Medicare fraud just got more dangerous — here’s your defense

Medicare fraud prevention tips: how to protect your identity and benefits

In this FinStream short, Bob Powell interviews Jae Oh about a recent advisory from the Financial Crimes Enforcement Network highlighting rising fraud risks.

The message is clear: Medicare fraud prevention tips are more important than ever, and beneficiaries themselves are the first line of defense.

Why fraud risks are increasing

Federal regulators warn that many fraud schemes begin with stolen personal information.

Criminals may:

Submit unauthorized Medicare claims

Impersonate officials to extract personal data

Bill for services never received

For retirees, the financial and administrative consequences can be significant.

What changed, who is affected and why it matters

The latest advisory increases expectations not only for financial institutions, but also for individuals.

Medicare beneficiaries — particularly older adults — are increasingly targeted through scams designed to capture sensitive information.

Even small missteps, such as sharing a Medicare number or ignoring billing notices, can lead to long-term issues.

What this means for you

Applying basic Medicare fraud prevention tips can significantly reduce your risk:

Treat unsolicited Medicare calls as suspicious

Regularly review your Medicare statements

Protect your Medicare number like a financial account number

These simple actions can help prevent both financial loss and administrative complications.

Start with basic fraud prevention steps

Oh emphasizes the importance of verifying who you are dealing with.

Licensed insurance professionals have a National Producer Number (NPN), which consumers can request. If a caller refuses to provide it, that is a clear red flag.

Equally important:

No one from Medicare or Social Security will contact you to ask for sensitive personal information.

Review your Medicare Summary Notice (MSN)

One of the most effective fraud detection tools is the Medicare Summary Notice.

Although often overlooked, it provides a detailed record of services billed to Medicare.

Review your MSN for:

Services you did not receive

Duplicate charges

Providers you do not recognize

While some discrepancies may be simple errors, others may indicate fraud.

This step is especially important for those with Medigap coverage, where out-of-pocket costs may be low and issues less noticeable.

Protect your Medicare number

Your Medicare identification number is sensitive information.

Although it is no longer tied directly to your Social Security number, it still provides access to your benefits.

To reduce risk:

Avoid sharing your Medicare number unnecessarily

Be cautious with phone calls, emails or messages requesting information

Use official channels when communicating with providers

Know what to do if you suspect fraud

If something seems wrong, act quickly.

Medicare provides reporting channels that allow beneficiaries to flag suspicious activity, even anonymously.

These systems are designed to protect consumers — but they depend on individuals taking action.

The growing role of advisers and families

Financial advisers are increasingly helping clients manage not just investments, but also risks like fraud.

Health care costs and coverage issues are often top concerns for retirees.

Families also play a key role. Adult children frequently help aging parents navigate financial and medical decisions, especially as cognitive changes can affect judgment over time.

Stay informed without being overwhelmed

One of the simplest ways to stay current is by signing up for updates through official Medicare resources.

These updates provide timely information on risks, policy changes and best practices — helping beneficiaries stay protected without becoming overwhelmed.

The bottom line

Medicare fraud is becoming more sophisticated, but prevention often comes down to awareness and consistency.

By following basic Medicare fraud prevention tips, reviewing your statements and protecting your personal information, you can reduce risk and maintain control over your health care and finances.