How do I know if my health insurance enrollment is real?

Log in to HealthCare.gov (for ACA plans) or Medicare.gov (for Medicare) and check your current plan directly. If you do not recognise the plan shown, or if you cannot find any active enrollment, your coverage may be fraudulent. Call 1-855-997-1890 to verify your Marketplace enrollment with CMS.

I have been paying premiums for months - what do I do?

Stop paying immediately if you cannot verify the plan through HealthCare.gov or Medicare.gov. Contact your bank or card issuer to dispute recent charges. File a complaint with your state insurance commissioner, the FTC, and CMS. You may also be eligible for a Special Enrollment Period to get real coverage without waiting for open enrollment.

Is the broker or agent who contacted me licensed?

You can verify any insurance agent or broker through your state insurance commissioner's website - most have a free public lookup tool. Legitimate ACA brokers are also listed in the HealthCare.gov Find Local Help tool. Unsolicited contact - especially cold calls, door-to-door visits, or social media messages - is a red flag regardless of whether the agent is licensed.

What is an unauthorized plan switch?

An unauthorized plan switch is when an agent changes your existing health insurance plan to a different one without your explicit consent, often to earn a higher commission. You may not notice until your old plan stops paying claims or your medications are no longer covered. CMS received 73,884 complaints of this in the first six months of 2024 alone and has suspended over 850 agents for this conduct.

Can I still get real health coverage after being scammed?

Yes. If you were the victim of enrollment fraud, you are typically entitled to a Special Enrollment Period outside the normal open enrollment window. Contact HealthCare.gov or your state marketplace and explain that your previous enrollment was fraudulent. They have processes specifically for this situation.

Phishing & impersonation Active · 2024–2026 Health insurance fraud

Got an unsolicited insurance offer? Here's what to check.

ScamChecker.online · Last verified June 2026 · Active and growing · 6 min read

In a nutshell

Unsolicited calls, texts, and ads promising zero-premium ACA plans or Medicare upgrades frequently lead to fake or near-worthless coverage.
Real ACA plans are enrolled through HealthCare.gov or your state marketplace - not through cold calls, social ads, or door-to-door agents.
You may not discover the fraud until you try to use the insurance - leaving you with months of premiums paid and no real coverage at the doctor's office.
CMS received 183,553 complaints of unauthorized health plan enrollments in just eight months of 2024.1

Our verdict

This is a scam. If you didn't seek out the broker or agent who contacted you, treat any unsolicited health insurance offer as suspect. The only legitimate path to ACA coverage is HealthCare.gov or your state's official marketplace. The FTC has obtained over $295 million in judgments and refunds against two fake insurance operators alone in 2024.2 3

Does this sound familiar?

You get a call from someone saying they're a "licensed marketplace agent" and can get you a zero-premium health plan. Or you see a social media ad promising ACA coverage for $0 a month and click through to a form. Or a Medicare representative contacts you to say you qualify for an upgraded plan with extra benefits. Or you later discover your existing plan was changed to one you never chose.

Below are reconstructed examples of how this scam arrives. (Illustrations, not real screenshots. Names and details shown are fictional.)

Unknown

+1 (555) 555-0163

Text Message · Today 10:11

Hi! I'm a licensed ACA marketplace agent. Based on your ZIP code you qualify for a $0/month health plan with dental + vision. Takes 5 minutes to enroll. Want me to check your options?

Unsolicited contact from "licensed agents" is the most common entry. Legitimate brokers do not cold-text or cold-call strangers.

Social ads leading to third-party "quote" sites harvest your SSN and income data, then enroll you in plans without your full understanding.

Marketplace Enrollment Confirmation

Plan Year 2026 · Reference #MCK-48820

Plan nameBrightCare Silver Plus

Monthly premium$0.00

Coverage startJuly 1, 2026

EnrolleeYou (sample)

✓ Enrollment Active

Confirmation emails look real and reassuring. The plan may not exist at any hospital or pharmacy, despite appearing to be active.

The scam arrives differently depending on the variant: a new fake enrollment, a plan switched without consent, or premiums paid to a company with no real insurer behind it.

How it works

This scam has two overlapping variants - fake new enrollment and unauthorized plan switching - but the financial harm follows the same arc. (Screens shown below are illustrations of how these interactions typically appear.)

The unsolicited pitch

Contact arrives uninvited: a phone call from a "licensed marketplace agent," a social media ad promising zero-premium ACA plans, a door-to-door visit during open enrollment season, or a text message claiming you qualify for improved Medicare benefits. The caller may use official-sounding language ("CMS-authorized," "government health marketplace") to sound legitimate. When calls impersonate CMS or Medicare directly by name, they overlap with broader government phone impersonation scams - the same pressure tactics, different hook.

‹

ACA Agent (sample)

online

Hi! I'm calling about your ACA health coverage. You may qualify for a $0 plan with dental included. Can I confirm your details?

10:14

Sure, what do you need?

10:15 ✓✓

Just your date of birth, ZIP, household income, and Social Security number to check eligibility.

10:16

⚠ Asking for your SSN over the phone to "check eligibility" is the key collection moment.

Personal information collected

The agent collects what they need: name, date of birth, Social Security number, household income, family size, and often bank or card details for "future premium billing." They use this information to complete an enrollment on HealthCare.gov or your state marketplace on your behalf - without you ever logging in or reviewing the plan details. The enrollment appears real in CMS systems, but it may be to a plan from a carrier with no real network, or to a plan you didn't choose.

Eligibility Check

Social Security Number

•••-••-••••

Household Income (Annual)

$42,000

Family Size

2 people

Check My Plans →

By submitting you authorize a licensed agent to enroll you on your behalf in available Marketplace plans.

💡 The fine print authorises third-party enrollment. Victims often don't notice until coverage fails.

Premiums flow - coverage doesn't

Two things now happen simultaneously. If the plan is genuinely fake, premiums go to a company with no insurer behind it. If the plan is real but unauthorised, government subsidies flow to the broker's chosen carrier while the victim pays premiums for coverage they didn't select and may not need. Either way, months pass without incident - until you try to use the insurance. The fake subscription renewal pattern - where you receive renewal invoices for a policy you didn't initiate - follows the same dynamic as fake invoice and renewal scams more broadly.

Monthly Premium Charges

February 2026-$189.00

March 2026-$189.00

April 2026-$189.00

May 2026-$189.00

Total paid so far $756.00

Four months of payments before the victim tried to use the plan.

Discovery - at the worst moment

The fraud typically surfaces when the victim tries to fill a prescription, visit a doctor, or schedule a procedure. The pharmacy or hospital cannot verify the plan. The insurer has no record of the policy. Or the coverage exists but is so limited it covers nothing the victim actually needs. For seniors, an unauthorized Medicare plan switch can cut off access to existing doctors and medications mid-treatment. The financial and health consequences arrive together. CMS has created a specific dispute process for unauthorized enrollments and can cancel fraudulent plans retroactively.1

Pharmacy Benefit Check — Sample Illustration

⚠ Coverage Not Verified

Plan name: BrightCare Silver Plus

Member ID: BCH-4829017

This plan cannot be verified with the carrier on file. Patient is responsible for full cost.

Discovery at the pharmacy or hospital - months after enrollment.

Remember

Legitimate ACA enrollment happens through HealthCare.gov or your state marketplace - not cold calls.

You can check your real enrollment anytime at HealthCare.gov or Medicare.gov.

Verify any agent or broker through your state insurance commissioner before sharing personal information.

Victims of enrollment fraud can qualify for a Special Enrollment Period to get real coverage.

Red flags to catch it early

None of these alone is proof. Several together means stop and verify.

Unsolicited contact from an "agent" or "marketplace representative"

Legitimate marketplace brokers exist, but they advertise and wait for you to come to them. No real ACA or Medicare enrollment process involves someone cold-calling, texting, or knocking on your door unsolicited.

Promising $0 premiums or "guaranteed approval"

ACA subsidies are real and some people do qualify for very low or zero-premium plans - but eligibility depends on specific income levels and plan types. A promise of $0 without any income verification is a red flag.

"Everyone in your state qualifies for $0 coverage right now - no questions asked."

Asking for your Social Security number before showing any plan options

An SSN is required to complete enrollment, but a real broker shows you plan options and lets you choose before collecting sensitive identifiers. Asking for your SSN as the very first step is a data-harvesting signal.

Enrollment confirmation you don't recognise or didn't initiate

If you receive a health plan enrollment confirmation email or letter for a plan you don't remember choosing, check HealthCare.gov immediately. Unauthorized enrollments are common enough that CMS created a dedicated dispute process for them.

Your existing Medicare plan or ACA coverage was "upgraded" without a conversation

If you discover your plan has changed to one you didn't select - different insurer, different formulary, different network - your information was used to switch you without consent. This is one of the most common Medicare fraud patterns.

Offers of free extras - gift cards, phones, gas cards

The FTC has specifically flagged offers of free phones, gift cards, or utility credits as common tactics used to recruit enrollees for fraudulent plans. Legitimate insurance does not come with sign-up gifts.

Already enrolled through an outside agent or paying unrecognised premiums?

Need the steps by payment method? See what to do if you've been scammed.

If you're in this situation right now

Verify, stop, report - in that order

Act quickly - every month of delay means more premiums paid and a longer gap in real coverage.

Check your actual enrollment right now Log into HealthCare.gov (ACA) or Medicare.gov (Medicare) and look at your current plan. If it's a plan you don't recognise, or if you find multiple active enrollments, your information was used without your full consent. Call the CMS Marketplace directly: 1-855-997-1890.

Request cancellation of the unauthorised enrollment through CMS CMS has a specific process for cancelling plans enrolled without consent. Call the Marketplace Call Center (1-855-997-1890) and explain the situation. For Medicare, call 1-800-MEDICARE (1-800-633-4227). Cancellations can often be made retroactive to the start of the fraudulent plan.

Stop paying premiums to unverified accounts If premiums have been going to a third party rather than a recognised insurance carrier, contact your bank or card issuer and dispute the charges as fraudulent. Do not continue paying while you investigate.

Freeze your credit and monitor your accounts Your SSN, date of birth, and income were shared with a scammer. Place a credit freeze with all three major bureaus (Equifax, Experian, TransUnion) and monitor accounts for new lines of credit you didn't open.

Report to the agencies below and get real coverage File reports with the FTC, your state insurance commissioner, and HHS OIG. Victims of enrollment fraud are typically entitled to a Special Enrollment Period outside the standard open enrollment window - ask CMS about this when you call.

Ignore anyone offering to "recover" your lost premiums for a fee People who've lost money to health insurance scams are sometimes targeted by a follow-up money recovery scam - a second fraud that charges an upfront fee to retrieve funds. No legitimate service operates this way.

Where to report it

For the full country guide - agencies, phone numbers, and what happens after you report - see how to report a scam by country.

If your ACA enrollment was fraudulent - start here

HealthCare.gov — Marketplace Call Center

Call 1-855-997-1890 to verify your enrollment, report unauthorized plans, and request cancellation. CMS has a specific process for unauthorized enrollment disputes and can act retroactively.

healthcare.gov/protect-from-fraud-and-scams

If your Medicare plan was switched without consent

Medicare Fraud Line — 1-800-MEDICARE

Call 1-800-633-4227 to report unauthorized plan switches and fraudulent Medicare enrollment. The Senior Medicare Patrol (SMP) also provides free help: 1-877-808-2468.

medicare.gov/basics/reporting-medicare-fraud-and-abuse

To report the broker or agent

HHS Office of Inspector General

The OIG investigates healthcare fraud, including fake insurance brokers and unauthorized enrollment schemes. Hotline: 1-800-HHS-TIPS (1-800-447-8477).

oig.hhs.gov/fraud/report-fraud

For the broader fraud record

FTC - ReportFraud.ftc.gov

The FTC has brought major enforcement actions against fake health insurance operators. Your report feeds directly into investigator databases.

reportfraud.ftc.gov

Also contact your state insurance commissioner to report unlicensed brokers. Most states have a free license lookup tool to verify whether any agent who contacted you is actually registered.

Start here

Action Fraud

UK national fraud and cybercrime reporting. The ACA and Medicare variants are US-specific, but fake private health insurance brokers operate in the UK too. Online or phone: 0300 123 2040.

actionfraud.police.uk

If a regulated financial or insurance product was misrepresented

FCA ScamSmart

Financial Conduct Authority. Report unauthorised insurance sales and fake broker activity.

fca.org.uk/consumers/report-scam

Start here

Scamwatch (ACCC)

scamwatch.gov.au/report-a-scam

To verify a private health insurer

Private Health — Government Register

The Australian government's official register of private health insurers. Verify that any plan you were enrolled in is from a real, registered insurer.

privatehealth.gov.au

Start here

Europol - Report Cybercrime

Links to official reporting services for every EU member state. Use it to find where to file in your country.

europol.europa.eu/report-a-crime

Report to your national financial regulator and health ministry if a fake state health scheme was impersonated. The ACA and Medicare variants are US-specific, but equivalent local health coverage scams exist across EU countries.

If you lost money

Policia SR - trestne oznamenie

File a criminal complaint at any police station, electronically through the slovensko.sk government portal (needs eID), or call 158.

slovensko.sk

If a Slovak health insurer or broker was impersonated

Urad pre dohľad nad zdravotnou starostlivosťou

The Healthcare Surveillance Authority (UDZS) oversees health insurance in Slovakia. Report fake health brokers or unauthorised plan changes here.

udzs-sk.sk

Canada

Canadian Anti-Fraud Centre

antifraudcentre-centreantifraude.ca

If a US-based company was involved

FTC - ReportFraud.ftc.gov

The FTC accepts complaints from non-US victims about US-based fraud operations, including health insurance scams targeting Americans abroad.

reportfraud.ftc.gov

Report to your national financial regulator or consumer protection agency. Health insurance fraud involving real premium collection is typically a criminal matter - your local police or fraud office is the right starting point.

How big is this problem?

Fake health insurance enrollment surged during and after the COVID-19 pandemic, when expanded ACA subsidies made more Americans eligible for low-cost plans - and made the eligibility claims fraudsters use more believable. The scale documented by CMS in 2024 alone is striking.

183,553

CMS complaints of unauthorized ACA plan enrollments received between January and August 2024 alone1

850+

Insurance agents and brokers suspended by CMS in just four months (June-October 2024) for suspected fraudulent enrollment conduct1

$195M

FTC judgment against Simple Health Plans LLC in 2024 - the company sold fake or misleading plans and permanently banned its CEO from telemarketing2

463,629

Consumers who received refunds totalling $100 million from Benefytt Technologies, which sold non-ACA plans as comprehensive coverage3

The expanded ACA subsidies introduced during the pandemic made coverage genuinely affordable for many Americans - and simultaneously created a believable cover story for fraudulent brokers. When a scammer promises $0 premiums and some people do legitimately qualify for $0 premiums, the lie is harder to detect. CMS has responded with new consent verification rules and enforcement tools, but the sheer volume of complaints - nearly 200,000 in eight months - reflects how broadly this pattern spread.1

The Medicare plan-switching variant targets a different population but follows the same logic: use a senior's Medicare number to switch them to a plan that pays the broker a higher commission, without the enrollee understanding or consenting to the change. The same cold-call and door-to-door tactics used in fake ACA enrollment appear here, sometimes also impersonating Medicare directly by phone - a pattern that overlaps with government phone impersonation.

Frequently asked questions

How do I know if my health insurance enrollment is real?: Log in to HealthCare.gov (for ACA plans) or Medicare.gov (for Medicare) and check your current plan directly. If you do not recognise the plan shown, or if you cannot find any active enrollment, your coverage may be fraudulent. Call 1-855-997-1890 to verify your Marketplace enrollment with CMS.
I have been paying premiums for months - what do I do?: Stop paying immediately if you cannot verify the plan through HealthCare.gov or Medicare.gov. Contact your bank or card issuer to dispute recent charges. File a complaint with your state insurance commissioner, the FTC, and CMS. You may also be eligible for a Special Enrollment Period to get real coverage without waiting for open enrollment.
Is the broker or agent who contacted me licensed?: You can verify any insurance agent or broker through your state insurance commissioner's website - most have a free public lookup tool. Legitimate ACA brokers are also listed in the HealthCare.gov Find Local Help tool. Unsolicited contact - especially cold calls, door-to-door visits, or social media messages - is a red flag regardless of whether the agent is licensed.
What is an unauthorized plan switch?: An unauthorized plan switch is when an agent changes your existing health insurance plan to a different one without your explicit consent, often to earn a higher commission. You may not notice until your old plan stops paying claims or your medications are no longer covered. CMS received 73,884 complaints of this in the first six months of 2024 alone and has suspended over 850 agents for this conduct.
Can I still get real health coverage after being scammed?: Yes. If you were the victim of enrollment fraud, you are typically entitled to a Special Enrollment Period outside the normal open enrollment window. Contact HealthCare.gov or your state marketplace and explain that your previous enrollment was fraudulent. They have processes specifically for this situation.

Sources

Centers for Medicare & Medicaid Services, "CMS Actions to Protect Consumers and Strengthen Exchange Program Integrity", October 2024. Source of unauthorized enrollment complaint volumes (183,553), plan switch complaints (73,884), and broker suspensions (850+).
Federal Trade Commission, "FTC Obtains $195 Million Judgment and Permanent Ban on Telemarketing", February 2024. Source of Simple Health Plans LLC judgment and CEO telemarketing ban.
Federal Trade Commission, "FTC Sends Nearly $100 Million in Refunds to Consumers Harmed by Benefytt Technologies Sham Health Plans", March 2024. Source of $100M refund total and 463,629 consumer count.
Federal Trade Commission, "Spot Health Insurance Scams", FTC Consumer Advice. Source of common red flags including free-gift offers and fake celebrity endorsements.

Researched and maintained by ScamChecker.online

We document recurring online scam patterns using primary sources - government agencies, law enforcement, and security researchers. We do not accuse named businesses, and ads on this page do not influence our reporting. Read about how we research or who we are.

Last verified: June 2026 · Reviewed against current CMS, FTC, and HHS OIG guidance