Healthcare Scams: How to Spot and Avoid Them

Healthcare Scams: How to Spot and Avoid Them

In today’s world, scams are prevalent, and unfortunately, even health insurance is not immune. With the rise in the number of fraudsters and malicious individuals creating fake health insurance cards, it has become crucial to educate the public about healthcare scams and how to identify a fake health insurance policy.

According to The Fitzgerald, a CNBC writer, these scams cost older Americans nearly $3 billion annually. Scammers employ various tactics, and here are 10 common phone scams that are currently circulating:

  1. Threatening calls from the IRS.
  2. Technical support calls.
  3. Fake charity appeals.
  4. Lottery scams.
  5. Family members in distress.
  6. Bank fraud calls.
  7. Insurance, health care, and debt scams.
  8. Requests for website passwords.
  9. Fake customer service requests.
  10. Urgent and suspicious requests.

Scams targeting healthcare programs like Medicare, Medicaid, NHS, and NHIS have severe consequences, depriving vulnerable individuals of essential care and medications. These scams divert valuable resources into the hands of a few selfish individuals. Bogus policies have resulted in millions of dollars lost by victims, while system manipulations have siphoned off billions of dollars from healthcare schemes. As a result, families suffer, and it is our duty as a public health information site to help you recognize and avoid such scams.

There are several warning signs that indicate you may be dealing with a fake health insurance company, agent, or representative. These signs include:

Identifying Fake Health Insurance Schemes: What to Look Out For

Healthcare Scams: How to Spot and Avoid Them
  1. Persistent barrage of phone and email messages: If you’re constantly bombarded with calls and emails, it’s a red flag. Genuine providers don’t use such unprofessional tactics.
  2. Incredibly low-priced deals: While not all low-priced deals are scams, if an offer seems too good to be true, it probably is. Double-check the details to avoid falling victim to healthcare scams.
  3. Pressure to sign up immediately: If you’re being rushed to make a decision, take a step back. Pressure tactics are often used by scammers.
  4. Claims of working for a government agency or sanctioned program: If someone claims to be affiliated with a government agency or an official program like “Obamacare,” be cautious. It’s a warning sign of a potential healthcare scam.
  5. Evasive sales representatives: If an agent avoids answering questions or redirects you to brochures instead of providing direct information, something may be suspicious. Ensure you have all necessary details before committing to any offer.
  6. Membership in an unknown association or union: Be wary if you’re told you must join an association or union to access the coverage you need. These organizations may not exist or be relevant, and it could be a ploy to deceive you.
  7. Official-looking websites: Scammers often create professional-looking websites to appear credible. Don’t solely rely on appearances. Seek feedback from previous customers and be cautious of fake reviews.
  8. Non-delivery of insurance card or policy: Genuine insurers prioritize effective customer service. If you don’t receive your insurance card or policy as promised, it could indicate a scam. Fake health insurance cards are sometimes used by fraudsters.
  9. Delayed payment of medical bills: Scammers often delay or fail to pay medical bills promptly. If the insurer consistently makes excuses or blames accounting errors, it’s a warning sign that should not be ignored.
  10. ERISA excuse for lack of state licensing: If an agent claims that special federal laws like ERISA exempt them from state licensing requirements, they are likely lying. This is a clear indication of a healthcare marketplace scam.

Be cautious of identity theft and insurance scams related to the Affordable Care Act (ACA). Scammers may pose as government employees, requesting personal information for a national Obamacare card. Remember, government representatives don’t sell insurance through phone calls, door-to-door visits, or emails. Rely on official sources for information to avoid falling victim to such schemes.


No Obamacare or new Medicare cards: The ACA does not issue specific cards. If someone claims to be from a government agency or institution and asks for your bank account or full social security number, it’s a scam. Hang up immediately!

Incomplete application or complex family structure: If you’ve submitted a health insurance application to the Health Insurance Marketplace and receive a call about incomplete information or complex family details, it may be legitimate. During such calls, the employee may verify the last four digits of your social security number to confirm your identity.

Contact the Marketplace Call Center for questions: If you have any concerns about these calls, reach out to the Marketplace Call Center at (800) 318-2596. They can provide assistance and clarify any doubts you may have.

Stay vigilant and protect yourself from health insurance scams by being cautious with your personal information and verifying the legitimacy of any calls or requests you receive.


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