How to Protect Yourself From Health Insurance Scams

You might be sleeping or taking your dog for a walk. You could be at work, at your kid’s soccer game, or meeting friends for dinner. Life is good, right? You have no idea that scammers down the street, one state over or half a world away are doing their darndest to steal your personal info.

Most often, scammers want to clean out your bank account or go on a shopping spree with your credit card. But mortgage title theft and health insurance scams are becoming more and more common.

While the Affordable Care Act (ACA) gives more people access to health care, it also makes more people vulnerable to fraud.

Protect Yourself

Guard your digits. Don’t give your Social Security, credit card, bank account or phone numbers to anyone offering an “ACA card.” There’s no such thing as an “ACA card.”

Beware of people pushing an ACA health plan. Yes, the Affordable Care Act calls for most people to have health insurance. But you don’t have to buy a new plan. If you already have health insurance through your job, Medicare or Medicaid, you can keep it or look at other plans offered by your insurer.

Shut the door on con artists. Health insurance companies don’t send reps to make door-to-door sales calls. If someone shows up at your home, tell them to mail information to you. If you get something in the mail, carefully check out the company before you add your private data to any enrollment form. Ask a trusted family member or friend to also look at the information.

Watch out for fake government workers. Scammers often use this ruse to steal your health information by saying they need to update it in the system. No such workers exist. If you need to change your information, call your insurance carrier directly.

Watch Out for These Tricks

What other tricks do health insurance fraudsters use? Here are some common schemes.

Fake health insurance policies. Con artists promise low prices, no medical exams and guaranteed acceptance. Any too-good-to-be-true promises should raise a red flag.

High-pressure sales. Con artists know the faster they get you to make a decision, the more likely they are to walk away with your private information. Be leery of anyone who says you must act now.

Bogus websites for insurance companies. These fake sites mimic sites for legitimate health insurance companies. Make sure you’re interacting with a company’s real website before giving any personal information — especially before sharing your debit or credit card number. If you’re not sure, call the insurance company to confirm their official web address.

Phony state health exchanges. Some states let the federal government set up their health care exchange rather than create their own. In these states, con artists often set up fake state exchange websites. Unsuspecting health care consumers hand over their personal information, financial data and money only to get nothing. Check to see if your state has a state-run health exchange. 

ACA navigators who charge for advice. The government provides trained navigators to help people who don’t know much about health insurance. Con artists posing as navigators ask customers to pay for their advice. Official ACA navigators never charge for their services.

Discount cards called insurance plans. These cheap “insurance plans” usually boast a phony list of doctors, high fees hidden in the fine print and zero benefits.

Remember, it’s important to think about many factors — not just price — when choosing a health plan. Buy from an insurance company you trust. Beware of any company you’ve never heard of before. They may not exist. You could end up without health insurance and without the money you set aside to pay for it. Search for reviews about any insurance company you’re considering. 

Visit our article library to learn more about health insurance scams.

Source: Spot Health Insurance Scams,  Federal Trade Commission Consumer Information, 2021

Original publish date: August 18, 2015; Revised 2019, 2020, 2021, 2023