It’s mid-November and the Affordable Care Act’s open enrollment season is in full swing.
While the 2022-2023 official numbers won’t be available until 2023, last year’s open enrollment period saw 14.5 million Americans sign up for a government-sponsored health care insurance plan.
ACA open enrollment, which goes from November 1, 2022, to February 15, 2023, also brings some risks to the table in the form of health care-related scams and fraudulent activity.
Those scams usually present themselves as health insurance deals that are too good to be true, which should be a red flag for health care consumers, but time and time again, that’s not the case.
“According to the U.S. Federal Communications Commission (FCC), healthcare scams do spike during open enrollment,” said OneRep chief executive officer Dimitri Shelest. “People looking for health care plans can expect an increase in spam calls and emails. In daily interactions with our health care provider clients, they note users are reporting an increase in such activities already. It's definitely top of mind for them.”
The Biggest ACA Open Enrollment Scams for 2022-2023
Fraud experts are sounding the alarm on ACA-related scams, which appear to be getting more aggressive.
“These attacks are almost always sophisticated operations involving social engineering and digging for a victim’s personal information,” Shelest told TheStreet. “Criminals collect this information from any source available to them–from people-search sites to social media–and use it to take over their victims’ identity.”
What are the biggest scam threats to open enrollment consumers? These fraud scenarios rate highest with security experts.
Phishing scams. Scammers have gotten increasingly sophisticated about using phishing scams to target people this year.
“One go-to tactic is to create carefully designed emails that look like they're being sent from HealthCare.gov,” said Ari Parker, co-founder of Chapter, a Medicare services company. “Too many unsuspecting people respond to these messages and provide their personal information or financial information.”
ACA visitors should never share any identifying information through emails such as banking, credit card, or any financial account number.
“That’s especially during the ACA Open Enrollment season as this is when scams tend to spike,” Parker told TheStreet.
Impersonation scams. Another popular tactic scammers often use is to call you directly claiming they are with the Health Insurance Marketplace or directly from health care insurance companies.
The FCC cites one major case where robocalls falsely claimed to offer plans from well-known health insurance companies such as Blue Cross Blue Shield (BCBS) and Cigna.
“The real BCBS offers fraud prevention advice on its website, warning that it has received complaints about scammers who use “spoofing” to make it appear that calls are coming from its national “Call Blue” customer service number (888-630-2583),” the agency noted in a warning statement to consumers. “However, the toll-free number can only receive incoming calls, according to BCBS, and they do not use that number to make calls.”
Consequently, if the “Call Blue” customer service number appears on your caller ID, the call is malicious and you should not answer, the FCC states.
That’s good advice for any calls taken by health insurance consumers during open enrollment.
“Don’t share any financial information with ACA-related callers to protect your pocketbook and save yourself from the mental anguish of becoming the victim of financial fraud,” Parker advised.
The “You’ve missed the open enrollment” scam. Fraudsters will call, text, or email Americans warning them they’re either about to miss or have already missed the ACA open enrollment period (again, the period extends from November 1, 2022, to February 15, 2023.)
“Alaska's Division of Retirement and Benefits announced, just this month, a sophisticated phishing scam which falsely informed recipients that they had missed the open enrollment period,” said Modulus CEO Richard Gardner, an internationally recognized phishing and fraud expert. “As we enter the open enrollment period, there will be an enhanced attempt to scam consumers in attempts just like this one.”
ACA Consumers will want to be sure that any emails they receive are from official agencies and institutions. “If there's ever any doubt, don’t click on any links,” Gardner told TheStreet. “Instead, go to the website of the institution directly to find the information you need.”
Email record keeper fraud. Typically, this form of open enrollment fraud happens when cybercriminals infiltrate a victim’s email account.
“The fraudsters often contact recordkeepers and health plan administrators to lure them into the trap, impersonate the victim, and request added new accounts and authorized users,” Shelest said.
How will you know you’re a victim of this form of fraud? Shelest points to these red flags.
- You realize that you have not received any recent emails from a recordkeeper/plan administrator.
- Your password no longer works and you’re denied access to your account.
- A customer representative tells you your verification information is incorrect.
“Once you have access to your account, several things might confirm ACA-related data theft, including changes to your email address, phone numbers, and street address, and unauthorized users who’ve changed your username or password,” Shelest added.
