For a questionable Medicare claim, call 1-800-MEDICARE (1-800-633-4227) or use Medicare’s online reporting route. You can also report suspected fraud to the HHS Office of Inspector General (OIG) at 1-800-447-8477 or tips.oig.hhs.gov. If the issue involves a Medicare Advantage or Medicare drug plan, I-MEDIC at 1-877-772-3379 is an additional channel. For an unsolicited caller, do not provide personal or payment information: hang up and independently call Medicare. Treat a suspicious website as untrusted, save its details without entering data, and use the appropriate official channel.
Choose the reporting route that matches the problem
“Medicare fraud” and a suspicious Medicare-themed call or website are related but not identical problems. A billing dispute normally starts with checking the claim and contacting the provider. Suspected fraud can then be sent to Medicare or the HHS OIG. A Medicare Advantage or Medicare drug-plan case has an additional plan-fraud route through I-MEDIC. A suspicious call should be stopped and verified through a number you look up yourself. A suspicious website should be handled as unsafe until its legitimacy is established.
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The right destination depends on both the conduct and your coverage. An unfamiliar Original Medicare claim is different from a call demanding a payment, and a fake enrollment page is different from a provider’s corrected billing entry. You can use more than one official channel when the facts overlap, but describe the same event consistently and keep your records of each report.
| What happened | Primary action | Official contact |
|---|---|---|
| An unfamiliar or incorrect Original Medicare claim | Check the claim, ask the provider about an apparent error, then report suspected fraud | Medicare fraud and abuse reporting or 1-800-MEDICARE (1-800-633-4227) |
| Suspected fraud involving a provider, supplier, or Medicare program | Send as much factual information as possible to the HHS OIG | 1-800-447-8477 or tips.oig.hhs.gov |
| Medicare Advantage or Medicare drug-plan concern | Use the plan-related fraud channel in addition to the general routes | I-MEDIC: 1-877-772-3379 |
| Unsolicited caller asking for information, money, or threatening benefits | Hang up; do not disclose information; call Medicare directly | 1-800-MEDICARE (1-800-633-4227) |
| Suspicious website or online form | Do not enter data; document the page; report the underlying Medicare issue through Medicare or OIG | Medicare or OIG routes above; the FTC reporting service’s availability must be checked before use |
Check the claim before calling
An unfamiliar entry is not automatically fraud. A provider may have used a different billing name, or a claim may appear before you receive a bill or explanation. Medicare recommends reviewing claims regularly, comparing the listed service and date with your own records, and asking the provider to explain an apparent mistake.
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Use your records and Medicare account
- Match the service, date of service, provider or supplier, and any amount shown on the Medicare statement against appointments, receipts, and notes.
- For Original Medicare, a secure Medicare.gov account can show claims as they are processed. Check the account through Medicare.gov rather than a link in an unexpected message.
- Write down why the item is unfamiliar. A short, precise explanation is more useful than a general statement that the bill “looks wrong.” Note whether you were elsewhere, received a different service, or never saw the provider.
- Keep the statement, receipts, correspondence, and your notes. Do not alter the original document. Make a copy or photograph for your working file.
- Check for duplicate entries, dates that do not match your appointments, services you declined, or a supplier you do not recognize. These are reasons to ask questions, not proof by themselves.
Ask the provider about a simple error
Contact the provider or supplier named on the statement and ask for an explanation of the date, service, and billing entry. Use contact information from your statement, prior records, or the provider’s independently verified website, not a number supplied by a suspicious caller. If the provider corrects an administrative error, keep the explanation and any corrected paperwork.
If the provider cannot explain the charge, refuses to correct it, or the facts suggest intentional billing, report it through an official fraud channel. Do not let a provider’s request that you “wait” prevent you from reporting a reasonable suspicion. You can explain that you contacted the provider and include the response, or say that you could not reach the provider.
Do not delay a report merely because you are still collecting every detail. CMS’s July 2024 4R’s for Fighting Medicare Fraud publication advises giving as much information as possible; you can provide additional facts if an agency asks for them. Separate what you personally observed from what someone else told you.
Report suspected Medicare fraud
Option 1: Medicare
- Gather the statement, provider information, service dates, receipts, and notes describing what appears wrong.
- Call 1-800-MEDICARE (1-800-633-4227), or use the online instructions on Medicare’s “Reporting Medicare fraud & abuse” page.
- Explain whether the issue is an unfamiliar service, a duplicate charge, a service you did not receive, or another discrepancy. Give the names, dates, and amounts exactly as shown on your records.
- Keep a record of when you reported the matter and any reference information the representative provides. Record any follow-up instructions and the date you were told to expect a response.
Use the number and website you obtain from Medicare’s official domain. Do not follow a link in an unexpected email or rely on a phone number supplied by a suspicious caller. Medicare’s reporting route is appropriate even when you are unsure whether an entry is an innocent mistake or intentional fraud; describe the uncertainty rather than making a conclusion you cannot support.
Option 2: HHS Office of Inspector General
The CMS July 2024 fact sheet lists the HHS OIG hotline at 1-800-447-8477 and its online complaint portal at tips.oig.hhs.gov. This is an appropriate route for suspected fraud involving a provider, supplier, or Medicare program. Submit the facts you can verify: who was involved, what happened, when and where it occurred, and how the contact or billing took place.
Explain the sequence in plain language. For example, identify the date of service, what you actually received, what the statement lists, and the provider’s response. For a call or message, include the claimed organization, number displayed, number provided for a callback, request made, and any threat or deadline. Avoid embellishment, speculation, or accusations about motives you cannot document.
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Option 3: I-MEDIC for Medicare Advantage or drug plans
If you have Medicare Advantage or a Medicare prescription drug plan, call I-MEDIC at 1-877-772-3379 as an additional reporting channel. Include the plan name, the disputed service or communication, dates, and any claim or member-reference information that is safe to share through the official route. You can still report a broader suspected fraud matter to Medicare or HHS OIG.
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What to do when a caller claims to represent Medicare
Medicare says it does not call people to sell products or visit their homes. An unsolicited request for your Medicare number, Social Security number, payment details, or other personal information is a reason to end the call. A caller who threatens to cancel benefits or demands immediate payment is also using a warning sign, not a normal verification process.
During the call
- Do not confirm personal details. Do not provide your Medicare number, Social Security number, bank or card information, passwords, or one-time codes to an unsolicited caller. Even confirming that a name, address, or date of birth is correct can help a caller build a profile.
- Do not stay on the line to argue. Say that you will contact Medicare independently, then hang up. You do not have to persuade the caller that you know the call is suspicious.
- Do not press buttons, install software, or open a link merely because the caller directs you to do so. The call itself does not establish that the person is from Medicare.
- Do not pay to keep benefits active. Treat an urgent demand for a gift card, wire transfer, cryptocurrency, check, or card payment as suspicious and end the call.
- Verify independently. Call 1-800-MEDICARE using the number you already know or obtain from Medicare.gov, not a callback number dictated by the caller.
Understand the limited legitimate-callback exception
Medicare’s guidance allows for limited situations in which Medicare may call, such as returning a call after you contacted Medicare. That exception does not make an unexpected request for money or sensitive information trustworthy. If you are unsure, end the call and initiate contact yourself through 1-800-MEDICARE. A caller’s knowledge of basic personal information, caller-ID display, or official-looking language is not independent verification.
Record the details after hanging up
- Write down the date and time, the number displayed, the number the caller gave you, the name or department claimed, and the exact request.
- Save a voicemail, text message, email, or caller-ID screenshot if you can do so safely. Do not call back merely to obtain more evidence.
- Note whether the caller used a threat, a deadline, a promise of a benefit, or a request for payment.
- Record whether you disclosed anything or clicked a link. If you did, tell Medicare or the relevant official reporting channel exactly what happened; do not hide an accidental disclosure.
- Report the underlying Medicare impersonation or attempted fraud to Medicare. If it involves a plan, also use I-MEDIC; if it appears to be broader program fraud, HHS OIG is another route.
Handle a suspicious Medicare website
A page can use Medicare’s name, seal-like graphics, or familiar wording without being an official Medicare page. Do not enter your Medicare number, Social Security number, payment information, login credentials, or other personal data into a page you reached from an unsolicited message, advertisement, pop-up, or call.
Capture evidence without interacting with the page
- Copy the complete web address exactly as displayed, including the domain and path. A long or familiar-looking path does not prove that the domain is official.
- Record how you reached it: email, text, search result, social-media post, advertisement, or phone call.
- Save screenshots showing the page, request, payment demand, or impersonated organization, provided the screenshot does not require entering information.
- Note the date and time, and preserve the message that contained the link. Keep the original message instead of forwarding it as your only record.
- If the page opens a download, asks you to install remote-access software, or repeatedly redirects you, close it. Do not continue clicking to investigate.
Choose the reporting destination
The verified Medicare materials cover reporting Medicare fraud, but they do not establish a separate Medicare-specific form dedicated solely to suspicious websites. If the page is trying to obtain Medicare information, payment, or a benefit-related fee, report the underlying conduct to Medicare at 1-800-MEDICARE or through its fraud-reporting page. You can also send suspected program fraud to HHS OIG at 1-800-447-8477 or tips.oig.hhs.gov.
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If the page is tied to a Medicare Advantage or drug plan, report it to I-MEDIC at 1-877-772-3379 as well. Include the URL, how you reached it, what information it requested, and any name or plan it impersonated. Do not send account credentials as “proof” that the page targeted you.
The FTC’s ReportFraud page at reportfraud.ftc.gov displayed a government-shutdown notice when it was checked for this guide and said the service would resume when government funding resumed. That operational notice can change, so check the page’s current status before relying on it. If it is unavailable, do not postpone a Medicare report: use Medicare or HHS OIG and retain the page details.
Prepare a factual report
A clear report lets the receiving agency distinguish a billing error from suspected intentional conduct. Provide what you know and label anything uncertain rather than guessing. Organize the information chronologically so the agency can see what happened first, what you did, and what happened afterward.
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|---|---|
| Who | Provider, supplier, plan, caller, website name, email address, phone number, or organization the person claimed to represent |
| What | Service not received, duplicate billing, altered claim, request for payment, request for personal data, threat to benefits, or misleading website form |
| When | Date of service, date of call or message, date you saw the claim, and any deadline the caller stated |
| Where | Provider location, telephone number, email address, complete website address, or page where the contact occurred |
| How | Phone call, text, email, mail, advertisement, search result, or referral from another site; include what the person asked you to do |
| Documents | Medicare statement, receipts, appointment records, screenshots, messages, and your contemporaneous notes |
For a claim, preserve the statement showing the provider or supplier, service date, and amount, plus records showing what care you actually received. For a call or website, preserve the exact wording of the request, the displayed and supplied contact numbers, and the URL. If you contacted the provider or caller afterward, note the response or that no response was received.
Send only through a verified agency website or phone route. Do not email passwords, account credentials, or other sensitive information to an address you have not independently verified. If an online form requests information you do not recognize, stop and use the agency’s published phone number instead. Agencies may ask for identifying information to locate a claim, but you can ask why it is needed and whether there is a secure way to provide it.
Independent reader supportYour contribution helps us test, update, and keep practical guides available for everyone.Get local help from Senior Medicare Patrol
CMS’s July 2024 publication identifies Senior Medicare Patrol as an education and assistance resource for people with Medicare. Its locator is smpresource.org, and the listed telephone number is 1-877-808-2468. SMP can help you understand the care and claims you receive and address suspected fraud. It is a support and education resource, not a replacement for the formal Medicare, HHS OIG, or I-MEDIC reporting channels.
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SMP can be useful when paperwork is confusing, a family member is helping you review claims, or you want help organizing questions before contacting an agency. Bring the statement, your notes, and the dates of any calls or messages. Use the locator or number published by SMP rather than an unsolicited person claiming to be an SMP representative.
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- Is there a claim you do not recognize? Compare it with your records, ask the provider about an apparent error, and report unresolved suspected fraud to Medicare, HHS OIG, or I-MEDIC when the case involves an Advantage or drug plan.
- Did someone call unexpectedly? Do not disclose information or money. Hang up and call 1-800-MEDICARE yourself.
- Did a website request Medicare or payment information? Leave the page, do not submit data, preserve the URL and message, and report the underlying conduct through Medicare or HHS OIG.
- Do you need help understanding the paperwork? Contact Senior Medicare Patrol at 1-877-808-2468 or use its locator at smpresource.org.
- Are you unsure which route applies? Start with Medicare at 1-800-MEDICARE, explain the facts, and ask whether Medicare, HHS OIG, or I-MEDIC should receive the report as well.
Keep your report factual, use official contact details, and preserve the documents that show what happened. You do not need to prove the entire case before reporting a reasonable suspicion. Promptly ending an unsafe call, avoiding a suspicious page, and documenting the details can prevent further disclosure while giving the appropriate agency useful information.
Frequently Asked Questions
What is the main number for reporting Medicare fraud?
Call 1-800-MEDICARE at 1-800-633-4227 or use Medicare’s “Reporting Medicare fraud & abuse” page on Medicare.gov. You can also report suspected provider or program fraud to the HHS OIG at 1-800-447-8477 or tips.oig.hhs.gov.
Where should Medicare Advantage or prescription-drug plan fraud be reported?
Call I-MEDIC at 1-877-772-3379. It is an additional channel for Medicare Advantage and Medicare drug-plan concerns; you may also report broader suspected fraud to Medicare or HHS OIG.
Will Medicare ever call me?
Medicare says it does not call to sell products or visit your home. Limited calls may occur to return a call after you contacted Medicare. If an unsolicited caller requests personal information, money, or threatens your benefits, hang up and call 1-800-MEDICARE yourself.
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What should I do if I entered information on a suspicious website?
Stop interacting with the page and document its URL, message, date, and requests. Report the underlying Medicare-related conduct to Medicare or HHS OIG, and tell the representative exactly what information you entered. Do not provide additional credentials to an unverified contact.
Is there a separate Medicare form for fake websites?
The verified Medicare materials cover reporting Medicare fraud but do not establish a separate Medicare-only form dedicated solely to suspicious websites. Report a page seeking Medicare information, payment, or benefit fees through Medicare or HHS OIG. If the matter involves an Advantage or drug plan, also contact I-MEDIC.
Can I report a claim before I have every document?
Yes. CMS’s July 2024 4R’s publication advises providing as much information as possible. Report the facts you can verify, keep the documents you have, and provide additional information if the agency requests it.
Is the FTC ReportFraud website available?
The ReportFraud page checked for this guide displayed a government-shutdown notice and said service would resume when funding resumed. Its status can change, so check it before relying on it. Do not delay a Medicare report; use Medicare or HHS OIG if the FTC service is unavailable.
Where can I get help understanding a Medicare statement?
Senior Medicare Patrol provides education and assistance. CMS lists its locator at smpresource.org and telephone number 1-877-808-2468. SMP supplements, rather than replaces, the formal Medicare, HHS OIG, and I-MEDIC reporting routes.
The Bottom Line
Check the claim, stop engaging with suspicious callers or websites, and preserve the details. Report suspected Medicare fraud to 1-800-MEDICARE, HHS OIG, or—when applicable—I-MEDIC. Use only contact information obtained independently from official sources.
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