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November 26, 2019

How to spot an insurance scam during open enrollment for ACA, Medicare plans

Read these tips from the Better Business Bureau, Federal Trade Commission

Health Insurance Scams
Medicare, ACA Phone Scam Source/Image licensed from Ingram Images

It's open enrollment season for health insurance plans. That also means scammers are phishing for your personal information.

It's open enrollment season for health insurance plans, including those offered through Medicare and the Affordable Care Act.

The season also tends to bring out scammers. Sometimes, they can be pretty crafty in their attempts to obtain personal information that can be used for identity theft.

The Better Business Bureau already has reported a couple common scams this year. Both involved Medicare.

RELATED STORY: It's Obamacare season. Here's what you need to know

In one scam, people receive a call from someone claiming to be a "Medicare advisor" offering enrollment in Medicare or another health insurance program over the phone. The scammers then request personal information, saying they need it to get started.

Other scammers try to frighten people by claiming their Medicare benefits will discontinued if they do not re-enroll. In this case, they again ask for personal information, saying they need it for re-enrollment purposes.

To help spot a scammer, the Better Business Bureau offers these tips:

Be wary of anyone who contacts you unsolicited. People representing Medicare or ACA plans don’t contact you by phone, email or in person unless you are already enrolled. Be especially cautious of calls that require quick action or immediate payment, or that threaten you in any way.

Decline promotional gifts in exchange for personal information. Keep a healthy level of skepticism any time a broker offers you free gifts, health screenings, or other special deals. Never sign up with a broker who offers you an expensive “sign-up gift” in exchange for providing your Medicare ID number or other personally identifiable information.

Beware of dishonest brokers who offer “free health screenings.” Some brokers offer this to weed out people who are less healthy. This is called “cherry picking” and is against the Medicare rules.

Guard your government-issued numbers. Never offer your Medicare ID number, Social Security number, health plan info, or banking information to anyone you don’t know. Keep your government ID cards in a safe place.

The Federal Trade Commission adds that anyone offering to sell Medicare insurance as some type of so-called "official Medicare agent is a scammer." Medicare does not have any sales representatives.

Additionally, anyone claiming you must join a prescription drug plan to maintain Medicare coverage is a scam artist. Medicare's prescription drug plan – Plan D – is voluntary. It does not affed Medicare coverage.

Anyone who spots a scam is urged to report it to the FTC at Any scams involving Medicare should be reported to 1-800-MEDICARE.

Scams do not always involve a live voice on the other end of the phone. They can be conducted through robocalls, too.

Pennsylvania Insurance Commissioner Jessica Altman warns distinguishing between a company that legitimately sells insurance and a scam can be difficult, especially with the expanded marketplace for Short-Term Limited Duration Insurance plans, which do not have to meet minimum requirements for comprehensive coverage under the ACA.

"If a consumer is contacted by an automatic robocall about buying insurance or changing a plan, and hasn't previously listed a phone number, they should contact their agent or insurance company before making any decisions," Altman said.

Her office provided the following tips regarding robocalls. 

Robocall Warning Signs:

• Automated sales call from a company or organization you have not previously given consent to contact you.

• Prerecorded message tells you to press “1” or some other key to be taken off a call list.

• The message highlights health insurance available at a suspiciously discounted rate.

What Consumers Should Know:

• Add your number to the Federal Trade Commission’s National Do Not Call Registry; legitimate telemarketers won’t call numbers on the registry.

• Verify callers; hang up and call the business or organization directly to ask if they have contact ed you for any reason.

• Avoid answering calls from unknown numbers.

• Don’t press any keys or say anything when prompted; alerts robocall organizations that your number is working, and this may lead to more calls.

• Do not request to speak to a live operator; this can lead to an aggressive sales pitch or phishing for more personal information.

• Robocalls can mask their location; phone numbers can appear to be legitimate government agencies, corporations and numbers similar to one you know.

Open enrollment for Medicare continues until Dec. 7. The open enrollment deadline for the ACA is Dec. 15.

For more information on insurance scams, visit the website's of the Better Business Bureau and the FTC. Additionally, offers tips to avoid tax scams related to health insurance purchased on the marketplace.

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