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If a Medicare claim looks wrong, a caller asks for your Medicare or Social Security number, or a website appears to impersonate Medicare, stop sharing information and use an official reporting route. Check the claim against your records, preserve the evidence, and report the issue to the destination that matches it: Medicare, the HHS Office of Inspector General (OIG), I-MEDIC for Medicare Advantage or prescription-drug-plan cases, or an available consumer-fraud service for a suspicious website.
The safest rule for an unexpected call is to hang up and contact Medicare independently. Do not use a callback number, web address, or payment instruction supplied by the caller.
Choose the reporting route by what happened
Different problems belong with different offices. A questionable bill is not handled exactly like an impersonation call, and a suspicious website may require a different response from a plan-related complaint.
| Situation | Primary action | Official contact |
|---|---|---|
| Unfamiliar or incorrect Original Medicare claim | Check your statement and records, contact the provider about an apparent error, then report suspected fraud. | Medicare reporting route: Medicare.gov reporting Medicare fraud and abuse; 1-800-MEDICARE (1-800-633-4227) |
| Suspected fraud requiring an HHS investigative channel | Submit as much factual detail as possible. | HHS OIG hotline: 1-800-447-8477; online complaint portal: tips.oig.hhs.gov |
| Medicare Advantage or Medicare prescription drug plan concern | Use Medicare’s route and add the plan-specific I-MEDIC channel. | I-MEDIC: 1-877-772-3379 |
| Unsolicited call claiming to be Medicare | Do not provide information or payment. Hang up and independently call Medicare. | Use the Medicare number in this table, not a number supplied by the caller. |
| Suspicious website or payment page | Leave the page, do not enter data, save the address and other facts, and check the current status of the FTC consumer-fraud reporting service. | FTC ReportFraud status is operationally changeable; the page observed at this FTC FAQ address displayed a shutdown notice when checked. |
CMS’s July 2024 4R’s for Fighting Medicare Fraud publication lists the Medicare, OIG, I-MEDIC and Senior Medicare Patrol resources together. You can read the contact sheet at Medicare publication 11610.
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These routes can overlap. For example, a fake enrollment page that collects a Medicare number is both a suspicious website and a potential Medicare fraud lead. Preserve the page information, then report the Medicare-related conduct to Medicare or OIG. If the person is enrolled in Medicare Advantage or a drug plan, add I-MEDIC. Do not wait for a website-reporting service to become available before reporting a claim or impersonation issue through an official Medicare channel.
Before reporting an unfamiliar Medicare claim
An unfamiliar entry is a reason to investigate, not automatic proof of fraud. Providers can make billing or coding mistakes, and a service may appear under a date or description that differs from your appointment notes.
- Find the statement. Gather the Medicare Summary Notice or other claim statement showing the service, date, provider or supplier, and amount.
- Compare it with your records. Check appointment calendars, discharge papers, prescriptions, transportation records, receipts and notes from the person who received care. Look for services that were never received, duplicate charges, an incorrect date, or a provider you do not recognize.
- Check claims online when available. A secure Medicare.gov account can show Original Medicare claims as they are processed. Sign in by entering the address yourself or using a trusted bookmark; do not follow a login link from an unexpected message.
- Ask the provider about an apparent error. Use contact information from a statement, an established medical record, or the provider’s independently verified office—not a phone number supplied by a suspicious caller or website. Explain the specific date, service and amount in question and keep the response.
- Report when the explanation does not resolve the concern. If the service was not provided, the answer is inconsistent, or the pattern suggests intentional billing, use a formal route in the table above.
Review claims regularly rather than waiting for a problem to become urgent. If someone else manages paperwork for the beneficiary, agree on a secure way to compare statements and retain receipts. When you call a provider, record the date, the department, the person spoken with and what correction, if any, was promised. That record helps an agency distinguish a simple mistake from an unresolved pattern.
Do not delay simply because you are still collecting every detail. Report what you know, identify what remains uncertain, and keep additional documents available if an agency follows up.
How to submit a Medicare fraud report
Use Medicare’s general reporting route
Medicare’s reporting Medicare fraud and abuse page explains its online reporting route and telephone option. Give a clear account of the claim or conduct, including the beneficiary’s contact information when you are authorized to provide it, the provider or supplier, dates of service, the service shown, and why it appears wrong. Attach or retain supporting records according to the instructions on the official form; never email account passwords or submit a Medicare login credential.
For a telephone report, call 1-800-MEDICARE (1-800-633-4227). Make the call yourself through a number obtained from Medicare’s official site or your trusted statement. Write down the date of the call, the department or representative name if offered, any reference number, and what documents you were told to provide. If you are calling for another beneficiary, ask what authorization or identifying information is needed before disclosing details.
Use the HHS OIG hotline or complaint portal
The HHS OIG channel is useful when you want to report suspected fraud to the department’s investigative office. CMS’s 2024 fact sheet lists 1-800-447-8477 and the online portal at tips.oig.hhs.gov. Describe who was involved, what occurred, when and where it happened, and how the contact, service or billing took place. Distinguish facts you personally observed from information someone else gave you.
Save a copy of what you submitted and any confirmation screen. Use the same factual timeline if you submit through more than one appropriate channel, and note the dates so you do not accidentally provide conflicting descriptions. The OIG route does not make an unfamiliar charge valid or guarantee a particular outcome; it gives investigators a factual lead that can be evaluated with other information.
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Add I-MEDIC for a Medicare Advantage or drug-plan case
If the beneficiary is enrolled in Medicare Advantage or a Medicare prescription drug plan, CMS lists I-MEDIC at 1-877-772-3379 as an additional reporting channel. Have the plan name, member or claim details, dates, provider information and notes ready. You may also report through Medicare or OIG; I-MEDIC is an extra plan-related route, not a replacement for documenting the incident.
Check the insurance card or plan materials for the plan’s own fraud-and-abuse contact if one is provided, but verify any number independently. Do not assume that a caller who knows the plan name is authorized to speak for it.
How to handle a suspicious Medicare call
Medicare says it does not call people to sell products or visit their homes. An unexpected caller who requests a Medicare number, Social Security number, bank or card details, a one-time code, or money—or who threatens to cancel benefits—should be treated as suspicious. Medicare may make a limited return call when someone previously contacted Medicare, so the fact that a call is inbound is not by itself proof of fraud; verify it independently.
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- Do not authenticate yourself to the caller. Do not confirm your full name, date of birth, Medicare number, Social Security number, address, payment details or account codes merely because the caller already knows part of them.
- Do not click or remain on a prompted website. A caller may try to move the conversation to a remote-support tool, text-message link or payment page. Decline and end the call.
- Hang up without arguing. You do not need to keep the caller engaged to gather proof. If you want a record, note the displayed number, caller’s claimed organization, time, callback request, script, and any payment demand after the call ends.
- Call Medicare independently. Use 1-800-MEDICARE (1-800-633-4227) from the official Medicare source in the table, your statement, or a known safe record. Ask whether the contact was legitimate and report the impersonation or attempted disclosure.
- Secure accounts if you disclosed information. Tell the relevant financial institution or plan, monitor statements, and follow the official agency’s instructions. Do not call back using a number in the suspicious message.
A caller’s use of familiar terms, a local-looking number, a badge number, or a claim that your benefits will end does not establish legitimacy. Caller ID can be manipulated, and real agencies do not require you to pay immediately to preserve Medicare coverage. Treat pressure, secrecy, requests for gift cards or unusual payment methods, and demands for a one-time verification code as reasons to end the conversation rather than proof that you must act quickly.
How to respond to a suspicious Medicare website
A fraudulent page may copy government colors, logos, enrollment language or a sign-in screen. A plausible appearance is not verification.
- Exit before entering information. Do not type a Medicare number, Social Security number, password, payment-card data or medical details into a page reached from an unsolicited email, text or call.
- Verify the destination separately. Open a new browser window and type Medicare.gov yourself or use a bookmark you created previously. Check the domain character by character; look-alike spellings and extra words are warning signs.
- Preserve non-sensitive evidence. Record the complete web address, date and time, how you reached it, the claimed organization, the message that contained the link, and what the page requested. A screenshot can help, but do not capture passwords or full account numbers.
- Do not send credentials to an unverified address. If a form asks you to upload identity documents or email a copy of your Medicare card, stop and verify the request through an official channel.
- Check the FTC reporting service before using it. The FTC ReportFraud page linked above displayed a government-shutdown notice when it was checked, stating that the service was unavailable and would resume when funding resumed. That observation is time-sensitive and does not establish its current availability. If the service is unavailable, retain the evidence and use the Medicare or OIG route when the incident concerns Medicare, while following any current instructions shown on an official FTC page.
The verified Medicare materials provide reporting routes for Medicare fraud but do not establish a separate Medicare-specific form solely for reporting a deceptive website. Report the Medicare-related conduct through Medicare or OIG, and describe the website as part of the facts. If you already entered data, do not revisit the page to test it or download a supposed security tool; use a separate, trusted device or official contact route to get account-security instructions.
What information makes a report useful
CMS advises providing as much information as possible. Organize the material so an investigator can identify the people, event, timing and method without guessing.
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- What: service billed, service promised, information requested, payment demanded, statement language, or exact claim that appears wrong.
- When and where: dates of service, call or message times, location of care, mailing address, email address, and web address.
- How: whether contact came by phone, text, email, mail, an advertisement, a portal or an in-person visit; include the sequence of events.
- Documents: Medicare statement, receipts, appointment notes, provider correspondence, messages, envelopes and screenshots. Keep originals and label copies with dates.
Write a short timeline before submitting: first contact, request made, your response, any payment or disclosure, and what happened afterward. Quote unusual wording accurately when you can, but do not guess at the caller’s identity or intent. If another person witnessed the call or handled the mail, identify that person and separate their account from your own.
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Do not alter a document to make it clearer, and do not forward a suspicious attachment to friends or family. Store evidence in a secure location and redact unnecessary Social Security, Medicare, banking or login information when sharing a copy is not required. An agency may request a complete document later through a verified channel; keep the unredacted original private until then.
After you report
Reporting is not the same as deciding that a provider committed fraud. Agencies may need to compare records, contact the provider or request more information. Keep your notes, confirmation numbers and claim statements together, and respond only through contact details you verify independently.
Continue checking later Medicare statements and financial accounts for related activity. If a provider confirms a billing error, retain the corrected statement and the provider’s explanation. If a suspicious caller or website obtained personal information, follow the affected plan’s or financial institution’s account-security process promptly; do not wait for the suspicious party to contact you again.
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Free local help from Senior Medicare Patrol
CMS’s July 2024 publication points to Senior Medicare Patrol (SMP) for education and assistance. Use the locator at smpresource.org or call 1-877-808-2468. SMP helps people with Medicare understand the care they receive and address suspected fraud. It is a support and education resource, while Medicare, HHS OIG and I-MEDIC remain the formal reporting channels described above.
SMP can be especially useful when a beneficiary wants help reading a statement, organizing records or understanding what to report. Confirm the contact details through the SMP site, and remember that an educator or volunteer should not need your password or ask you to send payment to obtain assistance.
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The statement shows a service you never received
Compare the date and provider with your records, ask the provider to explain the entry, and report it through Medicare. Add an OIG report when appropriate, and use I-MEDIC as an additional route if the coverage is Medicare Advantage or a drug plan.
A caller demands immediate payment to keep benefits
End the call, do not pay or disclose information, document the script and displayed number, and independently call Medicare. A threat to cancel coverage is a reason for caution, not a reason to comply quickly.
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A text or email links to a Medicare-looking login page
Do not open the page again or enter credentials. Save the message and full address, verify Medicare through a separately opened official site, and report the Medicare-related deception through the applicable agency route.
You are unsure whether an entry is an error or fraud
Report the uncertainty accurately. State what the statement says, what your records show, what the provider told you, and which facts you cannot verify. Agencies can assess intent; your job is to preserve the evidence and avoid adding assumptions.
You gave a caller your Medicare number
Stop further contact, write down exactly what was disclosed and when, and call Medicare through 1-800-MEDICARE. Notify the plan or financial institution involved and monitor later statements. Do not trust a caller who offers to “fix” the exposure for a fee.
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Can I report a suspicious call even if I did not give the caller any information?
Yes. Record the claimed organization, displayed number, time, request and any threat, then independently contact Medicare and describe the attempted contact. An attempted impersonation is worth documenting even when you ended the call immediately.
Should I call the provider before reporting an unfamiliar claim?
For an apparent billing error, Medicare recommends contacting the provider first. Report through an official channel when the explanation does not resolve the concern or the facts suggest intentional billing. Do not let a provider’s request that you stop asking questions prevent you from reporting facts you still cannot reconcile.
Is the FTC ReportFraud website currently available?
Its availability can change. The FTC page cited here displayed a government-shutdown notice when checked, so verify its current status before relying on it. A Medicare-related claim or impersonation can still be reported through Medicare or HHS OIG even if that FTC service is unavailable.
What if I have Medicare Advantage or a prescription drug plan?
Report through Medicare or HHS OIG as appropriate and use I-MEDIC as the additional plan-specific channel listed by CMS. Keep the plan name, member information, claim details and dates ready, and use contact information you verify independently.
Does Medicare ever call people?
Medicare says it does not call to sell products or visit the home. It may make a limited return call after someone has contacted Medicare. Because caller ID and scripts can be copied, end an unexpected request for personal information and call 1-800-MEDICARE yourself.
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What should I do if I cannot prove the website was fraudulent?
Do not make a conclusion you cannot support. Save the address, message, screenshots without sensitive data and the information the page requested. Report the observable conduct and explain what you could not verify; the receiving agency can evaluate whether it was deceptive.
Frequently Asked Questions
Can I report a suspicious call even if I did not give the caller any information?
Yes. Record the claimed organization, displayed number, time, request and any threat, then independently contact Medicare and describe the attempted contact.
Should I call the provider before reporting an unfamiliar claim?
For an apparent billing error, Medicare recommends contacting the provider first. Report through an official channel when the explanation does not resolve the concern or the facts suggest intentional billing.
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Is the FTC ReportFraud website currently available?
Its availability can change. The FTC page cited here displayed a government-shutdown notice when checked, so verify its current status before relying on it.
What if I have Medicare Advantage or a prescription drug plan?
Report through Medicare or HHS OIG as appropriate and use I-MEDIC as the additional plan-specific channel listed by CMS.
Does Medicare ever call people?
Medicare says it does not call to sell products or visit the home. It may make a limited return call after someone has contacted Medicare. Verify any unexpected request by hanging up and calling 1-800-MEDICARE yourself.
What information should I include in a report?
Give the people or organizations involved, what happened, dates and locations, how the contact or billing occurred, and supporting statements, receipts, messages or screenshots. Separate facts you observed from information you cannot verify.
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What if I already shared my Medicare or payment information?
Stop communicating with the caller or site, contact Medicare and the affected plan or financial institution through independently verified numbers, monitor statements, and follow their account-security instructions.
The Bottom Line
Check the claim, stop unsolicited contact, preserve non-sensitive evidence and report through the channel that fits the problem: 1-800-MEDICARE or Medicare.gov, HHS OIG at 1-800-447-8477 or tips.oig.hhs.gov, and I-MEDIC at 1-877-772-3379 for Advantage or drug-plan cases. Medicare does not call to sell products or visit homes. Verify every contact independently, and check the FTC service’s current status before using it for a suspicious website.
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