Open Enrollment Scams: Medicare and Marketplace Look-Alikes

People are searching, and ads sit on top.

The FTC notes that health insurance scams happen year-round but pick up during open enrollment for Medicare and the Marketplace, when people search online for plans. Scammers and dishonest businesses sometimes pay to appear at the top of search results, use web addresses that look like government ones, and add official-looking logos. Using the link or phone number in such an ad can lead to paying for a plan that is not health insurance, or to medical identity theft.

Type the address, look for .gov.

The FTC’s advice: type the site name yourself. For Medicare, that is Medicare.gov, or call 800-633-4227. To compare Marketplace plans, check coverage, or see if you qualify for savings, use HealthCare.gov or call 800-318-2596. In search results, look for small “Ad” or “Sponsored” labels, scroll past paid ads, and confirm the .gov ending before entering anything. The same habit beats phishing generally.

No sales calls, no home visits.

Medicare.gov says Medicare will never call you to sell you anything or visit you at your home. Medicare, or someone representing it, calls and asks for personal information only in limited situations, such as returning your call after you joined a plan, reported fraud, or left a message. Do not give your Medicare number, Social Security number, or card to anyone except your doctor or others who should have it, such as your insurer or your State Health Insurance Assistance Program, and do not accept money or gifts in exchange for “free” medical care. Callers who push a plan by phone are a reason to hang up; see how to stop robocalls.

SHIP, Senior Medicare Patrol, and local Marketplace help.

You do not need a paid middleman to compare plans. The FTC points Medicare beneficiaries to their State Health Insurance Assistance Program (SHIP) and local Senior Medicare Patrol, and Marketplace shoppers to HealthCare.gov’s “Find Local Help.”

Medical identity theft shows up there first.

Compare the dates and services on your Medicare statements with your own calendar, and check receipts and statements from providers for anything you did not get. A secure Medicare.gov account lets you view Original Medicare claims as soon as they are processed. Unfamiliar claims can mean someone is using your information; the data breach checklist covers the steps when personal data is exposed.

FTC, your attorney general, and Medicare.

Report health insurance scams to the FTC at ReportFraud.ftc.gov and to your state attorney general. If the scam involves Medicare, report it at Medicare.gov or 1-800-MEDICARE (1-800-633-4227). For a Medicare Advantage or drug plan, you can also call the Investigations Medicare Drug Integrity Contractor at 1-877-7SAFERX (1-877-772-3379).