$12.5B
FTC-reported fraud losses in 2024
FTC says consumers reported losing $12.5 billion to fraud in 2024.
Medicare Advantage unauthorized switch scam
Scammers enroll Medicare beneficiaries into Medicare Advantage plans without their knowledge or consent by using personal information obtained through deceptive calls.
“Medicare scam”
↑ 71%Key indicators
Estimated impact
$1.4K
median reported loss
Typical range$90 – $9.0K
Recovery rate~15%
Scam breakdown
1
Scammers obtain Medicare numbers through other fraud schemes or data breaches
2
They enroll beneficiaries into Medicare Advantage plans without consent, earning enrollment commissions
3
Beneficiaries discover the switch when their doctors refuse their insurance or they receive bills for previously covered services
What to do first
Review your Medicare Summary Notices regularly and report any unfamiliar plan enrollments immediately
Related terms
Medicare Advantage slamunauthorized enrollmentMA plan hijackingMedicare and health scamsPhoneRisingSeniorsMedicare beneficiariesCaregiversHealthcare workersRetirees and seniorsParents and familiesUnited StatesMedicare Advantage slamunauthorized enrollment
Real-world example
How this scam plays out in practice
Based on reported patterns. Names and details are illustrative.
The setup
Sarah, 72, a seniors, encountered what appeared to be a legitimate medicare and health scams situation while using Phone. Scammers obtain Medicare numbers through other fraud schemes or data breaches
Step 2
What happened next was calculated: They enroll beneficiaries into Medicare Advantage plans without consent, earning enrollment commissions
Step 3
The pressure escalated quickly: Beneficiaries discover the switch when their doctors refuse their insurance or they receive bills for previously covered services
The outcome
Sarah realized something was wrong when you receive a new insurance card from a plan you never enrolled in. By that point, significant damage had already been done — money sent, personal information shared, or trust exploited.
The lesson
Review your Medicare Summary Notices regularly and report any unfamiliar plan enrollments immediately Sarah's experience shows why you receive a new insurance card from a plan you never enrolled in and your regular doctors are suddenly out-of-network are the clearest early warning signs.
How to identify it
- You receive a new insurance card from a plan you never enrolled in
- Your regular doctors are suddenly out-of-network
- An explanation of benefits arrives for services under an unfamiliar plan
- Pause before paying, clicking, or sharing information. Scammers rely on speed.
- Verify the sender, company, or agency using a phone number or website you already know is legitimate.
- Treat secrecy, urgency, and off-platform payment requests as strong scam signals.
What to do now
- ✓Review your Medicare Summary Notices regularly and report any unfamiliar plan enrollments immediately
- ✓Call 1-800-MEDICARE to disenroll from unauthorized plans and restore your original coverage
- ✓Report unauthorized enrollment to the Senior Medicare Patrol (SMP) program in your state
What to save before reporting
- ✓Save the message, profile, phone number, email, or URL that was used.
- ✓Keep payment confirmations, receipts, and account alerts before you dispute or delete anything.
- ✓Write down the timeline while the details are still fresh.
- ✓Save the full chat or call log before blocking the sender so the reporting path still has the original context.
How big is this problem
You are not alone — this scam affects millions of people.
These numbers come from government agencies and official reports. If you have been affected, know that this is a widespread problem — not something that only happens to careless people.
FTC 2024 fraud losses
Imposters
Most common FTC fraud category in 2024
FTC says imposter scams remained the most commonly reported fraud category in 2024.
History and evolution
- This scam family tends to persist because the social-engineering pressure works even when the exact scripts, platforms, and payment methods change.
- The specific packaging evolves over time, but the core pattern usually stays the same: create urgency, control the channel, and push action before verification.
- CMS has reported a significant increase in complaints about unauthorized Medicare Advantage enrollments and has issued new marketing rules to combat the practice
Recovery and follow-up
- ✓Save the messages, receipts, account alerts, and transaction details before you block or delete anything.
- ✓Report the scam through the official platform or government channel that best matches where it happened.
- ✓Tell close contacts if a phone or text scam used your identity, so scammers cannot reuse the same story against people around you.
- ✓Review your Medicare Summary Notices regularly and report any unfamiliar plan enrollments immediately
- ✓Call 1-800-MEDICARE to disenroll from unauthorized plans and restore your original coverage
Why this pattern keeps working
Even when the story changes, most scams still use the same pressure pattern: urgency, authority, and a request to move money or data fast.
CMS has reported a significant increase in complaints about unauthorized Medicare Advantage enrollments and has issued new marketing rules to combat the practice
OpenScam research
Where to report it
If you have been targeted by this scam, reporting it helps authorities track the pattern and protect others. United States has dedicated agencies that handle fraud reports.
ReportFraud.gov
Federal Trade Commission
Central U.S. consumer fraud reporting portal.
File an IC3 complaint
FBI Internet Crime Complaint Center
FBI portal for internet-enabled crime reports.
Start identity theft recovery
IdentityTheft.gov
Official U.S. identity theft recovery plan builder.
Explore further
Understand the bigger picture
Who is most at risk
Who this scam targets
Primary targets
Seniors, Medicare beneficiaries, Caregivers
Geographic concentration
United States
Primary channel
Phone — Medicare and health scams
Why this group is vulnerable
Seniors are particularly vulnerable because this scam exploits trust in familiar brands, authority figures, and time-sensitive decisions. The growing number of reports suggests that awareness among this demographic remains low.
Sources and methodology
How we verify this information
OpenScam tracks scam patterns using a combination of government consumer protection databases (FTC, IC3, Action Fraud), platform-specific fraud reports, and verified consumer complaint data. Each entry is cross-referenced against at least two independent sources before publication.
Severity ratings are based on financial impact potential, reversibility of damage, and volume of reports across multiple reporting channels. Trend velocity reflects the rate of change in report volume over the most recent 90-day window.
This page was last verified on 2026-04-04. Red flags, recovery steps, and reporting resources are reviewed quarterly against current agency guidance.
Evidence and indicators
- CMS has reported a significant increase in complaints about unauthorized Medicare Advantage enrollments and has issued new marketing rules to combat the practice
Source notes
- OpenScam research
Frequently asked questions
Common questions about medicare advantage unauthorized switch scam
How does the medicare advantage unauthorized switch scam work?+
Scammers obtain Medicare numbers through other fraud schemes or data breaches They enroll beneficiaries into Medicare Advantage plans without consent, earning enrollment commissions Beneficiaries discover the switch when their doctors refuse their insurance or they receive bills for previously covered services
What are the warning signs of medicare advantage unauthorized switch scam?+
You receive a new insurance card from a plan you never enrolled in Your regular doctors are suddenly out-of-network An explanation of benefits arrives for services under an unfamiliar plan
What should I do if I encounter medicare advantage unauthorized switch scam?+
Review your Medicare Summary Notices regularly and report any unfamiliar plan enrollments immediately Call 1-800-MEDICARE to disenroll from unauthorized plans and restore your original coverage Report unauthorized enrollment to the Senior Medicare Patrol (SMP) program in your state
Who is most at risk for medicare advantage unauthorized switch scam?+
This scam primarily targets Seniors, Medicare beneficiaries, Caregivers. It is most commonly reported in United States and typically appears on Phone.
Is medicare advantage unauthorized switch scam on the rise?+
Medicare Advantage unauthorized switch scam is currently on the rise with growing reports. It has been reported across US. Last updated 2026-04-04.
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Help someone avoid this scam.
Scammers succeed because people do not talk about it. If you or someone you know has been affected, there is no shame in it — it happens to millions of people every year. Share this page with friends and family so they know what to look for.