Health Insurance Phone Scam

Health Insurance Phone Scam

What You Should Know About Health Insurance Phone Scams


The American healthcare system is very complex (and confusing for many). As a result, there’s a lot of opportunity for bad actors to exploit innocent people. Scam phone calls and text messages play no small part of this type of criminal activity, that’s where we come in.

We know healthcare phone scams are a common type of insurance fraud in the US and part of the reason is because they’re so lucrative for criminals. The National Healthcare Anti-fraud Association estimates that health care fraud costs the nation about $68 billion annually.

Insurance scams also happen all the time, but health care scams (specifically marketplace insurance scams) tend to ramp up during open enrollment on healthcare.gov during November 1st to December 15th.

What should you do if you’re receiving calls about health insurance?

If you’re receiving calls or text messages from strangers about new health insurance plans, Medicare fees, or other healthcare related spam, the number one rule is never give away your personal information. Hang up and contact your health insurance provider for help or information.

The best way to protect yourself from calls like these is to never receive them in the first place. A third-party robocall scanner app like RoboKiller can filter out and protect you from scam calls, and ensure that only the calls you want get through.

We want to arm you with the knowledge to take control back from scammers and keep you safe. No one wants the already complicated process of getting insurance to get even more challenging. We’ll dive into how to identify health insurance phone scams and how to prevent them. Here’s what you should know.

What are common health insurance phone scams?

Health insurance is tricky to navigate and scammers are chomping at the bit to take advantage of the complex systems that are already in place. Here are some common health insurance scams you should be on the lookout for:

Medicare scams —The caller will reach out demanding a Medicare renewal fee, and threaten you with loss of coverage if you don’t comply immediately. Of course, Medicare admins will never call you asking for personal information, and you are protected from surprise fees.

Other scammers will call to sell Medicare advantage or supplement plans that don’t exist. Once on the line, they’ll request personal information to “set up an account,” which they will then steal. Beware of any cold callers who wish to sell you supplemental health insurance, and never share your Medicare number with a stranger over the phone.

Medical discount club scams — Many victims are enticed by promises of lower or more predictable out-of-pocket costs. Scammers will call looking to sell medical discount plans or “club” memberships that reduce prices from certain doctors. If you’re being told about one of these “clubs,” that’s your cue to hang up. The discount plans are fake and the scammer will just make off with your money, personal information, or both.

Price comparisons ― The caller will offer to help you shop for health insurance to compare different quotes and get the best rate for you and your family. All they need to get started is your Social Security number, bank account, or maybe a credit card number. This is where the scam begins.

Don’t fall for go.hc.gov scams where someone claims to help you with the process of getting health insurance. This is a process you can do or get help with for free. If you’re looking for help there are legitimate companies and individuals, known as navigators or assisters, that can help guide you through the health insurance marketplace. Unlike those “helpful” scammers, official navigators and assisters are not allowed to charge you for the service, and will never ask you for personal or financial information. You can find reputable local help on the HealthCare.gov website.

Health care rep imposter — Some sneaky scammers will use phone number spoofing techniques to have their number show up as the official number for a legitimate insurance company. From there, the caller might ask for personal information, upsell you on new plans or unbundled features, or make threats about ending coverage all together for unpaid fees.

A recent example of this scam targeted Blue Cross Blue Shield customers. The insurance giant has warned their policyholders that scammers are spoofing their national number and advised them to hang up the phone and report illegal activity.

Government impostor — The caller will claim to be a representative of the IRS or Medicare. Maybe they’ve called to collect fees or penalties related to your healthcare account or maybe they want to verify some personal information such as your Social Security number or bank account number. Remember, no government administrator will call you to push for immediate payment. They won’t ask for personal information and they will never try to sell you additional insurance. If someone does any of these things while posing as a government official, hang up and report the call to the FTC.

COVID-19 scams — Scammers are always innovating new ways to take advantage of people. Outbreaks of COVID-19 have fed into cycles of fear and misinformation that leave many people vulnerable to scams.

In recent months, a number of new scams have hit American phone lines, including offers of free COVID-19 testing and magic cures, phishing websites, and warnings of a virus outbreak in the victim’s area. Some will try to collect fees for free tests or vaccines. All of these are intended to sell fake products or steal personal information that can be used to commit fraud.

Here are some examples of what health insurance scam calls may sound like:

A lower-cost health plan with better benefits—sounds great, right? The only problem is, it’s not your health insurance provider calling.

You’ll notice in the recordings a few giveaways:

  • The callers don’t identify themselves, nor to they mention a specific healthcare provider
  • The callers offer a list of benefits that seem too good to be true
  • The first caller employed pressure tactics in saying “this is our final attempt to reach you” and in giving a 48-hour window to respond

Wondering how to stop health insurance scam calls?

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How to tell if a health insurance call is a scam

There are some major red flags you should know to look for when determining if a call about insurance is legitimate or not.

Common signs of health insurance scams include:

  • Urgent, pushy sales pitches — Scammers rely on quick action in order to succeed. They will use a number of sales tactics and approaches, from “limited availability” claims to outright threats, to push their agenda. If a caller is trying to get an immediate sale out of you over the phone, this should be a big red flag.
  • “New healthcare reform” perks, programs, or fees — Many scammers will call about new requirements for specific programs or features that members receive thanks to healthcare reform. According to them, those “new programs” may require a fee to join or additional information from you to go into effect. Of course, the fake offer is usually limited time and limited enrollment to amp up the pressure.
  • Suspect licensing — Some scammers will claim that a plan is licensed under the federal Employee Retirement Income Security Act (ERISA). This is a lie meant to lend credibility to the caller’s claims. In reality, insurance companies are licensed by individual states, not any federal body.
  • Evasive answers — When a caller won’t answer your questions or give you specifics about services provided, that should put you on red alert. Hang up the phone immediately and use the information provided to you to conduct research on your own.
  • “Membership required” — Scammers will offer exclusive health coverage plans that require a membership, or say you have to join an association or union to be covered. This is meant to build the illusion that you’re buying group health insurance. Instead, this should be a big warning sign that something isn’t right.

It’s important to remember that you can get help for free through the proper healthcare insurance channels. Go to healthcare.gov or your state’s health insurance board for more information on getting assistance.

Always protect your health insurance plan ID like you would a credit card number — and never give it out to a cold caller.

What should you do when you get a health insurance scam phone call?


We all know how annoying and frustrating scam phone calls and robocalls can be, but there’s something especially ugly and dangerous about health insurance scammers. That’s why we want to arm you with all the knowledge you need to take back control of your phone.

If you’ve just gotten a suspicious health insurance call, the best thing you can do is hang up the phone. Then, spring into action:

Don't

Don't

  • Never give them any personal information
  • Stop answering phone calls or texts
  • Don’t click any links or visit any websites the scammer sends
Do

Do

  • Take down any caller information to report
  • Do your own research
  • Contact the authorities listed below

If you think you may be a victim of health insurance fraud, take these steps to protect yourself:

  • Call your insurance company immediately to monitor for suspicious activity
  • Contact your state’s Insurance Fraud Bureau to report the incident
  • File a complaint with your state’s medical boards

Getting involved in a health insurance scam is stressful and confusing. Fortunately, there are organizations on the federal and local level that can help you out.


How to stop receiving spam calls

Scam calls are annoying and disruptive at best and unsettling and harmful at worst — especially when they spoof reputable insurers or federal agencies. The most effective thing you can do to prevent robocalls, scam calls, and cold calls is get a third-party robocall blocker like RoboKiller.

For people who get numerous spam calls or texts, the FTC recommends adding a blocker app to your mobile device to eliminate contact with questionable numbers at the source.

Pro tip

Don’t leave your personal data vulnerable. Always make sure the spam call-blocking app you download is committed to safety and privacy when it comes to your information. Click here to read RoboKiller’s stance on protecting your privacy.

Your mobile device likely also has blocking features to support your call-screening efforts. For example, Apple iPhones now feature an option to silence unknown callers. When activated, this feature silences ringing and vibration for any incoming calls that aren’t saved to your address book.

Here’s how to enable this setting:

  1. Go to “Settings,” then “Phone.”
  2. Toggle “Silence unknown callers” on.
  3. Calls from unknown numbers will not ring when they call.

Please note: This function will silence all unknown calls, so if you’re expecting an important call that could come from outside your address book, you may miss it.

Android phones have a similar function that uses caller ID to notify you of potential spam calls.

Here’s how to block robocalls on Android phones:

  1. On your device, open the Phone app
  2. Tap More options Settings. Spam and Call Screen.
  3. Turn See caller & spam ID on or off.
  4. Optional: To block spam calls on your phone, turn on Filter suspected spam calls.

Of course, you should also Add your phone number to the National Do Not Call Registry. This option costs nothing, and prevents sales callers from contacting you over the phone without prior consent. Unfortunately, it doesn’t block scam calls (because scammers don’t follow the law).

Or, inquire with your mobile or landline phone provider to see if it offers call-blocking or call-labeling services. Some of these services are complementary or included in certain plans, but some may cost an additional fee.

See more: The FTC’s list of call blocking and labeling tools currently available to consumers.

How does Robokiller work?

You shouldn’t have to receive annoying calls, especially if it’s a scammer that’s going to make the health insurance process more complex than it already is. Fortunately, there’s an easy option that allows you to block scam calls and unwanted text messages for good.

RoboKiller is the only call blocker app that uses A.I. and machine learning to identify and block potential spam calls and text messages.

It does this by using digital fingerprints to identify the caller or texter behind the message instead of just relying on consumer feedback or caller ID. With that information, the app cross references numbers against a Global Blacklist of untrustworthy numbers associated with health insurance scams. This list is updated daily to change with the ever present movement of illegal activity. That means no matter how many times the scammer changes their number, we’ll be able to stop them.

Health Insurance Block Graphic

Stop getting unwanted spam texts

RoboKiller doesn’t just prevent unwanted and annoying scam calls, we can help prevent unwanted texts, too. Our advanced software also uses metadata associated with a text to look for common characteristics of a spam text. It will then automatically anonymize and remove identifiable information like your name and phone number, and then determine whether or not to block it for good.

Get control of your phone back

Occasionally, you will want to get a text from a number that was flagged by RoboKiller.

All you have to do is add it to your “allow list” to circumvent the blocking feature and let you receive calls and text messages from that person. If you decide to block them again, you can. It’s that easy to take back control and start getting only the calls you want, and none of the rest.

Protect yourself from healthcare scam calls today

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