Not everyone claiming to be from the HealthCare Marketplace is legit.

If you’re shopping for health insurance during the Healthcare Marketplace open enrollment period from November 1, 2021 to January 15, 2022, you could become a victim of Healthcare Marketplace fraud if you’re not careful, warns HealthCare.gov, the official government site where you can enroll in a health plan.

Ploys used by Marketplace fraudsters include calls from imposters claiming to be representatives of the HealthCare Marketplace or companies offering to enroll you at the Marketplace for a fee. But those aren’t the only ways you may unwittingly provide information to scammers who could use your personal information for identity theft purposes.

Here’s what you need to know to avoid becoming a victim of Healthcare Marketplace fraud during this year’s open enrollment.

1. Never pay a fee to enroll in a health plan

When you enroll in a 2022 health plan on the Marketplace, you’ll usually have to pay in advance for the first month’s premium. However, you won’t have to pay a fee just to enroll. Beware of people who claim they can enroll you in Marketplace or “Obamacare” insurance, but only if you pay a fee, warns the Office of Inspector General (OIG), a department of the U.S. Department of Health and Human Services.

Legitimate enrollment assisters won’t ask for money for the service of enrolling you in a Marketplace health plan, says the OIG.

The Marketplace has agents/brokers and assisters who are trained and certified to provide help with your open enrollment application. They can discuss health plan options, determine whether you qualify for a premium tax credit and help you choose the best health insurance for your needs and budget at no cost for the service.

To find a local Marketplace agent/broker or assister, visit Find Local Help at HealthCare.gov.

Find out: 5 Strategies to Minimize Health Insurance and Medical Costs

2. Don’t give financial information to uninvited solicitors

Don’t trust people who call, send letters or show up at your front door uninvited asking for your personal information so they can enroll you in a health plan on the Marketplace. These solicitors may be trying to steal your identity, according to the OIG.

Never give financial information such as banking, credit card or account numbers to someone who shows up at your home uninvited, even if that person claims to be from the Marketplace, warns HeathCare.gov.

Find out: Take These 5 Steps to Check Your Medical Bills for Errors

3. Run from high-pressure tactics

If you receive high-pressure visits, letters, emails or phone calls from people pretending to work for the government, don’t give in to pushy tactics. And don’t cave to empty threats, either. “No one should threaten you with legal action if you do not sign up for a plan,” says the OIG. “Always ask for identification if someone comes to your door.”

Find out: How to Control Healthcare Costs That can Lead to Debt

4. A call from the Marketplace might be legitimate

When you’re vigilant about recognizing fraud attempts, getting a phone call from someone saying that he or she works for the Marketplace will likely put you on high alert. That’s great if the caller is a fraudster after your personal information. However, sometimes the caller is a legitimate Marketplace representative.

After you apply for health insurance on the Marketplace, a representative may call you if more information is needed or to verify something in your application. Don’t hand over that information without first making sure the caller is actually a Marketplace representative, though.

HealthCare.gov offers these tips for making sure you’re speaking with a Marketplace rep:

Check the number on your caller ID. Legitimate callers may show the following:

  • Health Insurance MP
  • InsMarketplace
  • 1-855-997-1890
  • 844-477-7500

Even if these names or numbers display, keep in mind that scammers often use “spoofing” on caller ID to mask their true identities and gain your trust. That’s why you must take further steps to make sure the caller is legitimate

Verify the caller’s identity. If someone is calling from the Marketplace, that person must provide a first name and agent ID number, according to HealthCare.gov. Write both down for your records. Beware of callers asking for personal financial information. If a fraudster gains your trust under the guise of being a Marketplace representative, the information that he or she asks you to provide can be a red flag that the caller isn’t actually from the Marketplace.

For example, an actual Marketplace rep may ask you to verify your identity, full name, address, Social Security number, application ID, policy ID, user ID, date of birth or phone number. The representative may also want to verify income, household and employment information.

However, a Marketplace representative won’t ask for personal financial information such as your bank name and account number. They also won’t ask about any personal health information such as your medical history or conditions.

Knowledge is key to fraud prevention

Learning the basics of getting health coverage at the Marketplace is a good place to start if you want to avoid becoming a victim of Marketplace fraud. You can find information about how to enroll during open enrollment, tax premium credits and what to expect when you enroll in a health plan on the Marketplace at HealthCare.gov.

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About the Author

Deb Hipp

Deb Hipp

Deb Hipp is a full-time freelance writer based in Kansas City, Mo. Deb went from being unable to get approved for a credit card or loan 20 years ago to having excellent credit today and becoming a homeowner. Deb learned her lessons about money the hard way. Now she wants to share them to help you pay down debt, fix your credit and quit being broke all the time. Deb's personal finance and credit articles have been published at Credit Karma and The Huffington Post.

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