How to Protect Yourself from Health Insurance Scammers

Consumer Beware!

The recent reforms to the healthcare system have allowed millions of previously uninsured Americans access to affordable healthcare. Unfortunately, changes to any system can result in a lot of confusion, which scammers and identity thieves can use to their advantage. While most people will not encounter any fraudulent activity, it is important to be informed of the risk and of ways you can protect yourself.

 How to protect yourself

  • Make sure websites are true and secure. Scammers can set up fake websites that may look like real health insurance websites or marketplaces that they can use to collect your personal information from you. You should always be sure to check that any website in which you enter personal information is true and secure. You can do this by checking to see that there is a locked padlock sign to the left of the site’s web address in the address bar. You can also check the security of the page by checking to see that the beginning of the web address is https:// rather than http://. You should also check that the insurance company you are buying from is trustworthy and licensed in Texas by using the Company Lookup feature on the Texas Department of Insurance website: https://apps.tdi.state.tx.us/pcci/pcci_search.jsp.
  • Never give personal information to anyone you don’t know or aren’t certain you can trust. Insurance companies do not usually come to you so be cautious of any one that does. Never give your personal information (social security number, etc.) to anyone that you did not contact yourself first.
  • Verify that calls from the Marketplace are authentic. Sometimes a representative from the Marketplace may call you asking for additional information for your application. If they do, write down their full name and agent ID and make sure that the number that called you is one of these:
    • Health Insurance MP
    • 606-260-4191
    • 479-877-3203
    • 636-698-6320
    • 580-354-7707

Marketplace representatives will not ask you for personal financial information (bank names and account numbers) or about personal health information. If you do not feel comfortable answering any of their questions over the phone, ask the representative to mail you their inquiries instead.

  • Don’t fall for tricks and double check fishy information or requests. Scammers may try to convince you that you owe them money for their help, that you must pay a tax penalty, that you must have an insurance card, or that being without health insurance is a crime for which you can go to jail. None of these things are true. Official Marketplace assistants provide their services free of charge and will not call or bill you for a tax penalty. Similarly, you will not go to jail for not having health insurance and you are not required to have an insurance card.
  • Take your time. Always take your time when making a decision and ask questions when you don’t understand something and take notes.
  • Stand up to pressure. Scammers may pressure you to purchase their insurance plans even if you already have one. If you already have comprehensive health coverage then there is no need for you to change plans if you do not want to. Be cautious of anyone who insists that you do.
  • Collect important information. Write down names and contact information of the people you talk to.
  • Always read what you are signing before you sign it. And make sure that you fully understand what you are signing as well.

Who should you listen to?

Applying for health coverage can be very confusing. Luckily, there are people out there who can help. Navigators and Certified Application Counselors are certified by the federal government and registered insurance agents and brokers who have been licensed through the Texas Department of Insurance are trained to protect your personal information and to help guide you through the insurance marketplace free of cost. You can trust them to provide accurate information about the process.  You can verify whether a health insurance agent or broker is licensed in Texas using the Texas Department of Insurance’s Agent and Agency Search feature: https://txapps.texas.gov/NASApp/tdi/TdiARManager.

What to do if you suspect you have been a victim of fraud

If you are contacted by a suspicious person or suspect any fraudulent activity, you can call any of these numbers:

Texas Department of Insurance Helpline:       1-800-252-3439

The Health Insurance Marketplace:                   1-800-318-2596

Or your local police department:                       9-1-1

Additionally, you can file a complaint online at any of these websites:

TDI Fraud Unit:                                                     http://www.tdi.texas.gov/fraud/

FTC Complaint Assistant:                                   https://www.ftccomplaintassistant.gov

Sources:

http://www.texashealthoptions.com/cp2/protect.html

https://www.healthcare.gov/how-can-i-protect-myself-from-fraud-in-the-health-insurance-marketplace/

Written by Catherine Samuel, Children's Defense Fund-TX.

Cover Texas NowACA Enrollment, Affordable Care Act (ACA)