Medicare Open Enrollment Scams 2026: Who Can Call, and the 42474 Text

Medicare Open Enrollment Scams 2026: Who Can Call, and the 42474 Text

Medicare Open Enrollment opens October 15, and the marketing season for 2027 plans has been running since October 1. So for the past couple of weeks your phone has probably been busier than usual: a friendly voice saying Medicare's "new plan year" is here and they're calling to help you lock in your 2027 coverage, or a five-digit number texting you about a "senior card" worth thousands of dollars. Here's the thing: the calendar part is true. Plans and agents really are allowed to market 2027 Medicare plans right now. The rest of it, a stranger calling you out of the blue or a short code offering you money, is still not how any of it works.

That gap, between "marketing is open" and "anyone can contact you about it," is where this scam lives. And this year it has a text-message cousin with its own short code, which we'll get to.

How this scam actually works

Medicare's Annual Enrollment Period runs October 15 through December 7, 2026, when anyone with Medicare can switch Medicare Advantage or Part D drug plans for coverage starting January 1, 2027. The marketing calendar starts earlier: under CMS's Medicare marketing rules, plans and agents can't market next year's coverage before October 1. That's the real rule, and it flipped on October 1 like it does every year. The scam works because most people only half-remember it: they heard "agents can start talking about 2027 plans on October 1" and assume that includes calling them unprompted.

It doesn't. As I read the CMS beneficiary-contact rules, Medicare Advantage plans can't make unsolicited calls to people who haven't asked for contact. Agents and plans can call you back, or call when you've given permission, for example by returning a reply card or an email asking for a call. Texts, robocalls, and voicemail drops don't get a pass either.

The pitch usually starts with an unsolicited call or text, sometimes from a spoofed number that looks local. The caller introduces themselves as a "certified Medicare advisor," a "benefits specialist," or claims to represent a "national Medicare database." They tell you your current plan is being discontinued, that your area is losing coverage, or that a better plan is available — but only if you act today. Then comes the ask: your Medicare number, your Social Security number, sometimes your bank account "to set up your new plan's premium." Some versions try to enroll you in a real or fake plan right there on the phone, whether or not enrollment has legally opened yet.

The text from 42474

The phone version has a text-message sibling, and it comes from a five-digit short code: 42474. If you're on Medicare and you've had a phone this fall, there's a decent chance you've already seen it.

The most common version right now is branded "CenturyMed." It announces a "new $2,600 senior card" you can use for food, gas, and utilities "this month," and tells you to reply CARD to claim it. The dollar figure rotates: Gentle Medicare Guide's write-up of the 42474 texts and consumer reports on eCautious and the BBB Scam Tracker have logged $2,600, $2,750, $4,200, $5,100, and $6,400 versions of the same message. CenturyMed is not Medicare, not a government program, and not an insurance plan. Reply, and what you get is not a card. It's a sales pipeline: calls from "benefits specialists" who now know they're talking to a Medicare beneficiary who answers texts about free money, which is exactly the list a scammer wants to be on the other end of.

The other message riding the same short code is the "plastic chip card" text: your paper Medicare card is "expiring," tap here to get your free secure plastic chip card. Lehigh Partners, a Medicare brokerage, flagged this version as a straightforward scam, and they're right. Medicare cards don't expire. There's no plastic version and no chip; the card has been plain paper since 2018, when the agency took Social Security numbers off it. The link lands on a form asking for your Medicare number, your Social Security number, or both, "to process your free upgrade." We covered the phone version of that con, and the real card reissue it piggybacks on, in our chip-card breakdown.

One honest wrinkle: some Medicare Advantage plans do offer real flex cards or over-the-counter allowances. Those come from the plan you're already enrolled in, through the plan's own mail and app, with a balance that matches your plan documents, not a round number in a text from a five-digit code. Nobody has ever gotten one by replying CARD to a stranger.

What to do with the text is simple. Don't reply, not even STOP, because a reply to a scam short code confirms your number is live. Forward it to 7726 (SPAM) if your carrier supports that, then delete it. If you want a second opinion first, Cautellus's scam text checker can tell you in seconds whether it matches known patterns.

Why this one is harder to spot than the Medicare card scam

Most Medicare impersonation scams collapse the moment you ask a simple question, because the premise is flatly impossible: Medicare cards don't have security chips, and Social Security numbers can't be "suspended." The enrollment version doesn't have that easy tell, because everything around it is real. Open Enrollment is a real, high-stakes annual event. Plans genuinely do change every year. Marketing for those changes is legitimately allowed right now, so a mailer or a TV ad about 2027 plans isn't suspicious at all. The scam isn't inventing an event. It's borrowing a real one and hoping you won't ask how they reached you, which is a much harder lie to catch than "your card needs a chip."

There's a second route, too. The FTC's September 28 consumer alert on open-enrollment health insurance scams warns that scammers pay to appear at the top of search results and use web addresses and logos that imitate Medicare.gov and Healthcare.gov. You don't get a call at all: you go looking for help and land on the wrong page. The FTC's advice is to look for the small "Ad" or "Sponsored" label and scroll past paid results to the real .gov address.

And there's a third wrinkle this year, and it's regulatory. CMS's contract-year 2027 rule for Medicare Advantage and Part D drops the 48-hour waiting period between you signing a Scope of Appointment form and an agent holding a sales appointment with you, and it drops the old 12-hour separation between an "educational" event and a sales pitch at the same location. The Scope of Appointment form itself is still required. Per Crowell & Moring's summary of the final rule, the marketing provisions apply from October 1, 2026, which means this enrollment season. In plain English: a real agent can now go from "let me explain your options" to "let's sign you up" in the same conversation, which used to be a compliance violation and the kind of thing we told you to treat as a red flag. It's still a red flag for you. It's just no longer proof the person is a scammer, so your own rule, nothing gets signed in the conversation where you first heard about it, has to do the work the regulation used to do.

The red flags hiding in plain sight

• A call, text, or voicemail you didn't ask for. This is the single clearest tell, and it holds every day of the season, from the October 1 marketing opening through December 7. Marketing for 2027 plans is open, but unsolicited phone contact about Medicare Advantage and Part D plans isn't.
• A text from a five-digit short code, especially 42474, about a "senior card," "flex card," or "chip card." Medicare doesn't text you about money or cards. A real plan benefit shows up in your plan's own mail, not as a reply-CARD offer from a brand you've never enrolled with.
• "Your current plan is being discontinued" — without a letter to back it up. By law, your plan has to mail you an Annual Notice of Change by September 30 explaining exactly what's different about your coverage next year. If a caller is telling you your plan is ending and that letter hasn't arrived, they're the ones inventing the emergency.
• Pressure to decide on the call. "I can only guarantee this rate if you enroll right now" isn't how Medicare works. You have from October 15 through December 7 to compare and choose. The 2027 rule change means a licensed agent can legally close same-day now, so this one no longer proves fraud on its own, but nobody legitimate needs an answer in the next five minutes either.
• A caller who won't give you their National Producer Number. Every licensed agent has one, and giving it out costs them nothing. Hesitation, deflection, or a sudden change of subject is the answer.
• Vague claims of representing "Medicare" itself. Medicare doesn't sell or market plans directly — private insurers do, through licensed agents. A caller claiming to be "from Medicare" selling you a specific plan is already misrepresenting who they are.
• A request for your Social Security number, Medicare number, or bank details to "hold your spot." Nothing about comparing or enrolling in a plan requires locking in your identity over the phone before you've agreed to anything.
• Unsolicited texts pushing you to click a link to "review your options." Legitimate plan comparisons happen through medicare.gov, your plan's official site, or a SHIP counselor — never a link in a text you didn't ask for. If you get one, Cautellus's scam text checker can tell you in seconds whether it matches known scam patterns.

If this already happened to you

Don't spend time on embarrassment — this scam is built specifically to exploit a real rule almost nobody knows about, which is a design flaw in the system, not a lapse in judgment on your part. Call 1-800-MEDICARE and ask them to check your account for any plan enrollment or changes you didn't authorize; a scammer with enough of your information can sometimes submit a fake enrollment before you even realize what happened. If you shared your Social Security number, place a free credit freeze with Equifax, Experian, and TransUnion the same day. Report what happened to your state's Senior Medicare Patrol at smpresource.org, which specifically investigates Medicare fraud, and to the FTC at ReportFraud.ftc.gov. FTC data on 2025 imposter scams — the category this falls under — shows more than a million reports and $3.5 billion in losses, up nearly 20% from the year before, so you are very much not alone in this.

If all you did was reply to the 42474 text, you haven't lost money yet. You've confirmed a live number, so expect calls. Treat every one of them as unsolicited, which, per the rules above, is reason enough to hang up. If you tapped the link and typed in your Medicare number, follow the 1-800-MEDICARE and credit-freeze steps above, and start reading your Medicare Summary Notices closely for the next few months; an unfamiliar provider or piece of equipment showing up there is usually the first visible sign your number is being billed.

How to not become the next victim

The single best defense is asking one question: "How did you get my number?" If you didn't request the contact, treat the call as a scam until proven otherwise. Check your mailbox for your Annual Notice of Change before believing any claim that your plan is ending or changing. Your plan is required to send it by September 30, so if it's late, call the number on your plan card and ask. If you want to compare plans, start at medicare.gov (check for the .gov, not the ad above it) or call a State Health Insurance Assistance Program counselor yourself; SHIP counseling is free, federally funded, and — unlike an agent — SHIP counselors don't sell or get commissions on any plan, so they have no reason to rush you. Before giving any agent your information, ask for their National Producer Number and check it against NIPR's public lookup tool or your state's Department of Insurance license search. And never enroll or share personal information based on a call or text you didn't initiate — if you want to act on an offer, hang up and call 1-800-MEDICARE or your plan's number printed on your card yourself.

Save 1-800-MEDICARE in your phone now, before you need it, so that when a call or text raises a question you're dialing a number you already trust instead of one a stranger just handed you. And build one rule that doesn't bend just because the regulation did: nothing gets signed, confirmed, or handed over in the same conversation where you first heard about it. A real Medicare option is still there tomorrow. A scam usually isn't.

This scam sits right alongside the wider pattern of government impersonation scams that target Social Security, the IRS, and Medicare using the same urgency-and-authority playbook. For the other major Medicare scam making the rounds this year — the fake "security chip card" pitch — see our breakdown of that one, and for the full picture of how real Social Security and Medicare communications actually work, read our guide to Social Security and Medicare impersonation. If you're an adult child keeping an eye on a parent's whole financial picture during enrollment season, the elder scams guide covers what else tends to target this exact age group in the fall. Cautellus's Medicare scam directory tracks the specific scripts currently in circulation if you want to compare what you heard against what's already been reported.

Real Medicare enrollment is slow on purpose. It gives you eight weeks, not five minutes, because the people who designed it assumed you'd want to think it over. Anyone rushing you past that design isn't helping you enroll. They're hoping you won't ask how they got your number.

Sources: FTC consumer alert, "What to know ahead of Open Enrollment to avoid health insurance scams" (September 28, 2026) · eCFR, 42 CFR 422.2264 (beneficiary contact) · Crowell & Moring, "CMS Finalizes CY 2027 Medicare Advantage and Part D Rule" · Gentle Medicare Guide, "42474 Medicare Text Message: Who Is CenturyMed?" · Lehigh Partners, "New Medicare Plastic Chip Card Text: Real or Scam?" · BBB Scam Tracker and eCautious consumer reports on CenturyMed / 42474 · FTC ("FTC Data Show People Reported Losing $3.5 Billion to Imposter Scams in 2025," June 2026) · CMS Medicare Communications and Marketing Guidelines · Medicare.gov Annual Enrollment Period guidance · National Insurance Producer Registry (NIPR)