Fraud Protection Tips in the Health Insurance Marketplace® (2024)

When you apply for health coverage through the Marketplace, you can protect yourself from fraud by following a few simple guidelines.

Understand your health care choices

• Learn the basics about getting health coverage. Our website, HealthCare.gov, is the official Marketplace website. Look for official government seals, logos, or web addresses (which end in “.gov”) on materials in print or online. Compare insurance plans carefully before making your decision. If you have questions, contact theMarketplace Call Center.
• Know the Marketplace Open Enrollment dates. No one can enroll you in a health plan in the Marketplace until Open Enrollment begins or after it ends unless you qualify for a

  A time outside the yearly Open Enrollment Period when you can sign up for health insurance. You qualify for a Special Enrollment Period if you’ve had certain life events, including losing health coverage, moving, getting married, having a baby, or adopting a child, or if your household income is below a certain amount.

  Refer to glossary for more details.

  See Also

  Guidance on the Use of Email Containing PHIHealthcare and expat health insurance in Mexico | Expat AssureHow To Deal With A Medical Emergency in Mexico | AirCARE1First Aid for Medical Identity Theft: Tips for Consumers
  due to a

  A change in your situation — like getting married, having a baby, or losing health coverage — that can make you eligible for a Special Enrollment Period, allowing you to enroll in health insurance outside the yearly Open Enrollment Period.

  Refer to glossary for more details.

  or your income is below a certain amount.

Protect your private health care and financial information

Never give your:

• Financial information, like your banking, credit card,account numbers, or Social Security Numberto someone who calls, emails, texts, or comes to your home uninvited, even if they say they are from the Marketplace.
• Personal health information, like your medical history or specific treatments you’ve gotten, to anyone who asks you for it. (If you apply for certain Marketplace exemptions, you may be asked for medical documentation.)

If you get a call from the Marketplace

You may get a phone call from the Marketplace asking you to confirm or provide more information. If we don’t have this information, we may not be able to process your application.

• Calls come from 1-855-997-1890 or 844-477-7500. Caller ID may also show as Health Insurance MP or InsMarketplace.
• The Marketplace representative will say they’re calling from the Marketplace and provide a first name and agent ID number. Write them down.
• If you’re not sure the call is from Marketplace or you don’t want to provide information over the phone:
  • You can hang up and contact the Marketplace Call Center directly for help over the phone.
  • Ask the representative to mail you a letter with instructions.
• If you’re asked to provide additional documents, it’s safest to upload documents through your Marketplace account. Get details on how to upload documents.

Ask questions and verify the answers you get

The Marketplace has trained assisters in every state to help you for free. You’ll never be asked to pay for services or help to apply for Marketplace, Medicaid, or CHIP coverage. Find a free, trained local assister.

There are several types of official assister organizations. They might be called “Navigators,” “Enrollment Assisters,” or “Certified Application Counselors,” and they all work with the Marketplace to provide free, fair, impartial, and accurate information to you and your household.

Assisters are trained by the Marketplace to give you information about your health coverage options, answer your questions, and help you enroll in a Marketplace plan, Medicaid, or CHIP. Assisters will:

• Never ask you for your credit card number or any other form of payment
  • Their services to help you get health coverage are free of charge
  • When you enroll in a health plan, you’ll always pay your premiums directly to the insurance company – never to the Marketplace or its assisters
• Always provide a Privacy Notice Statement, and get your consent or “authorization” before discussing or accessing your personal information

When talking to an assister:

• Ask questions if any information is unclear.
• Write down and keep a record of the name of a salesperson or anyone who may assist you, who they work for, telephone number, street address, mailing address, email address, and website.
• Double check any information that is confusing or doesn’t sound right. Verify information on our website or contact the Marketplace Call Center.

Protect your account more with security codes

When you create a Marketplace account, you can protect your account even more by getting a unique security code each time you log in. This makes it harder for someone to get into your account, if they get your password.

• Security codes are randomly created and sent to you. No one sees the code before it’s sent to you.
• You can pick ways to get security codes – text message, email, or phone call. You can even choose to get codes in more than one way.
  • Text messages and phone calls are sent by 1-888-486-3063.
  • Emails are sent by accounts​@​healthcare.gov.
• If you set up more than one way to get codes, we’ll ask you where we should send the code each time you log in. You’ll be able to pick what works best for you at that time.

We can’t respond to replies to security codes. If you need help setting up security codes or logging into your account, contact the Marketplace Call Center.

Never share your Marketplace account password or security code with anyone, even if they say they are from the Marketplace. We’ll never ask you for your password or security code.

When to report suspected fraud

Take action if:

• Someone other than the insurance company you’ve chosen contacts you about health insurance and asks you to pay – or asks for your financial or personal health information.
• Someone you don’t know contacts you about getting health insurance and asks you to pay – or asks you for your personal financial or health information.
• Someone contacts you and claims to be from the government, your state, Marketplace, Medicaid, CHIP, or Medicare – and asks you to pay or send them gift cards to get or keep coverage.
• You give your personal health, bank account, or credit card information to someone who calls you and says they’re from the government.

How to report suspected fraud or scams

Take action if:

• Someone calls, emails, or texts you asking for your information (like your Social Security Number) or for money (like credit card payment, gift cards, cash, prepaid debit card, or cryptocurrency) or if they threaten you or anyone in your household with legal action.
• You suspect identity theft, or feel like you gave your personal information to someone you shouldn’t have.