Health insurance scams to watch for during open enrollment

If you've been shopping for health insurance lately, you've probably noticed the ads popping up everywhere. Some promise surprisingly low monthly payments. Others claim you'll qualify for generous benefits or even receive cash rewards for signing up. And with open enrollment underway, those offers can be awfully tempting. But here's what worries me. You could enroll in what looks like a great health insurance plan, only to discover that it barely covers your medical bills when you actually need care.

The Federal Trade Commission (FTC) is now warning about misleading health insurance advertising, including plans that promise comprehensive coverage but deliver far less. Some offers promote medical discount programs rather than traditional insurance. Others may come from scammers impersonating government agencies or familiar insurance companies. With Americans reviewing their coverage for 2027, knowing how to recognize health insurance scams could save you from a very expensive mistake.

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Recently, the FTC announced it was sending warning letters to 25 companies that market healthcare plans or generate sales leads for insurance-related products. The agency identified several advertising practices that could violate federal law. These include misrepresenting a plan's benefits, hiding important costs or falsely suggesting that a limited-benefit product provides comprehensive medical coverage. The FTC also raised concerns about advertisements promising free offers, cash rewards or rebates that people may never receive.

Now, there's an important detail here. The FTC says the warning letters do not accuse any of the 25 companies of wrongdoing. Instead, the agency is reminding businesses about advertising laws and warning that it continues to monitor the market. Officials also indicated that additional letters could follow.

Still, the timing deserves attention. Open enrollment brings a surge of legitimate advertising from insurance providers. Unfortunately, it also gives dishonest marketers and scammers another opportunity to reach people looking for affordable healthcare.

Let's say you're searching online for a more affordable health insurance plan. You type a few words into Google and see a sponsored result offering excellent coverage at a price that seems almost impossible to beat. The website looks professional. It might display a familiar logo or suggest a connection to a government program. You click through and enter your phone number to learn more. Before long, someone calls with an offer. They tell you that you qualify for special coverage and encourage you to sign up immediately. You may even hear that the deal expires today.

Here's where things can get tricky. The website might belong to a lead-generation business collecting information for insurance sellers. Lead generation itself is a legitimate practice, but misleading advertisements can send people toward products they never intended to buy. The FTC warns that scammers sometimes purchase search advertisements that imitate official websites. Some use addresses resembling HealthCare.gov or Medicare.gov. Others copy recognizable branding to create the appearance of legitimacy.

We've seen similar tactics with financial scams. CyberGuy previously reported on criminals buying Google ads to steal bank logins. In those cases, sponsored search results directed people to convincing fake banking websites. The same underlying trick can work with health insurance. When an advertisement appears near the top of your search results, it's easy to assume the company behind it has already been checked out. But a paid placement offers no guarantee that the seller or its claims are trustworthy.

One of the FTC's biggest concerns involves products that look like comprehensive health insurance but offer limited protection. For example, some advertisements promote medical discount programs. You pay a fee and receive access to discounts from participating healthcare providers. While legitimate discount programs exist, they don't provide the same financial protection as comprehensive insurance.

Other products, such as fixed indemnity plans, may pay a predetermined amount when you receive certain medical services. Depending on the policy, that payment could fall far short of your actual bill. Think about what happens if you suddenly need emergency surgery. You might expect your insurance to help cover the expense. Instead, you discover that your plan pays only a limited benefit, leaving you responsible for a substantial portion of the charges.

That possibility makes understanding your coverage so important. Plans sold through the official Affordable Care Act (ACA) Marketplace must cover essential health benefits, including emergency services and hospitalization. They also provide coverage for preexisting conditions. However, deductibles and other out-of-pocket costs can still apply.

You can review those protections directly through HealthCare.gov's explanation of Marketplace benefits at healthcare.gov/coverage/what-marketplace-plans-cover. Before purchasing any plan, ask exactly what type of coverage you're getting. A low monthly premium means very little if the policy leaves you exposed to major medical expenses.

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Have you ever answered your phone and heard a recorded message claiming you've been approved for an affordable health insurance plan? Maybe the recording tells you that you qualify for special benefits. It might even suggest that you're running out of time to claim them. Be skeptical.

The FTC's October 29 consumer warning specifically highlights illegal prerecorded telemarketing calls promoting health insurance. Unsolicited recorded insurance sales calls deserve particular caution. They may come from scammers or businesses using questionable marketing practices.

And don't assume a familiar name on your caller ID proves anything. Scammers can manipulate caller ID information to make calls appear to come from legitimate organizations. If you receive an unexpected insurance sales call, hang up. Then contact the insurer through a phone number you've independently verified.

You don't need to become an insurance expert to avoid misleading offers. However, a few simple precautions can help you make a more informed decision before committing to a plan.

The safest starting point for comparing ACA Marketplace coverage is HealthCare.gov. You can also call the Marketplace directly at 1-800-318-2596. If your state operates its own Marketplace, the federal website can direct you there. Avoid starting your search through an unfamiliar advertisement or a link someone sends you unexpectedly. Typing the official website address into your browser gives you greater control over where your information goes.

A sponsored result means an advertiser paid for placement. It doesn't mean the government has approved the company or verified every claim in the advertisement. Check the website address before entering personal information. Watch for misspelled domains or websites that imitate official government branding. If something looks suspicious, close the page and navigate directly to the organization you're trying to reach.

Before enrolling, request the plan's Summary of Benefits and Coverage (SBC) when applicable. This document explains important costs and coverage details in a standardized format. Pay particular attention to deductibles and out-of-pocket limits. Check whether your doctors participate in the plan's network. Also, make sure the policy covers the medications or treatments you need. You can learn more about these documents through HealthCare.gov's Summary of Benefits and Coverage guide at healthcare.gov/health-care-law-protections/summary-of-benefits-and-coverage/.

The FTC specifically warns about misleading offers that promise cash rewards or other incentives for enrolling in healthcare plans. Now, legitimate Marketplace financial assistance does exist. Depending on your eligibility, premium tax credits can reduce what you pay for coverage. However, that assistance follows established eligibility rules. If someone promises guaranteed cash simply for signing up or refuses to explain the terms, take a closer look before providing personal information.

If you're considering a plan sold outside the official Marketplace, contact your state's insurance department. Ask whether the company and agent are properly licensed and whether the product provides the coverage being advertised. The National Association of Insurance Commissioners provides resources to help you find your state insurance regulator. Also, be cautious about anyone pressuring you to enroll immediately. Legitimate insurers should provide the information you need to review a policy before purchasing it.

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Health insurance applications can require sensitive information. That makes fake enrollment websites particularly dangerous. Never provide your Social Security number or banking details to someone who contacts you unexpectedly unless you've independently verified their identity and the reason they need the information. If you're unsure about an offer, contact the insurance company directly. You can also find trained Marketplace enrollment assistance through HealthCare.gov's official help page at healthcare.gov/find-assistance/.

Scammers may use fake health insurance websites, phishing emails or text messages to trick you into clicking malicious links. Strong antivirus software can help detect dangerous websites and block malware that could steal your passwords or personal information. Some security tools can also warn you about suspicious links before you open them. While antivirus protection can't tell you whether an insurance policy provides legitimate coverage, it adds another layer of protection when you're shopping online. Get my picks for the best 2026 antivirus protection winners for your Windows, Mac, Android & iOS devices at Cyberguy.com.

Health insurance scams can expose some of your most sensitive information, including your Social Security number and financial details. An identity theft protection service can monitor for signs that criminals are misusing your information and alert you to suspicious activity. Some services also provide assistance if your identity is stolen. Keep in mind that these services can't prevent every type of fraud. If you've already shared sensitive information with a scammer, visit IdentityTheft.gov to learn what steps to take. See my tips and best picks on Best Identity Theft Protection at Cyberguy.com.

If you create an account to compare or manage health insurance coverage, protect it with a strong, unique password. A password manager can help you create and store passwords without reusing them across multiple websites. Also, enable two-factor authentication (2FA) whenever it's available. That extra security step can make it harder for someone to access your account if your password gets stolen.

If you're reviewing health insurance for next year, knowing the enrollment deadlines can also protect you from misleading sales pitches. According to the current HealthCare.gov enrollment calendar, federal Marketplace open enrollment for 2027 coverage began November 1, 2026, and ends January 15, 2027. However, there's another important deadline. To have your Marketplace coverage begin January 1, 2027, you generally need to enroll by December 15, 2026, and pay your first premium. Enrollments completed from December 16 through January 15 generally begin February 1, provided the first premium is paid.

Some state-operated Marketplaces may have different dates, so check your state's official website. Medicare operates on a separate schedule. Its annual open enrollment period runs from October 15 through December 7, 2026, for coverage changes taking effect January 1, 2027. If you're comparing Medicare plans, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227). Knowing these dates makes it easier to question someone who calls with a supposedly urgent deadline that doesn't match the official schedule.

Maybe you've already clicked an advertisement or spoken with someone about a plan that now seems questionable. Perhaps you've even paid an enrollment fee. The first thing I recommend is verifying whether you actually have insurance coverage. Contact the insurance company directly using its official phone number. Ask for confirmation of your policy and request written information explaining your benefits.

If you shared financial information with a suspicious seller, contact your bank or credit card company. Explain what happened and ask about protecting your account or disputing unauthorized charges. And if you provided sensitive identifying information to someone you suspect was a scammer, visit IdentityTheft.gov for guidance on protecting yourself.

You can also report misleading health insurance advertisements and illegal robocalls to the FTC at ReportFraud.ftc.gov. The sooner you investigate a suspicious transaction or possible identity theft, the more options you may have to limit the damage.

What concerns me most about these health insurance offers is how easily someone could believe they're protected when they're actually facing an enormous financial risk. Think about it. You pay your monthly bill, receive something that looks like an insurance card and assume you're covered. Then a medical emergency happens, and suddenly you discover your plan has serious limitations. That's a frightening position to be in, especially when medical expenses can add up so quickly. I also think this FTC warning says something important about how we shop online. We've become accustomed to seeing sponsored results at the top of our searches. But the company willing to pay for that placement may have little to do with the organization we're actually trying to reach. When it comes to health insurance, I would always start with the official Marketplace or a company I've independently verified. And before signing anything, I want to know exactly what happens if I end up in the emergency room. That's the question that can reveal whether a seemingly affordable plan will actually protect you.

Should companies face tougher penalties for advertising misleading health benefits, especially when someone's financial security could be at stake? Let us know by writing to us at Cyberguy.com

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