Start plan shopping at HealthCare.gov for Marketplace coverage or Medicare.gov for Medicare information. A search result’s prominent placement, government-style logo, or official-sounding web address does not establish that a site is legitimate. Be cautious of unexpected requests for personal or financial details, pressure to act immediately, payment demands, and offers that emphasize gifts or cash over what a plan covers.
How do I know if a health insurance offer is a scam?
Scams and misleading sales pitches can surface during both Marketplace and Medicare enrollment. The Federal Trade Commission (FTC) notes that health insurance scams happen year-round and increase during open enrollment. The following signals warrant a pause and independent verification; no single signal, by itself, proves that every agent or offer is fraudulent.
Unsolicited requests or pressure to act
Treat an unexpected call, text, email, or social media message asking for personal, financial, or health information as a reason to stop and verify. Be especially wary of threats, urgent deadlines, or claims that you must pay someone to apply for or keep Marketplace coverage. HealthCare.gov says the Marketplace, assister organizations, and states will not threaten you or require payment for those purposes.
Do not respond with sensitive details simply because the sender knows some information about you or claims to represent a government program. Verify the contact through a trusted official channel first, and share only what is needed with someone whose authorization you have confirmed.
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Demands for unusual payment
Requests for cash, gift cards, prepaid debit cards, or cryptocurrency to qualify for or keep coverage are major warning signs. HealthCare.gov says, “We’ll never ask you for payment to apply for or keep coverage.” Marketplace premiums are paid directly to the insurance company, not to the Marketplace or an assister. Before paying, confirm the recipient using your insurer’s contact information or another official channel you reached independently.
Cash, gifts, or rebates take center stage
Be skeptical if an offer focuses on cash rewards, gift cards, rebates, or other incentives instead of the coverage, costs, and limits. CMS warns that marketing may also describe premium tax credits as cash incentives. Ask for the plan’s benefits and costs in writing, and evaluate the coverage rather than the promotional pitch.
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The product may not be comprehensive insurance
An offer described as comprehensive coverage may actually be a medical discount plan or a product with limited insurance benefits. A discount plan is not the same as comprehensive health insurance. Before enrolling, identify the product type and read what services it covers, what it excludes, and what costs you may still owe.
Is this Marketplace website or caller real?
Check the route, not the appearance
Type HealthCare.gov yourself to begin Marketplace comparisons and enrollment. For Medicare information, start at Medicare.gov. The FTC warns that scammers and dishonest businesses may pay for prominent search placements and use addresses resembling government websites or official-looking logos. A high search position, familiar name, or polished design is not proof of legitimacy.
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Verify a caller independently
If someone says they are calling from the Marketplace, HealthCare.gov says legitimate Marketplace callers identify themselves and provide a first name and agent ID. Do not treat that information alone as verification: use official contact routes you locate independently before sharing details or acting on a request.
Agents and brokers can help consumers enroll, and their involvement alone does not indicate fraud. CMS has documented unauthorized enrollments and suspicious agent and broker activity, so check that an agent is authorized and review any application or plan change before it takes effect.
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Can an agent enroll me without permission?
CMS has taken enforcement action over confirmed unauthorized enrollments and suspicious agent or broker activity. Its figures describe agency reviews and enforcement—not the likelihood that any particular consumer will be affected.
On August 31, 2026, CMS said it had canceled approximately 315,000 enrollments covering more than 760,000 individuals after confirming unauthorized enrollments through reviews with health insurers; approximately $2.2 billion in advance premium tax credit payments was expected to be returned. CMS also reported that, since January 2026, more than 200 non-compliant agents and brokers had received termination notices, and that it had issued 569 notices of intent to terminate to agents and brokers who submitted 2026 applications without identifying information such as an SSN. These are distinct enforcement counts, not a measure of all scams or consumer prevalence.
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If you find an application or plan change you did not authorize, review the confirmation and contact the Marketplace or insurer through an official channel to ask what happened and how to correct the record. CMS cautions that agent- or broker-assistance data do not necessarily show the channel through which an application was submitted, so an association with agent assistance does not by itself establish who submitted it or whether the consumer authorized it.
Independent reader supportYour contribution helps us test, update, and keep practical guides available for everyone.How to protect your information and money while comparing plans
- Start at the official program site. Use HealthCare.gov for Marketplace coverage or Medicare.gov for Medicare information; do not rely on a search ad or a link in an unexpected message.
- Pause before sharing sensitive details. Independently verify an unexpected caller, texter, email sender, or advertiser. Confirm that a helper is authorized and limit disclosure to information needed for the task.
- Confirm what you are buying. Get the plan’s benefits, exclusions, costs, and product type in writing. Check whether it is comprehensive insurance, limited-benefit insurance, or a medical discount product.
- Verify the payment recipient. For Marketplace coverage, pay premiums directly to the insurer. Do not pay the Marketplace or an assister to apply or keep coverage.
- Review enrollment records. Check confirmations and follow up with the Marketplace or insurer if you see an application or plan change you did not authorize.
Where do I report a health insurance scam?
For suspected Marketplace fraud, HealthCare.gov advises contacting the FTC and local police. The FTC’s September 28, 2026 consumer alert directs reports about Medicare-related scams to Medicare.gov or 800-633-4227; it directs reports about other fraud to ReportFraud.ftc.gov and your state attorney general. If the issue involves a specific enrollment or premium, also contact the Marketplace or insurer through its official contact route.
Keep relevant messages, emails, payment requests, or enrollment notices so you can describe what happened when reporting it. Do not use contact details supplied by the suspected sender to verify or report the contact.
What federal enforcement figures do—and do not—show
CMS’s 2026 enforcement figures document confirmed unauthorized enrollments and actions involving agents and brokers; they are not a count of every scam, nor do they establish an individual consumer’s odds of being targeted. Separately, a CMS letter dated 2025 reported that the FTC sent warning letters to 21 lead generators and third-party marketing companies on December 10, 2024. A warning letter is not a finding of liability. The letter described marketing categories that drew attention, not proof that every business in those categories broke the law.
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