Protect Yourself This Open Enrollment Season: How to Spot and Avoid Healthcare Scams

As open enrollment season approaches, many people are reviewing their health insurance options, looking for Medicare plans, or considering adjustments to their current healthcare coverage. Unfortunately, this period also attracts fraudsters who know that people are more vulnerable during this time. With so much personal and financial information in play, scammers exploit the opportunity to trick individuals into sharing sensitive details or paying for fake insurance plans. Let’s break down common healthcare scams, warning signs, ways to avoid them, and what to do if you’re targeted.

What Are Healthcare Scams?

Healthcare scams are schemes where criminals attempt to steal money, personal details, or healthcare information by posing as legitimate providers or insurers. The end goal of these scams can range from identity theft to fraudulent medical billing. During open enrollment, people seeking coverage or answers to healthcare questions may unknowingly fall victim to these fraudulent schemes.

Some common types of healthcare scams include:

• Phony Insurance Plans: Fraudsters offer fake health insurance policies that seem legitimate but cover little to nothing when it’s time to file a claim. Victims often only realize they’ve been scammed when they try to use the “insurance” and find it doesn’t provide the promised benefits.
• Medicare and Medicaid Scams: Scammers impersonate Medicare or Medicaid representatives, especially during open enrollment. They may call to “verify” information, request payment for a new card, or offer to “upgrade” benefits. Their goal is to collect sensitive details like Social Security or Medicare numbers.
• Fake Billing Scams: Using stolen personal information, scammers submit false claims to your insurer or Medicare for treatments you never received. You may notice strange charges or unfamiliar services listed on your statements.
• Healthcare Phishing Scams: Often delivered via email or text, these scams involve fraudulent messages that mimic legitimate healthcare organizations. They might claim your policy is at risk or ask you to verify personal details to continue coverage.

Understanding these scams will help you stay alert during open enrollment and beyond.

Red Flags and Warning Signs of Healthcare Scams

Be on the lookout for these warning signs:

• Unsolicited Calls or Emails: Scammers often reach out unexpectedly, claiming to represent a health insurance company or Medicare. Legitimate companies usually don’t ask for personal details out of the blue.
• Pressure Tactics: Scammers may create a false sense of urgency by saying the offer is only available for a short time or that you must act immediately to avoid losing coverage.
• Requests for Personal or Payment Information: If someone asks for your Social Security number, Medicare details, or payment over the phone or email, be wary. Reputable healthcare organizations don’t request sensitive information this way.
• “Free” Services that Require Personal Information: Fraudsters may lure you with offers of “free” genetic testing or medical devices, asking for your insurance or Medicare details. This is often a ruse to commit fraud using your information.
• Suspicious Charges on Your Statements: Always review your insurance statements. Unfamiliar charges for services you didn’t receive may indicate someone is using your information fraudulently.

How to Avoid Healthcare Scams During Open Enrollment

You can protect yourself with a few precautions:

• Verify Who You’re Dealing With: Always verify the identity of the person or organization contacting you before sharing any information. Hang up and call back using a trusted number, like the one on the back of your insurance card or listed on Medicare’s official website.
• Guard Your Personal Information: Avoid sharing your Social Security number, Medicare number, or bank details unless you’re sure it’s necessary and safe. Legitimate representatives won’t pressure you for sensitive information.
• Use Reliable Sources for Health Information: Go directly to trustworthy websites, like Healthcare.gov or Medicare.gov, to research or sign up for health coverage. Avoid clicking on ads or responding to emails from unknown sources.
• Be Skeptical of “Free” Offers: If someone offers you a free service or equipment in exchange for your insurance information, proceed with caution. This is a common tactic to commit fraud under your name.
• Check Your Statements Regularly: Review your healthcare and insurance statements closely. If you notice any unfamiliar charges, contact your insurance provider to investigate.

Steps to Take if You’ve Been Targeted by a Healthcare Scam

If you think you may have been a victim of healthcare fraud, here’s what to do:

• Report the Incident to Your Insurance Provider or Medicare: Contact your insurance company or Medicare immediately to report the suspected fraud. They can investigate and may take steps to block further charges.
• Place a Fraud Alert on Your Credit Report: If your personal information has been compromised, placing a fraud alert on your credit report can help protect your identity and prevent further misuse.
• File a Police Report: In cases of severe fraud, such as identity theft, filing a police report can help document the crime. This can be useful for future identity recovery efforts.
• Keep Records of All Interactions: Document any suspicious interactions, including dates, times, and the names of anyone involved. This information may be valuable if you must report the incident to multiple agencies or take further action.
• Contact Champions First Credit Union: If you believe your financial information has been compromised, contact us for support and guidance on securing your accounts.

Where to Report Healthcare Scams

Reporting healthcare scams helps fight fraud and prevent others from becoming victims. Here’s where you can report these incidents:

• Medicare: To report suspected Medicare fraud, call 1-800-MEDICARE (1-800-633-4227) or visit Medicare.gov.
• Federal Trade Commission (FTC): The FTC collects reports of healthcare fraud to monitor scams and take enforcement action. You can report scams at ReportFraud.ftc.gov.
• Fraud Free Florida: This initiative offers resources and allows Floridians to report scams. Visit Fraud Free Florida for more information and reporting options.
• National Center for Disaster Fraud (NCDF): If the scam is disaster-related, such as a healthcare scam following a natural disaster, report it at 1-866-720-5721 or submit a complaint online.

This open enrollment season, stay vigilant and informed. You can protect yourself and others from these threats by recognizing the warning signs of healthcare scams, guarding your personal information, and knowing where to report fraud. Remember, a little caution goes a long way in keeping your health and finances secure.