Medicare Scam or Medicare Survey? Does Medicare Ever Call You?

Dear Matt,

I don’t remember if you covered Medicare scams or not in your book.

I got a call this morning purporting to be from Medicare. He said they were taking a survey. I asked if this was an attempt to sell me on some Medicare insurance, and he said no, that he was just taking a survey.

I know that Medicare would not waste their time on the phone with a survey, so I told him I wasn’t interested in participating in a survey and it seemed to surprise him, and I said goodbye and he did also.

I don’t know what the actual intent was of the call, but I am usually a few steps ahead of phone scams and sometimes play along for a while. I wasn’t in the mood today, so I ended it rather quickly.

How do we know what is, and isn’t a Medicare scam?

Thanks!

Don H.

Don,

Awesome question, and good for you. If I’m certain it’s a telemarketer or potential scammer, sometimes I stay on the phone just a little bit to mess with them. When my kids were smaller, I used to just hand the phone to them to see how long the caller would put up with a 5-year-old answering their questions. It was entertaining.

I didn’t address Medicare scams in the book because quite frankly, there are a million of them. Maybe even a billion. Medicare themselves just released yet another scam warning this month, this time centered around COVID-19 tests. Here’s the text of the email they sent out.

“Have you gotten robocalls, text messages, or emails offering COVID-19 tests in exchange for your Medicare Number? Be careful! Scammers are selling fake and unauthorized at-home COVID-19 test kits in exchange for your personal or medical information. Do not give out your Medicare Number for COVID-19 test kits!”

So yeah, Medicare scams are everywhere.

Will Medicare Call Me?

But this is really the crux of your question: Does Medicare ever call me?

Don, I actually thought this was going to be an easy question to answer. I expected I was going to be able to tell you something along the lines of, “no Don, do NOT answer the phone. Don’t give them any information. Hang up.”

If you wander around the internet (don’t do it; I told you this was dangerous and time-sucking in my book, remember? Ha!), 99% of the generic “advice” on this topic goes something like this:

Hang up.
Do not carry your Medicare card with you. Keep it in a safe place.
Never give your Medicare or Social Security number to strangers.
Don’t take “free” offers in exchange for your Medicare number.
Don’t let anyone into your home.
Never sign a blank form.
HANG UP!!!
HANG UP!!!

Medicare gets in on the advice action, too. Here’s their website.

Besides a couple of those pieces of advice hopefully being patently obvious, the rest of it is usually to hang up. But when I started poking around, I quickly realized this isn’t the best advice, nor is it always a scam when “Medicare” calls you. It’s more nuanced than that.

That’s because the answer is yes. YES, “Medicare” can and does call you. What’s more, other federal agencies and research entities acting on behalf of Medicare can call you. But as far as I can tell, that phone call will likely be in addition to something being mailed to you. Not emailed – snail-mailed.

To put it another way: sure – there are scam phone calls being made where people try to give you a “survey” in exchange for something. Don’t fall for those, obviously. How can you tell? A few ways.

1. Don’t volunteer any information. If THEY call YOU, they should have all of YOUR information already. Make them read it to you, and then you can VERIFY that information, by corroborating it with something, like a date of birth.

2. Call them back. Don’t give out or validate anything; ask the caller for their name, (they’ll usually only give their first name and possible last name initial for their own privacy) their identification number and their company/organization’s call-back number so you can validate the legitimacy of the call. Obviously, if they falter, stammer, hedge or say no or can’t… THEN hang up.

-If they provide valid name, ID and call-back information, I’d personally hang up and call them back on the number they provided.

-Basically, YOU call THEM and ask THEM to validate themselves.

3. Ask them if they’re recording the phone call, or if, “this phone call is on a recorded line.” Legitimate Medicare organizations will record all their calls.

4. Check your mail pile. If you get a phone call about a legitimate Medicare survey, you will have already gotten a letter (or two!) in the mail telling you someone would call about a survey.

As far as I can tell, the four big “legitimate” Medicare surveys will initially start out as surveys they mail to you, and you’re supposed to mail back. In fact, even before they call you, they’ll usually send you two letters before they start calling you. But they will start calling you if you don’t answer their questions they sent to you and want you to mail back to them by USPS.

Keep reading for more information about the four “legitimate” Medicare surveys you may be asked to take and yes, be called on the phone for. But before we move on…

Medicare Insurance Companies Call, Too

If you have a Medicare Advantage plan, a Medicare Supplement plan or a Medicare Part D Prescription Drug Plan (PDP) your Medicare insurance company will also call you as well. Often. They’d call you about a bill, about a claim, they’d call you to market another product to you, they’d call you to get you into the doctor’s office, they’d call you if you hadn’t filled a maintenance prescription, or if your mail-order drugs were delayed… all sorts of reasons.

Why Would Medicare Call Me?

From what I can tell, there are actually a couple of reasons why Medicare might call you.

First of all, let’s be clear: I’m talking about Medicare, the federal program. Original Medicare, not your Medicare insurance company for your Medicare Supplement/Medigap, Medicare Advantage or your Medicare Part D Prescription Drug Plan. Those are administered my Medicare insurance companies. Not Medicare, but those Medicare insurance companies might call you, too for reasons I outlined above.

Now that we’re clear, the answer is yes. Yes, Medicare could call you if

You’ve previously called them, or
They’re attempting to survey you.

Medicare May Call You Back If You Called Them

I directly copied and pasted the following from the Medicare website: “A customer service representative from 1-800-MEDICARE can call you if you’ve called and left a message or a representative said that someone would call you back.”

In other words, if you’ve called 1-800-MEDICARE (1-800-633-4227) for any reason lately, and someone on the phone said they’d call you back, then -yes- Medicare can call you back. Or, if you left a message with Medicare after no one answered. Then, Medicare may call you back. Notice I said may call you back. *wink*

Why would you call Medicare? Lots of reasons. Maybe you’re “Bare with Medicare” and don’t have a Medigap, Medicare Supplement or Medicare Advantage plan and have a question. Maybe you filed a complaint against a Medicare insurance company, hospital or doctor. For example, if you filed a complaint by calling 1-800-MEDICARE, called them about a billing question, a claims question, medical records, or some other Medicare question and they didn’t have an answer for you, the phone representative might take your name/number down and have someone else call you with the answer, an update or a follow-up question.

So, here’s a good rule of thumb: Unless you have called Medicare in the past and filed some sort of complaint, 99% of the time Medicare doesn’t call you, either unless you’ve somehow got an outstanding issue with them. They usually send you something in the mail if anything at all.

Unless… Medicare is doing a survey, and they do a fair number of surveys.

Medicare Surveys

From what I can tell, there are at least four different types of Medicare surveys going on at different times of the year.

I say “as far as I can tell” because I can’t really tell. Based on my experience and professional background, I personally know of four. I spent a fair amount of time tooling around the internet looking for a comprehensive list of Medicare surveys and other reasons Medicare would call someone. If it exists, I cannot find it. Feel free to email me if you do.

What I did find was a list of surveys the Department of Health and Human Services holds throughout the year, but it’s dated 2012. Hm. Here it is anyway.

Four Common Medicare Surveys

Here are four of the Medicare surveys I’m aware of that may/might/will call you. The problem is, I can’t tell you when they’ll mail you or what those letters look like, before they start calling you. That’s because the websites associated with those surveys are about as helpful as a two-legged stool (with one exception; the MCBS website is fine and actually helpful).

CAHPS Survey

It’s pronounced, “caps” and this survey (The Consumer Assessment of Healthcare Providers and Systems; CAHPS) is an annual Medicare survey that runs from February through May every year, but they usually don’t start calling people until March or April. The survey results actually feed into the Medicare Star Ratings measurements, which I address in my book. Apparently, The Agency for Healthcare Research and Quality runs the CAHPS surveys. I tried calling them. No one answered, and when I pressed ‘1’ to leave a message as the voicemail system instructed, the system hung up on me. Very helpful.

But they will and can call you. However, they will mail you the CAHPS survey in the mail up to two times before they start calling you to do it over the phone. They begin calling you if you don’t return their survey.

HOS Survey

The Medicare Health Outcomes Survey (HOS) monitors the quality of care provided by Medicare Advantage insurance companies and runs from July to November each year, but they may have moved it due to COVID. So, if you’re on a Medicare Advantage plan, you may get an invitation to provide feedback.

The National Committee for Quality Assurance (NCQA) administers the Health Outcomes Survey (HOS) in partnership with the Centers for Medicare & Medicaid Services (CMS), but they essentially outsource the survey work to other entities or companies.

So, you may get a call from someone who says, “Hi, this is Matt and I’m calling on behalf of (insert your Medicare Advantage insurance company here).” It’s not really your Medicare insurance company, but it’s a vendor approved by the NCQA and CMS.

I called the phone number I found on their website, too. It wasn’t answered by a human, and simply asked the caller (me) to leave a message. I didn’t. Their website incidentally, looks like it was designed in 1998, so prepare to be underwhelmed.

As far as I can tell, this survey follows the same/similar cadence and guidelines as the CAHPS survey. They’ll snail-mail you the survey, do it again, then call you to do it over the phone or press you to return the mailed survey.

The Medicare Advantage and Prescription Drug Plan Disenrollment Reasons Survey

This survey can be given to anyone who dropped a Medicare Advantage plan or a Medicare Part D Prescription Drug Plan during the Annual Election Period (AEP), Medicare Advantage Open Enrollment Period (OEP) or any other time, even if they just moved from one Medicare Advantage plan to another, or from one Part D plan to another. They just want to know why you switched plans, it seems.

I can’t tell if someone will actually call you to take this survey. Here’s what it says (lightly edited so it’s not so much government-speak) on the website:

A random sample… is drawn monthly and surveyed as soon as possible following the beneficiary’s actual date of disenrollment. The participants receive a pre-notification letter and up to two mailed survey packages (original and follow-up) within a 1-2 month window from time of disenrollment. The survey asks participants what reasons prompted them to disenroll from their contract including financial, drug or health benefits, customer service, and the coverage of doctors and hospitals by the contract.

So, it looks like this follows the CAHPS and HOS survey methodology, which is mail, mail, then a phone call. Except I can’t tell if they actually call on this survey.

The Medicare Current Beneficiary Survey (MCBS)

The Medicare Current Beneficiary Survey (MCBS) is a survey Medicare outsources to NORC at the University of Chicago to conduct the MCBS. NORC engages in sampling, data collection, data processing, and data delivery as part of conducting the surveys for Medicare. Of the surveys I’ve listed, their website is by far the most helpful. I also called them at 844-777-2151 and someone immediately picked up. As far as phone calls into a governmental agency, it was a wonderful experience. When was the last time you heard the words “government” and “wonderful” in the same sentence? I kid, I kid…

Anyway, they will also send you something in the mail and then call you and attempt to get you to take a survey. The surveys can last for over an hour. Medicare takes great pains to explain on their survey-specific website why they’re doing the survey, and I’ve copied and pasted it for you below.

“The MCBS is an ongoing survey designed to learn more about the people who are covered by Medicare. MCBS data help legislators and policy makers understand the health care needs and utilization of Americans covered by Medicare.

MCBS data are also used to improve the Medicare program. The MCBS is an invaluable source of information for administering, monitoring, and evaluating the Medicare program. For example, data from the MCBS have been used to inform many enhancements to Medicare coverage, including the creation of new benefits such as Medicare’s Part D prescription drug benefit.

We will contact you by mail, by phone, or in-person to provide more information on the interview and schedule an appointment for the Medicare Current Beneﬁciary Survey.”

The person I spoke with was very helpful. I asked her how people could be sure this wasn’t a scam, and she had a very good answer, which you can also find right on the website.

“How will I recognize the Medicare Current Beneficiary Survey interviewer?

The interviewer is a representative from NORC at the University of Chicago who wears an official NORC ID badge with their picture, name, title, ID number and signature. On the back is a distinctive hologram and phone number to call to confirm the interviewer’s identity.

If you have any questions about the credibility of an interviewer or your survey participation, you can visit http://www.norc.org/verifyme, call 1-866-856-NORC, or email surveyhelp@norc.org. You may ask for an interviewer’s employee ID number on their badge and verify they work at NORC using any of the resources above.”

They have a very nice Q&A and FAQ on their site, and I’ve copied and pasted “What Can I Expect” for you to start with.

They even have a YouTube video you can watch! https://youtu.be/fW3KAcRs5oA

I mean, WOW! Right there on the website. I wish those other government websites would be as clear as the NORC’s. Nice job, NORC!

So there you have it, Don. What I thought was going to be a small 250-word blog post turned into a 2,800 word article.

I love answering Medicare questions. Send me yours by clicking here and I’ll pick a few for a future blog post!

To your wealth, wisdom, and wellness!

-Matt Feret

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Author Bio: Matt Feret is the author of the Prepare for Medicare book series and launched prepareformedicare.com to help people get objective answers to questions about Medicare. He’s also the host of The Matt Feret Show.

Matt has held leadership roles at numerous Fortune 500 Medicare health insurers in sales, marketing, operations, product development and strategy for over 20 years. Matt holds a BA from Virginia Tech and an MHA from Washington University in St. Louis.

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