Blog Post  Health Insurance Scams

Health insurance is meant to give you peace of mind, but scammers may exploit rising costs and enrollment deadlines to take advantage of policyholders. Criminals steal consumer information and data with a simple call or text, leaving victims to deal with identity theft. Here's how to protect yourself and your family.

Check that a company is real

When it comes to choosing a health insurance company before you act, check to see if the health plan is licensed by the Massachusetts Division of Insurance. You can call the division at (617) 521-7794 to verify an insurer or look for Massachusetts Licensed Insurance Companies on DOI’s web site.

You can also visit a trusted source like the Massachusetts Health Connector. Coverage purchased from the state marketplace is guaranteed comprehensive, coverage that is compliant with the Affordable Care Act. For private insurance coverage, remember to check with the Massachusetts Division of Insurance to confirm that a company is licensed.

Usually, fake companies offer promises or deals that seem too good to be true, lack specific names and addresses, don’t share much information about the plan, and try to lure you with limited time offers.

Be aware of fake health insurance plans

Scammers often call posing as a customer service representative and ask for money or personal information to verify an account. By using official sounding names and sending links that look legitimate, they first gain trust before striking. Then, they seek sensitive information to gain access to financial accounts, asking for “verification” to help with your insurance coverage.

For example, leveraging the increase of stories in the news and preying on people’s fear of losing coverage or paying more for it, scammers may falsely claim they are from the government-run program Medicare. You may receive an email or text saying that your Medicare coverage is expiring or the card needs a replacement. By creating a sense of urgency, criminals convince victims that their benefits are at risk of being canceled unless they act immediately by providing a password, clicking a link, or sending money. 

In reality, no one from the government or a legitimate company will contact you through a call, text, or email to verify your Social Security Number (SSN), bank account, credit card number, or password. They will never ask you to wire money or pay by gift card or cryptocurrency.

Know that AI generated calls help scammers commit crime

With the progression of artificial intelligence (AI), scammers have been using AI to increase the volume and “quality” of calls they make to commit fraud more efficiently. These recorded messages can respond to simple questions and imitate a real conversation, eventually getting personal information out of the victim with ease.

If receiving a call from someone claiming to be an insurance company:

• Hang up and call your company’s customer service number directly to verify if they made a call to you. The phone number should be on the back of your health insurance card.
• Remember that Medicare would never call you first. Call Medicare at (800) 633-4227 or visit Medicare.gov to check if an update is required.
• Never give your personal information over the phone unless you know exactly who you are calling.

If you think you might be the victim of a scam, call the Attorney General’s Health Care Helpline at (888) 830-6277 or file a complaint.