Medicare fraud scams continue to target seniors

Seniors always have to be mindful of scams that target them, but lately, Medicare fraud schemes are requiring special attention.

Federal watchdogs warn that these schemes not only cost taxpayers billions each year, but also put older Americans at risk of identity theft and unnecessary medical procedures. And because every American aged 65 and older is on Medicare and usually has retirement savings, scammers consider this population a target-rich environment.

One of the most common scams involves fraudulent offers for durable medical equipment, such as back braces, knee supports, or wheelchairs. Criminals often contact seniors by phone, claiming the devices are “covered by Medicare” and free of charge. In many cases, the equipment is either never delivered or billed to Medicare at inflated rates.

Genetic testing kit scams

Another rising scam involves so-called “free” genetic testing kits. Fraudsters lure beneficiaries into providing DNA samples under the pretense of cancer screening or personalized health services.

Victims are persuaded to hand over their Medicare numbers, which are then used to submit false claims. In reality, Medicare only covers genetic testing under strict medical necessity guidelines.

Additionally, telephone phishing schemes—where callers impersonate Medicare representatives—have become rampant. These callers often insist that beneficiaries must “renew” their Medicare cards or risk losing coverage, pressuring seniors into divulging personal and financial information.

Earlier this year, the New York StateWide Senior Action Council launched a crackdown on Medicare prescription drug price scams.

“As of Jan 1, 2025, Medicare is limiting the out-of-pocket costs for prescription drugs to $2,000 per year for seniors,” Maria Alvarez, executive director of StateWide, said at the time. “This cap applies to covered Medicare Part D prescription drugs, making medications more affordable for millions of beneficiaries. However, scammers may try to take advantage of this new program by offering fake services or creating fraudulent schemes.”

Beyond financial damage

The financial toll of Medicare fraud is staggering, estimated at tens of billions of dollars annually. But experts warn the personal impact on seniors can be equally devastating. Victims may face compromised medical records, denied legitimate services due to fraudulent claims, and emotional distress after realizing their trust was exploited.

The Centers for Medicare & Medicaid Services (CMS) and the Department of Justice have ramped up investigations, arresting hundreds of individuals in recent years linked to fraudulent billing networks. Still, officials say prevention remains the most effective defense.

Public education campaigns stress a few key reminders: Medicare does not cold-call beneficiaries asking for money or sensitive information, genetic tests must be ordered by a trusted physician, and suspicious charges should always be reviewed on Medicare Summary Notices.