Health Insurance Scams

Health insurance scams are common, and there tends to be more of them during annual open enrollment periods. But they can happen at any time. Scammers try to take advantage of the confusion about coverage, costs, and enrollment of health insurance laws and plans.

Some scams target certain groups of people like older adults, veterans, or immigrants.

Marketplace scams

The Marketplace may contact you to get more information about your health insurance application. But they will never ask you for a payment to apply for or keep your coverage.

Here are some important things to know about the Marketplace:

• Marketplace representatives (reps) may call 1-855-997-1890 or 844-477-7500. They may show as Health Insurance MP on a caller ID. But caller ID can be fake so, do not rely on it.
• Anyone who calls you from the Marketplace should provide you with their first name and ID number.
• If you’re not sure about a call, hang up and call the Marketplace directly at 1-800-318-2596 (TTY: 1-855-889-4325) to verify.
• The Marketplace has assisters, navigators, and counselors who are certified to assist people in finding a plan and completing applications. This help is always free, and they should never ask for a payment. Learn more about how to find a free, trained Marketplace assister.

Marketplace callers will never ask for your:

• Medical history or health condition, except for some medical documentation in cases like certain exemptions
• Marketplace account password or security codes
• Bank name, routing number, or account numbers

If you’re asked to provide documents, it’s safest to upload them through your secure Marketplace account. If something does not feel right at any time, contact the Marketplace call center.

Medicare and Medicaid scams

A common insurance scam involves someone contacting you and claiming your Medicare or Medicaid coverage will be cancelled unless you act right away. They might ask for information like your Social Security number, Medicare or Medicaid ID, or bank account information. Scammers might threaten you with legal action or major fees if you don’t renew right away over the phone. This is a scam.

Legitimate reps from Medicare and Medicaid do not usually call, text, or email people for this information. Official notices are usually sent as a letter in the mail. And you can renew online, by mail, or in person. There is no fee to renew Medicare or Medicaid.

Medical discount plans

Medical discount plans are not health insurance. These plans charge a monthly fee for their “discounted” services or products. Discount plans also do not cover health services such as surgery, chemotherapy, imaging tests, radiation, or preventive care.

These plans may have different names like affordable plans, supplemental plans, or premium plans. They may also have other hidden fees or extra charges. This can be misleading. If someone contacts you and pressures you to sign up quickly for a medical discount plan, it could be a scam.

How to spot a scam

The safest ways to sign up for health insurance coverage are:

• Through your or your spouse’s workplace
• Through the Marketplace

If you want information about health plans outside the Marketplace, be careful to take your time to review all the details. Watch for things like:

• Very low premiums
• Pressure to sign up right away
• Aggressive salespeople or unclear answers to your questions.
• No full details of the policy in writing.
• Plans that require you to join an association, union, or other group to get coverage.