to the official site or the phone number on your card to verify. Report what happened to ReportFraud.ftc.gov.

Grandkid and family emergency stories

A caller pretends to be a grandchild or relative in trouble and begs for secrecy and fast payment. Stop and verify with another family member or by calling the person back using a number you already have.  

Health insurance and Marketplace scams

Ads and callers may offer cheap plans, free gift cards, or say they are from HealthCare.gov. Some enroll people in plans without permission or switch plans behind their back. Get coverage information only from HealthCare.gov or the Marketplace Call Center. Never share personal data with unsolicited sellers. If you have Medicare, it is against the law for anyone to sell you a Marketplace plan.

Medicare genetic testing and free equipment scams

Fraudsters offer free genetic tests, cancer screens, or durable medical equipment at health fairs, by phone, or door to door, then bill Medicare when no doctor ordered the item. Do not share your Medicare number. Only your own clinician should order tests or equipment for you. Report suspected fraud to the OIG Hotline or Medicare.

Unwanted calls and texts

Scammers ignore the National Do Not Call Registry and use spoofing to fake caller ID. Your best defense is call blocking, call labeling, and refusing to answer unknown numbers. Register your number and report unwanted calls.

Medical billing and collection scams

Some bad actors send fake bills, pressure you to pay by unusual methods, or misstate what insurance allowed. Always compare every bill to your Explanation of Benefits or your Medicare Summary Notice. If you see services you did not receive, call the provider and your plan, then report suspected fraud.

Fast safety checks before you respond

• Pause and talk to someone you trust or your advocate. Scammers rely on secrecy and urgency
• Never pay with gift cards, cryptocurrency, or wire for any bill or plan
• Do not click links or open attachments from unknown senders
• Verify directly with your clinic, pharmacy, plan, or government site using a phone number you already have
• Review your Medicare Summary Notices and plan statements and keep a simple care calendar to match dates and services
• Register your number with the National Do Not Call Registry and turn on call blocking on your phone Consumer AdviceMedicareDo Not Call Registry

How an advocate helps you avoid scams

• Screen suspicious messages with you
  Send questionable emails, texts, letters, and voicemails to your advocate. We help check sender details, look up official contacts, and decide next steps so you do not respond to a fake request
• Verify benefits and bills
  We compare your bills and statements with your visit notes and your Medicare Summary Notices, then call the provider or plan with you to correct mistakes or challenge improper charges
• Coordinate with your care team
  We contact your doctor or pharmacy directly to confirm whether a test, device, or refill is real and necessary
• Report and document
  We walk you through reporting to ReportFraud.ftc.gov, the HHS OIG Hotline, Medicare, the FBI Internet Crime Complaint Center, and your state if needed. We help keep copies, dates, and case numbers for your records
• Set up practical protections
  We help you register for the National Do Not Call Registry, adjust phone settings, and use call blocking. We can also help you place alerts or freezes with credit bureaus if identity theft is suspected

Explore related Understood Care support
Care coordination https://understoodcare.com/care-types/care-coordination
Lower costs of medication https://understoodcare.com/care-types/lower-costs-of-medication
Appointments and visit support https://understoodcare.com/care-types/appointments
Financial help https://understoodcare.com/healthcare-info/financial-help
Why advocates matter https://understoodcare.com/healthcare-info/why-advocates-matter-for-your-care

What to do right now if something seems off

1. Stop contact with the caller, texter, or email sender
2. Save evidence screenshots, emails, phone numbers, and dates
3. Call your plan or Medicare using the number on your card and ask for a benefits check
4. Report
   ReportFraud.ftc.gov for any consumer scam
   HHS OIG Hotline for Medicare related fraud
   1 800 MEDICARE for billing issues or suspected abuse
   IC3.gov for internet enabled fraud and elder fraud concerns ReportFraud.ftc.govOffice of Inspector GeneralMedicareInternet Crime Complaint Center
5. Tell someone you trust and consider asking an advocate to help you follow through on every step

How Understood Care works with you

You are not alone. An advocate can join calls, help file reports, and keep follow up tasks organized so you feel supported and protected. We can also help you learn simple habits that reduce risk, like confirming requests through official phone numbers, keeping a care calendar, and reviewing your Medicare Summary Notices every month. Start a conversation with an advocate today at https://understoodcare.com or call (646) 904-4027

References

• https://consumer.ftc.gov/scams
• https://consumer.ftc.gov/features/how-stop-unwanted-calls
• https://www.donotcall.gov
• https://consumer.ftc.gov/articles/how-avoid-government-impersonation-scam
• https://consumer.ftc.gov/features/pass-it-on/impersonator-scams/grandkid-scams
• https://consumer.ftc.gov/features/pass-it-on/health-insurance-scams
• https://consumer.ftc.gov/articles/spot-health-insurance-scams
• https://reportfraud.ftc.gov
• https://www.medicare.gov/basics/reporting-medicare-fraud-and-abuse
• https://www.medicare.gov/publications/10111-protecting-yourself-from-fraud.pdf
• https://oig.hhs.gov/fraud/report-fraud
• https://oig.hhs.gov/fraud/consumer-alerts/fraud-alert-genetic-testing-scam
• https://oig.hhs.gov/newsroom/videos/genetic-testing-fraud-alert
• https://www.ic3.gov
• https://www.fcc.gov/consumers/guides/stop-unwanted-robocalls-and-texts
• https://www.healthcare.gov/protect-from-fraud-and-scams
• https://www.cms.gov/marketplace/outreach-and-education/protect-yourself-from-fraud-in-ealth-insurance-marketplace.pdf‍
• https://www.ftc.gov/business-guidance/blog/2024/04/new-ftc-data-spotlight-offers-illuminating-insights-impersonation-scams

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This content is educational and is not a substitute for medical advice. Always consult your healthcare provider for personalized care.