Key Takeaways

• Medicare-related fraud is increasing in complexity, with CMS issuing more warnings than ever in 2025—highlighting how sophisticated scams are targeting older adults.

• Staying informed and vigilant, especially during open enrollment periods and through unexpected communications, is your best defense against fraud.

Medicare Fraud in 2025: A Rising Threat

In 2025, the Centers for Medicare & Medicaid Services (CMS) is issuing fraud alerts at a record pace. You’re not imagining it—scams targeting Medicare beneficiaries have grown more aggressive and more deceptive. Whether it’s phone calls, text messages, emails, or even mailed letters, criminals are evolving their tactics faster than ever. And while CMS is working to get ahead of the curve, these warnings mean little if you don’t act on them.

You are the last line of defense.

Unfortunately, many people are still not paying enough attention. CMS can send out bulletins, but if you’re not aware of what to look for or how to respond, the consequences can be serious—from identity theft to fake enrollments to losing your legitimate Medicare coverage.

What’s Different About Medicare Scams in 2025?

New Technology, Old Tricks

Scammers today are blending cutting-edge tech with old-school deception:

• AI voice cloning is being used to impersonate CMS representatives or even family members.

• Phishing emails and texts are now mimicking official CMS designs and language so closely they’re fooling even tech-savvy recipients.

• Caller ID spoofing makes scam calls appear as if they are from Medicare or Social Security.

Broader Targets

In 2025, fraud isn’t just targeting new enrollees. Even longtime Medicare beneficiaries are being approached with fake plan “updates,” urgent requests for personal information, or bogus billing inquiries. If you have a Medicare number, you’re a target.

Scams That Time Their Attack

Scammers have become strategic about when they contact you:

• During open enrollment (October 15–December 7), when you’re likely to be exploring plan options

• Right after a life event (hospital stay, new prescription, birthday), when your guard may be down

• In early January, when new plans and coverage updates begin, creating confusion that scammers exploit

How CMS Is Responding

CMS is well aware of the fraud spike. Here’s how the agency is stepping up its response:

• More frequent public warnings are issued across its website and partner channels.

• Greater collaboration with law enforcement and the Department of Justice to take down fraud rings.

• Education campaigns targeted toward seniors, caregivers, and healthcare providers.

• AI-driven claim monitoring to detect unusual billing patterns or account activity.

Still, these initiatives rely on your active participation. Without your awareness and skepticism, the protection stops short.

Warning Signs You Can’t Ignore

CMS has highlighted a range of red flags that every Medicare beneficiary should memorize. If any of these show up in your mailbox, inbox, or phone, treat them with caution:

• You’re asked to confirm your Medicare number out of the blue.

• You receive a call saying your benefits will be cut off unless you act immediately.

• Someone offers a free genetic test, brace, or screening in exchange for your Medicare number.

• You get pressured to switch plans quickly, often with promises of better coverage or lower costs.

• You’re told you must pay a fee to keep your coverage active. Medicare never charges surprise fees.

What You Can Do to Stay Safe

There are concrete steps you can take to lower your risk of Medicare fraud. CMS recommends you:

• Never give your Medicare number to anyone who contacts you unexpectedly.

• Hang up immediately if someone asks for personal details or pressures you.

• Use the official 1-800-MEDICARE number or trusted websites to verify any claim.

• Check your Medicare Summary Notices (MSNs) regularly to confirm that all listed services were actually received.

• Report suspicious activity immediately to Medicare at 1-800-MEDICARE or online at the Office of Inspector General.

The Cost of Fraud Isn’t Just Financial

In 2025, Medicare fraud can damage more than your wallet. It can:

• Disrupt your coverage by enrolling you in fake or unauthorized plans

• Lead to identity theft that affects other areas of your life

• Cause delays in real healthcare services

• Impact national Medicare trust fund stability, which affects all beneficiaries

Taking one phone call or email at face value could result in months of stress, lost benefits, and hours on the phone trying to recover what you’ve lost.

Why Some Seniors Still Fall for It

Despite all the outreach, some people continue to fall victim. There are several reasons for this:

• Scams sound official. Fraudsters use CMS language, logos, and urgency to sound credible.

• People trust too quickly. A kind voice on the phone or an official-looking letter often lowers suspicion.

• Technology can fool anyone. Caller ID and email spoofing are convincing, and many people aren’t familiar with how they work.

• Cognitive decline or health stressors make it harder to process and verify information.

CMS can’t shield you from these risks alone—you need to remain skeptical by default.

How to Protect Someone Else from Medicare Fraud

If you’re helping a parent, friend, or neighbor manage their Medicare coverage, your role in fraud prevention is vital. Here’s what you can do:

• Review their mail and email with them. Talk through anything that looks suspicious.

• Help them create a habit of saying no to phone requests for information.

• Set up a calendar reminder to check their Medicare claims or MSNs monthly.

• Encourage them to let unknown numbers go to voicemail. Scammers rarely leave detailed messages.

• Walk them through verifying anything with the 1-800-MEDICARE hotline.

Extra Risk During Open Enrollment

The annual Medicare Open Enrollment period—from October 15 to December 7—remains the peak season for fraud. Scammers know this is when you are:

• Evaluating new coverage

• Comparing plan details

• Receiving official communications from Medicare

That makes it the perfect storm for deception. During this time, extra caution is warranted. You should:

• Avoid enrolling in any plan through a cold call or unverified email.

• Keep records of all plan comparisons and who you spoke to.

• Consult only licensed agents listed on trusted sources—never random callers.

CMS Recommendations Going Forward

CMS is urging all beneficiaries to be proactive:

• Register your phone number on the National Do Not Call Registry to reduce robocalls.

• Freeze your credit with all three bureaus if you suspect identity theft.

• Educate your friends and community. Spread awareness by attending local fraud prevention sessions or CMS webinars.

CMS’s 2025 fraud campaigns emphasize community effort. If one person spots a new scam early, others can be warned.

When in Doubt, Slow Down

One of the simplest fraud prevention tactics is to slow down. Scammers thrive on urgency. The faster you act, the less time you have to ask questions or verify facts. CMS encourages you to pause, write things down, and confirm through official channels before taking any action.

Waiting an hour could save you months of chaos.

Staying Informed Is Your Best Protection

With fraud on the rise and CMS issuing warnings more frequently, your best defense is staying informed and alert. Keep yourself updated through CMS bulletins, Medicare handbooks, and trustworthy local programs.

By taking a proactive approach and knowing the warning signs, you can guard your identity, protect your coverage, and help preserve the integrity of the entire Medicare program.

If you have questions about your plan or think you’ve been targeted by a scam, speak with a licensed agent listed on this website. They can help you understand your coverage and report any suspicious activity.