A friendly-sounding person calls and offers to help you reapply for Medicare. And all they say you need to do is give them your Medicare number. That’s your cue to hang up.
Health care scams increased amid the uncertainty and confusion at the height of the COVID-19 pandemic. In fact, in April 2020, the Social Security Administration reported that scammers might be stealing everything from people’s Medicare numbers and banking information to personal details like their date of birth and Social Security numbers.
Even the most careful and informed person can fall victim to a health care scam. And on the flip side, health care companies have to watch out for it too. People that commit health care scams are their problem as well.
“Consumers have to protect themselves against insurance scams, and insurance companies have to protect themselves against consumer scams,” says Noor Ali, M.D., M.P.H., C.P.H., a health insurance adviser and founder of Dr. Noor Healthcare Advisor.
Thankfully, you can protect yourself. And in case you ever get caught up in a scam, there are steps you can take and protocols in place to prevent it from happening again.
Read on to learn more about health care scams, and what you can do to protect yourself from them.
Scammers are getting better (and less obvious) when it comes to committing health care crimes. And if you’re trying to get an insurance quote, you may find yourself in a confusing and potentially problematic situation.
While it is easy to get an insurance quote, you want to make sure it’s from a licensed insurance agent, notes Dr. Ali. (A great place to start? Call a licensed agent at 1-844-211-7730.) But when you request a quote online, you won’t know who will be calling you back. “You may get bombarded by 10 agents trying to fight to give you that quote and earn that business,” says Dr. Ali.
While you may have asked for information, you probably weren’t aware you would get replies from so many people. The best way to protect yourself is by knowing what to watch out for and what to do next.
Here are 5 red flags that could be a sign of a health care scam:
Red flag #1: The caller says they are from the government. If you receive a call from someone claiming to be from a government agency, you should immediately be suspicious. The Federal Trade Commission (FTC) notes that government agencies will not directly call, email or text you.
Red flag #2: The caller asks that you pay to keep your coverage or get a new Medicare card. This is a big no-no. Let’s say you quit your job and bought an Affordable Care Act plan from the federal Health Insurance Marketplace (that’s a government-run website where you can buy health care plans). The website for the Marketplace states that you would never get a phone call from someone asking for payment to keep or qualify your health coverage.
Have a Medicare plan? No one will ever call you to ask for payment for a new Medicare card or about losing coverage, according to the U.S. Centers for Medicare & Medicaid Services.
Red flag #3: An insurance agent calls you out of the blue. Insurance agents will typically only call you if you have first reached out to them and set up an appointment. However, there are some exceptions.
“A strategy insurance agents use for prospecting new business is cold-calling,” says Dr. Ali. “So while you might not have asked for a quote, they might just get your information, because someone who just reached a certain age or had a certain life event (like retirement) may be a relevant prospect,” she explains. “You might get reached out to even if you didn't request the information.”
Red flag #4: A salesperson won’t tell you specific details about a plan. If the person on the other end of the line can’t answer your questions or share additional details about insurance plans, that’s a warning sign that something’s fishy.
“They should be able to talk to you about the insurance product, not just asking for information from you but answering your relevant questions,” says Dr. Ali. “It might be appropriate to ask for some literature or ask for a website with more information, either about the insurance product or the agent, so you can do more research.”
Red flag #5: A website or salesperson wants your sensitive personal information. You’ll never be asked for personal financial information, such as your Social Security number, bank account information or credit card number, when applying for health insurance, according to the FTC.
To get a price quote for health insurance, you only need to share general information, such as your age and ZIP code. (Case in point: You can enter your ZIP code to search available plans or call a licensed agent at 1-844-211-7730.)
Even if you think you’re not the type who might be duped by a scammer, anything is possible. And if you’re taking care of an older relative, you’ll want to be up to speed on how you can help them.
Now that you know the ways scammers can try to trick you, here’s what you can do to protect yourself (or your loved ones) from health care scams:
Don’t click on links in suspicious texts or emails. Government agencies will never call, email, text or reach out to you on social media, according to the FTC. So it’s never a good idea to click on links in messages that claim they’re from a government source. The FTC suggests deleting those messages.
Do your own research before signing up for anything. Let’s say you go to what you think is an insurance website. You get a bunch of weird pop-ups, and then you get redirected to another website. If you suspect something doesn’t look right about the site, do some additional research. Do a search of the website’s name and “scam,” and you might find that others have been targeted by it.
The same goes for suspicious phone calls. If someone calls you asking for your personal information, turn things around and ask them.
“Ask if they are a licensed insurance agent,” says Dr. Ali. “What is your name? What is your ID number? There’s the National Association of Insurance Commissioners (NAIC), which is a national database where you can look up any active licensed insurance agent with their NAIC number,” says Dr. Ali. “That would be a very valuable piece of information, to to check if they are a licensed insurance agent.”
Bottom line: If you think you or a loved one might be vulnerable to a health scare scam, the best way forward is to educate yourself. Get to know the warning signs and what you can do to protect yourself. And kudos to you for getting started by reading this article.
Centers for Medicare & Medicaid Services. “Protecting Yourself & Medicare from Fraud.” March 2022. Retrieved from https://www.medicare.gov/publications/10111-protecting-yourself-and-medicare.pdf
Federal Trade Commission. “How to Avoid a Government Impersonator Scam.” May 2021. Retrieved from https://consumer.ftc.gov/articles/how-avoid-government-impersonator-scam
Federal Trade Commission. “Spot Health Insurance Scams.” May 2021. Retrieved from https://consumer.ftc.gov/articles/spot-health-insurance-scams
HealthCare.gov “Protect yourself from Marketplace fraud.” Retrieved from https://www.healthcare.gov/how-can-i-protect-myself-from-fraud-in-the-health-insurance-marketplace/ Accessed June 14, 2023.
National Association of Insurance Commissioners. “Consumer Insurance Search Results.” Retrieved from https://content.naic.org/cis_consumer_information.htm#_ga=1.74044242.1731444020.1686813281 Accessed June 14, 2023.
Social Security Administration. “Coronavirus-Related Medicare Scam Alert,” updated February 21, 2023. Retrieved from https://blog.ssa.gov/coronavirus-related-medicare-scam-alert/.