Is This Medicare Calling?

Medciare scams on the rise

Be very cautious if someone calls you claiming to be from Medicare

If you’re age 65 or over, then you have undoubtedly received phone calls from a wide range of solicitors, asking you if they can “have just a minute of your time” to discuss anything from health care coverage to hearing aids. And, if you’re like most people, it is very possible that you politely declined.

But what about calls that you receive about Medicare benefits? Watch out!

Original Medicare – which is also known as Medicare Part A and Part B – has been around for more than fifty years. As a program of the U.S. government, most people are aware that these particular plans provide similar benefit offerings and charge similar premiums (or no premium at all for Part A) for most enrollees in the program.

But what many Medicare beneficiaries may not be so clear on is the fact that Medicare Advantage plans, and Medicare Part D prescription drug plans, are offered via private insurance companies – and because of that, there are insurance agents and brokers who work to solicit and sell such plans. Therefore, these insurance professionals are oftentimes in fierce competition for your business.

What Medicare Agents Can and Cannot Do Via the Telephone

Based on the new Medicare Communications and Marketing Guidelines, Medicare Advantage plan and Medicare Part D (prescription drug coverage) plan sponsors – as well as their agents and brokers – are not permitted to make unsolicited phone calls to prospective enrollees.

In fact, according to Medicare’s new communication guidelines, there is a list of various activities that are considered to be big no-no’s when it comes to promoting these types of Medicare coverage options.

These prohibited activities include the following:

  • Making unsolicited phone calls regarding other business as a means to generate leads for Medicare Part C and / or Part D plans. This type of activity is actually considered to be “bait and switch.”
  • Generating calls that are based on referrals. In this case, if an individual would like to refer a relative or a friend to a Medicare Advantage or Medicare Part D agent, then the agent or plan sponsor may provide their contact information (such as giving them a business card). However, the agent or plan sponsor is not allowed to initiate this type of phone contact with the referral.
  • Making calls to market Medicare plans or products to those who were formerly enrolled in a plan, but who have since disenrolled. Likewise, calls may not be made to current enrollees in such plans who are in the process of disenrolling.
  • Making phone calls to Medicare enrollees who attended a seminar or sales event – unless the individual has given express permission at the event to receive a follow-up call. (It is important to note here that there must be documentation of this permission to contact them).
  • Making calls to prospective Medicare Advantage and / or Medicare Part D enrollees in order to confirm receipt of information that was mailed to them.

If you do receive a call from someone who is soliciting Medicare Advantage or Medicare Part D plans – and that call is generated by an agent or a company with which you are not already a plan holder – then it is possible that the caller is not abiding by the Medicare communication guidelines.

If that’s the case, you should by no means feel obligated to continue the conversation with that individual, nor should you consider making a purchase of any Medicare-related coverage through him or her.

If you do happen to have questions regarding your present Medicare coverage and / or alternate Medicare coverage that you may be thinking about purchasing, it is typically best to contact a Medicare professional and / or to visit the official Medicare website at


Medicare Communications and Marketing Guidelines (MCMG). July 20, 2018.

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Author Bio: Ben started Prepare for Medicare in 2014 to help people help people get objective answers to questions about Medicare. He’s held leadership roles at numerous Fortune 500 Medicare health insurers in product development, sales, marketing and strategy for over 20 years.