Spot Health Insurance Scams

Wading through your health insurance options and plans can be complex, overwhelming, and confusing. Dishonest companies and scammers know this and use it to their advantage. Instead of getting the health insurance coverage you and your family need, you could end up with a so-called “health plan” that covers few if any medical expenses. And it could leave you on the hook for major medical bills.

Five Signs of a Health Insurance Scam

Medicare and health insurance scams are common. Scammers are always looking for new ways to steal your money and your personal information, but they use familiar techniques. Here are five signs you’re dealing with a health insurance scam:

1. Scammers say they’re from the government and need money or your personal information. Government agencies don’t call people out of the blue to ask them for money or personal information. No one from the government will ask you to verify your Social Security, bank account, or credit card number, and they won’t ask you to wire money or pay by gift card or cryptocurrency.

If you have a question about Medicare or the Health Insurance Marketplace®, contact the government directly:

2. Scammers say you need to pay a fee for a new Medicare card or you’ll lose your Medicare coverage. But you never need to pay for a new card. And Medicare will never call out of the blue to say you’ll lose coverage. Those are scams. Read more about Medicare cards.

3. Scammers try to sell you a fake medical discount plan. Medical discount plans charge you a monthly fee for discounts on specific medical services or products from a list of participating providers. They’re not a substitute for health insurance. While some medical discount plans provide legitimate discounts, others take people’s money and offer very little in return. So if you’re considering one, check out every claim the plan makes, including whether your doctor participates in the plan. And be sure to get the details of the discount plan in writing before you sign up.

4. Scammers want your sensitive personal information in exchange for a price quote. The Affordable Care Act’s (ACA’s) official government site is HealthCare.gov. It lets you compare prices on health insurance plans, check your eligibility for healthcare subsidies, and begin enrollment. But HealthCare.gov will only ask for your monthly income and your age to give you a price quote. Never enter personal financial information like your Social Security, bank account, or credit card number to get a quote for health insurance. You’ll be setting yourself up for robocalls or much worse — identity theft.

5. Scammers want you to pay for help with the Health Insurance Marketplace. The people who offer legitimate help with the Health Insurance Marketplace — sometimes called Navigators or Assisters — are not allowed to charge you and won’t ask you for personal or financial information. Go to HealthCare.gov and click “Find Local Help” to learn more.

What To Do Before You Sign Up for Health Insurance

While we’ve mentioned things to avoid, there are several steps you can take before signing up for health insurance. Here are a few to keep in mind:

Medicare Scams

People on Medicare — and those who aren’t — are regularly targeted for scams. You might have gotten a call saying something like “Hello, this is Medicare calling. Your coverage is about to be canceled.” Every year during open enrollment season (and plenty of other times too), scammers pretending to be from the government call trying to steal your money and your personal information. Here’s what to do:

Another scam is related to Medicare Part D, which is an optional prescription drug insurance program for people on Medicare. You pay a monthly premium to an insurance carrier for your Part D plan. In return, you use the insurance carrier’s network of pharmacies to buy your prescription medications. To protect people, the law is very specific about how Medicare prescription drug plan providers conduct themselves.

To learn more about Medicare Part D and the plans available in your area:

Medical Discount Plans and Scams

Medical discount plans, also known as discount health care programs, often say they’ll save you money on products and services your insurance may not cover — like dental, vision, hearing, or chiropractic services. With a medical discount plan, you generally pay a monthly fee for discounts on specific services or products from a list of participating providers.

While there are medical discount plans that give legitimate discounts, others take people’s money and offer very little in return. Dishonest marketers sometimes make it sound like they’re selling health insurance or lie about what their plans really offer. When you’re in the midst of an emergency, the last thing you want to find out is that you’ll have to cover most, or all, of the bills if what you have isn’t really health insurance.

So how can you tell if a medical discount plan is legitimate?

Report Scams

If you think you’ve spotted a scam, tell your friends and family about it so they can protect themselves, then report it to the FTC. People who know about scams are much more likely to be able to avoid them. Your reports help the FTC and our law enforcement partners build cases and stop scammers.

Report health insurance and medical discount scams to the FTC at ReportFraud.ftc.gov and your state attorney general.

Report Medicare scams at Medicare.gov or 1-800-633-4227.