Open Enrollment is the busiest shopping season in health insurance, and scammers know it. From November through January the ads, calls, and texts pile up, and mixed in with legitimate outreach are health insurance scams built to take your personal information, your money, or even your enrollment itself. The schemes change a little every year, but the warning signs stay remarkably consistent. This guide covers the red flags HealthCare.gov and the Federal Trade Commission are warning about this season, how to tell a real Marketplace call from a fake one, and exactly where to report a scam if one finds you.
The warning signs of a health insurance scam
HealthCare.gov and the FTC both publish lists of fraud warning signs, and they overlap almost completely. Treat any one of these as a stop sign:
- Someone says you must pay them to keep your Medicaid or CHIP coverage, or to apply for Marketplace coverage. Applying is free, and free enrollment help is available.
- An ad or caller promises free phones or cash cards for gas, groceries, or bills if you enroll in a plan. The FTC says these offers are probably scams.
- You are asked to pay with gift cards, a prepaid debit card, cash, or cryptocurrency. No legitimate insurer or government agency collects money that way.
- An unsolicited email, text, call, or home visit asks for your Social Security number, bank account, or credit card number.
- The caller threatens you or your household with legal action if you do not act now.
- A celebrity appears to endorse a plan. The FTC warns that the person in the ad may be a computer-generated fake.
Lookalike websites and sponsored search results
In its alert ahead of this Open Enrollment, the FTC flagged a quieter tactic: scammers and dishonest businesses sometimes pay to appear at the top of your search results. The ad looks official, the web address looks almost like a government site, and the logos are borrowed. Click through and you can land on a site selling something that is not health insurance at all, or one that exists to harvest your information for medical identity theft.
The defense is simple. Look for the small "Ad" or "Sponsored" label and scroll past paid results. Check that the address ends in .gov before entering anything. Better still, type HealthCare.gov directly into your browser instead of clicking an ad, and use the official Find Local Help directory there to locate Navigators and licensed agents.
What the real Marketplace will and will not do
After you apply, the Marketplace may genuinely call to confirm details on your application, which is exactly the opening scammers imitate. Here is how to tell them apart. According to HealthCare.gov, real Marketplace calls come from 1-855-997-1890 or 844-477-7500, and the caller ID shows "Health Insurance MP" or "InsMarketplace." A real representative may confirm things like your application ID, birth date, or household details, but will never threaten you, never ask for payment or a credit card number to keep or qualify for coverage, and never ask about your bank accounts or health history. You pay premiums to your insurance company directly, not to an individual.
If anything feels off, hang up and call the Marketplace Call Center yourself at 1-800-318-2596, which is open around the clock, or ask the caller to mail you a letter instead. A legitimate representative will not mind either one.
"Coverage" that is not really health insurance
Not every scheme is outright theft. Some of the most frustrating complaints involve products marketed as if they were ACA Marketplace plans when they are not. A short-term health insurance plan is a legal product with real uses, but it is not ACA coverage: it can turn you down or charge you more for preexisting conditions, and it does not have to cover the ACA's essential health benefits. Sold honestly as a stopgap, it has a place. Sold as a cheap "Obamacare alternative" during Open Enrollment, it leaves people underinsured without knowing it. Our guide to short-term health insurance explains what these plans do and do not cover.
Medical discount plans are a sharper trap: the FTC warns that they are not insurance at all, just a membership that promises reduced prices. Before you buy anything, ask one question — "Is this an ACA-compliant Marketplace plan?" — and get the answer in writing. If the seller will not put it in writing, walk away.
Enrolled or switched without your OK? Check your agent of record
The most damaging Marketplace fraud of recent years is unauthorized enrollment: being signed up for a plan, or switched out of the one you chose, without agreeing to it. It is common enough that CMS cancelled a large batch of enrollments it confirmed were unauthorized this fall; our coverage of the CMS cancellations explains what happened and what to do if your plan was affected.
The signs are usually paperwork you did not expect: a tax form for a plan you never bought, letters or ID cards from an insurer you do not recognize, or your financial help changing when you made no update. If anything looks unfamiliar, call the Marketplace Call Center and ask two questions: what plan am I enrolled in, and which agent, if any, is listed on my application. That second answer is your agent of record, and you have every right to know who it is.
There is also real protection arriving this season. New for 2027 coverage, the federal Marketplace requires agents to get your electronic approval, a one-time code or link sent to your phone or email, before they can work on your application. That makes a silent plan switch much harder to pull off. Our Marketplace agent authorization guide explains how a genuine approval request looks, so you can tell it apart from a phishing text.
How to report a health insurance scam
Reporting matters even when you caught the scam in time, because reports are how these operations get shut down. HealthCare.gov and the FTC point to these channels:
- ReportFraud.ftc.gov — the FTC's reporting site for scam ads, calls, texts, and fake websites.
- The Marketplace Call Center at 1-800-318-2596, available 24/7 — for anything touching your Marketplace application, including a plan or agent you never approved.
- Your state attorney general's office.
- Your local police department, especially if you lost money.
- If you already shared your Social Security number or financial information, the FTC's identity theft resources at consumer.ftc.gov walk you through the recovery steps.
Shop safely this Open Enrollment
Open Enrollment for 2027 coverage runs November 1, 2026 through January 15, 2027, with December 15 the deadline for coverage starting January 1. That schedule is the subject of a pending federal appeal, so check our Open Enrollment 2027 guide for the current dates before you plan around them. The safest way to shop is also the simplest: start at HealthCare.gov yourself, or work with a licensed agent you can verify by name and license number. A legitimate agent will tell you exactly who they are before asking you for anything. If you would like a licensed agent to review your options that way, request a quote and we will walk through your choices together, no pressure and no obligation.