Every year during open enrollment, millions of Americans shop for health insurance. And every year, scammers show up right on schedule.
Related Page: The Top Scams and Fraud Threats to Watch for in 2026 (and How to Protect Yourself)
They know this is a moment of urgency. Deadlines are looming. Choices feel overwhelming. And many people are worried about costs, coverage gaps, or protecting their families. That pressure creates opportunity — not just for insurers, but for fraudsters looking to move fast and disappear even faster.
At our community bank, we’ve seen firsthand how financial scams ripple through households. Health insurance fraud isn’t just frustrating. It can leave you uninsured, expose your personal information, and drain your bank account. That’s why we believe knowledge is one of the most powerful forms of protection.
Let’s walk through how these scams work, what to watch for, and how to protect yourself this open enrollment season.
Why Health Insurance Scams Spike During Open Enrollment
Open enrollment is a perfect storm for scammers.
People are actively searching for coverage. Ads are everywhere. Cold calls don’t feel unusual. And many legitimate plans are changing year to year, which makes it harder to tell what’s real and what isn’t.
Scammers exploit that uncertainty by posing as:
- Government representatives
- Licensed insurance agents
- Marketplace navigators
- Well-known insurance companies
They often promise lower premiums, “better” coverage, or exclusive plans that sound too good to pass up — especially if you’re worried about rising healthcare costs.
Common Health Insurance Scams to Watch For
Fake Marketplace Plans
One of the most common scams involves fake Affordable Care Act (ACA) or Marketplace plans.
You’re told you’re enrolling in a compliant health insurance policy, only to later discover:
- The plan doesn’t meet ACA requirements
- Essential services aren’t covered
- The policy doesn’t exist at all
A legitimate ACA plan can only be purchased through the official Marketplace or a verified provider. If someone claims they can offer a Marketplace plan “off-platform,” that’s a major red flag.
You can always verify legitimate plans at HealthCare.gov.
High-Pressure Phone Calls or Texts
Scammers often rely on urgency to cloud judgment.
You might hear:
- “Your coverage expires today.”
- “You must act now to avoid penalties.”
- “This offer is only available for the next 10 minutes.”
Legitimate insurers and government programs don’t pressure you into immediate decisions over unsolicited calls or texts.
If it feels rushed, pause. Real coverage decisions deserve time and clarity.
Requests for Sensitive Personal or Banking Information
Be cautious if someone asks for:
- Your Social Security number
- Online banking credentials
- Debit card or account numbers
- One-time passcodes
While legitimate enrollment may require personal information, it should only happen on secure, verified platforms — not over unexpected phone calls or text messages.
If you’re unsure, step back and independently verify before sharing anything.
“Too Good to Be True” Pricing
Promises of extremely low premiums with “full coverage” often mask:
- Limited benefit plans
- Short-term coverage that excludes major services
- Discount programs disguised as insurance
If the price sounds unrealistically low compared to other options you’re seeing, it’s worth asking deeper questions — and getting everything in writing.
How to Protect Yourself During Open Enrollment
Use Official Enrollment Channels Only
The safest way to enroll is through:
- HealthCare.gov (or your state’s official Marketplace)
- A licensed insurance agent you can independently verify
- Well-known insurers you contact directly
Avoid clicking links from unsolicited emails, texts, or social media ads unless you’ve confirmed their legitimacy.
Verify Agents and Companies
Before enrolling:
- Ask for the agent’s full name and license number
- Verify licenses through your state’s insurance department
- Look up the company independently (not through links they provide)
A legitimate professional won’t hesitate to prove who they are.
Slow the Process Down
Scammers rely on speed. You don’t have to.
Take time to:
- Compare plans
- Read coverage details
- Ask questions
- Discuss options with family or a trusted advisor
Open enrollment exists for a reason — you’re allowed to think it through.
Monitor Your Bank Accounts Closely
Unexpected withdrawals or recurring charges may be the first sign something is wrong.
We recommend:
- Reviewing transactions regularly
- Setting up account alerts
- Acting quickly if something looks unfamiliar
If you notice suspicious activity, contact your bank immediately. Early action can make a big difference.
What to Do If You Suspect a Health Insurance Scam
If something doesn’t feel right:
- Stop communication immediately
- Do not send money or additional information
- Report the scam to the Federal Trade Commission at ReportFraud.ftc.gov
- Contact your bank if any financial information was shared
You can also report suspected health insurance fraud through your state insurance department or the official Marketplace.
How We Support Our Community Beyond Banking
At a community bank, trust isn’t a slogan — it’s a responsibility.
We believe financial well-being goes hand in hand with protecting your identity, your income, and your peace of mind. While we don’t sell insurance, we’re always here to help you think through decisions, recognize warning signs, and take action if something feels off.
If you ever have questions about suspicious transactions, unexpected charges, or potential scams, our team is just a phone call or visit away. Sometimes, a quick conversation is all it takes to prevent a costly mistake.
Stay Informed, Stay Protected
Open enrollment is about securing peace of mind for the year ahead — not creating new risks.
By slowing down, using trusted sources, and staying alert to common scams, you can make confident choices that protect both your health and your finances.
And remember, you don’t have to navigate it alone. As your community bank, we’re here to help you stay informed, stay protected, and move forward with confidence — this open enrollment season and beyond.
