Most Common Healthcare Scams & How to Avoid Them
Healthcare scams trick people into giving up benefits, money, or sensitive medical data. Here are today’s most common schemes, how they work, and what to do next.
Table of Contents
Quick Facts
About this scam type
Healthcare scams often involve impersonators who pretend to be from Medicare, Medicaid, Marketplace health insurance, or legitimate providers. Their goal is to steal your insurance details, money, or personal and medical information. Techniques include fake enrollment offers, equipment freebies, demands for medical debt payment, and phishing for patient portal logins.
How scammers contact victims
Most healthcare scams start with texts or phone calls, especially during open enrollment. Scammers also use phishing emails that look like patient portal or billing system alerts, and social ads for fake health insurance or rewards. These channels catch people off guard and pressure them to act quickly.
Who is most at risk
Older adults on Medicare are targeted each fall during open enrollment. Families renewing Medicaid may get scam texts about fees. Marketplace shoppers see phony ads promising perks or fake help with plans. Anyone who receives a medical bill is at risk from impostor collectors or fake payment requests.
Understanding the risk level
If you fall for a healthcare scam, you risk identity theft and having your medical benefits used by someone else. Scammers can collect thousands of dollars using your insurance, enroll you in junk plans, or demand payments for debts you do not owe. Your credit and medical history could be affected for years.
Most Common Healthcare Scams
How it works: Scammers pose as Medicare, claiming to offer new cards, extra benefits, or plan changes. They ask for your Medicare, Social Security, or bank details, or trick you into switching to plans you did not choose. These scams spike during open enrollment.
Real Example (Apr 29, 2024)
Your Medicare card should be PLASTIC. Confirm your Medicare number to receive your replacement. Real Example (May 20, 2025)
We’re issuing new 2025 Medicare benefits packages at no cost. Red Flag Signs:
- • Unsolicited call or text asking for Medicare or bank numbers.
- • Pressure to act now to avoid losing benefits.
- • Claims of a plastic or chip card. Medicare cards are paper and free.
How it works: You might get calls, ads, or texts claiming you qualify for free braces, monitors, or check-ins. Scammers use your Medicare number to bill for medical devices or monthly check-in charges you never agreed to. Unordered equipment might arrive at your home.
Real Example (Jan 24, 2025)
You qualify for a knee and back brace at no cost with Medicare. Red Flag Signs:
- • “Free” equipment offers asking for your Medicare number.
- • Medical items or Explanation of Benefits (EOBs) show up for things you never ordered.
- • A provider you never heard of authorizes the order.
How it works: Scammers use social ads or robot calls to promise gifts, cash, or discounts for enrolling in a plan. They may use fake endorsements or offer 'help' from impostor navigators who charge illegal fees or sell junk insurance. Genuine enrollment help is always free through HealthCare.gov and local certified navigators.
Real Example (Nov 2024)
Enroll now. Get free phones or cash cards for gas, groceries, or bills. Red Flag Signs:
- • Requests for payment or SSN to get a quote.
- • Fees to keep or renew coverage, or to use a navigator.
- • Pressure to pay immediately and enroll off the official site.
How it works: Fake texts warn you that your Medicaid coverage is ending and demand payment to keep it active. They link to impostor websites or ask for immediate payment. State agencies confirm Medicaid never charges a renewal fee.
Real Example (PA AG alert)
Your Medicaid coverage has lapsed. Pay now to reinstate benefits. Red Flag Signs:
- • Requests for a 'renewal fee' or threat to cancel Medicaid coverage.
- • Links that do not end in .gov or match state websites.
- • Unknown senders claiming to be 'Health Services.'
How it works: Phishing emails may look like patient portal alerts or billing notices. They direct you to a fake site to steal your login or payment info. Attackers may also fax fake audit requests to steal sensitive records.
Real Example (SSM Health)
You have an important and unread message in your MyChart account. Red Flag Signs:
- • Links in email or text that do not match your provider’s official website.
- • Requests to update payment info urgently by email or text.
- • Unfamiliar sender addresses or domains.
How it works: You may get calls from people claiming you owe a medical bill, demanding fast payment, and making threats. They may refuse to send proper documents, want payment in gift cards or apps, or threaten arrest. Know your rights—real collectors must provide details in writing.
Real Example (MN AG debt scam)
Pay today or we will file for your arrest. Red Flag Signs:
- • Refusing to provide written debt validation.
- • Demands for gift cards, wire transfers, or crypto as payment.
- • Threats of legal trouble or arrest if you do not pay immediately.
Healthcare Scam Red Flags vs Legitimate Signs
Top 5 Phrases Scammers Use
- 1 "New plastic Medicare card. Confirm your Medicare number."
Creates a sense of urgency and requests sensitive personal details.
- 2 "Your coverage will be cancelled unless you pay a renewal fee now."
Tries to scare you into paying for something that does not exist.
- 3 "Enroll today and get free gas or grocery cards."
Offers fake perks to lure you into giving up personal info.
- 4 "You have an unread MyChart message. Click to verify billing."
Uses fake alerts to get your login or payment info.
- 5 "Final notice for unpaid medical debt. Pay by gift card or be arrested."
Uses high pressure tactics and asks for unusual payment methods.
Scam Warning Signs
- Unsolicited contact asking for SSN, Medicare, or bank info.Real providers will not ask for this out of the blue.
- Links not ending in .gov or correct portal domain.Official websites always end in .gov or match your doctor’s real portal.
- Requests to pay with gift cards, crypto, or money apps.These payment methods are a strong scam sign.
- Caller ID spoofing or refusal to provide a callback number.Legitimate agencies are happy to offer contact details.
- Pressure to act immediately to avoid losing benefits.Scammers use urgency so you do not verify the story.
- Equipment or EOBs you never ordered or authorized.If you see strange charges or get unexpected items, check with your insurer.
Legitimate Communications
- Medicare will not contact you unexpectedly for your number or payment.Cards are mailed free; never confirm sensitive info unless you called them.
- Marketplace help is free through HealthCare.gov and 1-800-318-2596.Certified navigators cannot charge for enrollment assistance.
- State Medicaid agencies never ask for a renewal fee.Renewals handled through official .gov sites only.
- Patient portal emails link to your provider’s known site or app.Always visit your portal by typing the address or using the app.
- Debt collectors must send written validation within 5 days.They cannot threaten arrest or refuse validation.
- No Surprises Act protects against many out-of-network bills.Call 1-800-985-3059 if you have a dispute over a surprise bill.
How to Protect Yourself From Healthcare Scams
A few simple steps can greatly reduce your risk. Use trusted contacts and official websites when dealing with health plans or providers.
- 1. Do Not Respond to Unexpected Calls or Texts
Delete suspicious texts and hang up on calls about your health coverage or benefits. Always contact Medicare, Medicaid, or your insurer using the official phone number.
- 2. Always Go to Official Websites or Hotlines
For help with Medicare, use Medicare.gov or call 1-800-MEDICARE. For Marketplace coverage, use HealthCare.gov or 1-800-318-2596. Assistance is always free.
- 3. Protect Your Patient Portal and Billing Logins
Enable two-factor authentication (2FA), use strong passwords, and only access your patient account by typing the address or using your provider's app. Never pay bills from email or text links.
- 4. Keep Your Medicare Number Private and Review EOBs
Treat your Medicare number as carefully as you would a credit card. Look over statements and explanation of benefits monthly for unfamiliar claims and report problems quickly.
- 5. Verify Medical Debt Before You Pay
Ask for a bill in writing, match it to your own records and explanation of benefits, and do not pay anyone who demands payment by gift card or threatens arrest.
- 6. Understand Your Billing Rights
If you have insurance, you may be protected from certain out-of-network surprise bills by the No Surprises Act. You can call 1-800-985-3059 for guidance.
Add the No Surprises Help Desk (1-800-985-3059) to your phone contacts for quick access.
For full protection from new healthcare scams, try Lifeguard. Sign up to get real-time alerts and monitoring for you and your loved ones.
What to Do If You’re a Victim of a Healthcare Scam
Act quickly to limit any losses and protect both your finances and your healthcare coverage. You are not alone, and there are clear steps to help you recover.
- 1. Stop All Contact and Save Evidence (Do immediately)
Save screenshots of messages, caller ID, bills, or anything you received. Forward scam texts to 7726 and report to ReportFraud.ftc.gov as soon as you can.
- 2. Notify the Right Program or Agency (Do immediately)
Medicare: Call 1-800-MEDICARE. Medicaid: Call your state office. Suspected fraud: HHS-OIG Hotline at 1-800-HHS-TIPS. Marketplace: 1-800-318-2596.
- 3. Contact Your Bank If Money or Card Info Was Shared (Do immediately)
Ask your bank or credit card company to reverse suspicious charges, watch for unusual activity, and issue a replacement card if needed.
- 4. Secure Your Identity With Credit Bureaus (Within 24 hours)
If your SSN or insurance number was exposed, place a free fraud alert or credit freeze with Equifax, Experian, and TransUnion. Start recovery at IdentityTheft.gov.
- 5. Reset Passwords and Turn On Two-Factor Authentication (Within 24 hours)
Change passwords for patient portals, insurance websites, and your email. Turn on 2FA to stop further access.
- 6. Call the No Surprises Help Desk for Billing Problems (Within 24 hours)
If you receive unexpected out-of-network medical bills, the No Surprises Help Desk is at 1-800-985-3059.
- 7. Monitor New Claims, EOBs, and Credit Reports (Within 1 week)
Check statements, EOBs, and credit reports weekly for the next month. If you see new claims or debts, dispute them with your insurer and the credit bureau.
- 8. Report Locally for Sham Plans or Collections
File reports with your state Department of Insurance or Attorney General if you see fake plan sales or debt abuses. For online scams, file at IC3.gov.
You can also contact the Senior Medicare Patrol, HHS-OIG, and your state insurance regulator for help. For identity theft, visit IdentityTheft.gov to start recovery.
Frequently Asked Questions About Healthcare Scams
No. Medicare will not unexpectedly call, text, or message you to ask for your Medicare, Social Security, or bank numbers, or to sell you anything. Cards are paper and free by mail. If unsure, hang up and call 1-800-MEDICARE.
No. Navigators and certified assisters provide free help. Use HealthCare.gov’s Find Local Help or call 1-800-318-2596.
No. States do not charge a fee to renew Medicaid. Delete the text and contact your state Medicaid office directly.
Only if the link goes to your provider’s exact portal domain. When in doubt, type the portal URL yourself or use the official app. Turn on 2FA.
Under federal law, collectors cannot threaten arrest or refuse to validate a debt. Ask for written validation and dispute if needed. Report to the CFPB and your state AG.
As of October 13, 2025, a federal court vacated the CFPB’s 2025 rule that would have removed medical debt from reports. Credit bureaus already exclude paid medical collections and those under $500. Check your reports and dispute errors.
Call the No Surprises Help Desk at 1-800-985-3059 for guidance or to file a complaint.
Refuse delivery or return to sender, keep records, review your EOBs, and report to HHS-OIG at 1-800-HHS-TIPS.
Stay Ahead of Healthcare Scams
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