Spotting Health Insurance Scams

Scammers often aim to steal your money and identity by exploiting those confused about health insurance laws and plans.

Health insurance scams typically target older adults, veterans, and immigrants, preventing them from getting the necessary medical coverage.

Warning Signs of a Scam

Here are some signs of a health insurance scam:

• People who assist with the Health Insurance Marketplace are assistors or navigators. Legitimate assistants and navigators will not ask for payment to provide assistance or require personal or financial information.
• Medicare and Medicaid scams occur when fraudsters ask you to renew your card over the phone. They might ask for your Social Security, Medicare and Medicaid ID or bank details and threaten cancellation of the medical benefits.
• Healthcare.gov is the official government site that lets you check healthcare subsidy eligibility, compare health insurance plan prices and begin enrollment.
• Scammers may impersonate government officials and ask to verify information like Social Security, credit card and bank details over the phone. They may ask for payment through gift cards, cryptocurrency or wire money to them.
• Medical discount plans charge a monthly fee to offer discounts on medical products or services from a specific list of medical providers. To get legitimate medical discount plans, check out what the plan claims to provide and whether your doctor participates.

Make sure you have the details of the medical discount plan in writing before you sign up.

Verifying a Scam

Before signing up for a health insurance plan, consider the following steps to help you avoid health insurance scams:

• Visit trusted sources like Healthcare.gov and state marketplaces for comprehensive health coverage.
• Check reviews and research online using the name of the company offering health coverage and words like “complaint,” “fraud,” or “scam.”
• Check with your health insurance commissioner to see if the company selling health insurance is licensed.
• Ensure you get a written copy of the statement of benefits or health policy from the salesperson.
• Scammers often use fake logos and written materials to impersonate major insurers. Where a company claims to sell health insurance policies of a major insurer, you must verify before purchasing the plan.
• A legitimate health plan representative will offer specific information about finding providers within the network, co-pays and deductibles without directing you to a brochure or website.

Common Medicare and Medicaid Scams

People on Medicare and Medicaid plans can get calls from scammers impersonating government officials who try to steal money and personal information.

Medicare scams are mostly related to Medicare Part-D, which requires paying a monthly premium to an insurance carrier. You pay by using the carrier’s network to get prescription medicines.

Medicare plan representatives will never contact you first or come to your house uninvited to ask for personal information or payment.

The state Medicaid Agencies will never ask for your personal information or bank and credit card details to renew your enrollment in the state’s program.

Reporting Scams

If you have spotted a health insurance scam, report it to the FTC at ReportFraud.ftc.gov and your State Attorney General.

You can report Medicare scams at Medicare.gov or 1-800-633-4227.

Takeaway

Health insurance plans can be daunting and confusing for the general public. Staying vigilant and reporting insurance scams to trusted authorities can help you stay safe.