Health Insurance Fraud Prevention Tips

August 26, 2016, 12:20 pm

As open enrollment draws closer, look for potential signs of insurance fraud. Below are some steps you can take to help prevent fraud from occurring.

  • Start by knowing your benefits and reading your Explanation of Benefits (EOB) statements and any paperwork received from your health care providers.
  • Be wary of Explanation of Benefits (EOB) statements for services you didn’t receive.
  • Protect your member ID card as if it were your credit card and report to your insurance company if it has been stolen.
  • Never give your financial information, like your banking, credit card, or account numbers, to someone who calls or comes to your home uninvited.
  • Write down and keep a record of the name of a salesperson or anyone who assists you.
  • Beware of people asking for money to enroll you in the Marketplace, "Exchange," or "Obamacare" insurance. Legitimate enrollment assisters will NOT ask for money. Especially be wary of anyone offering to sell Obamacare insurance cards. Scammers could try to sell you an insurance card without enrolling you in an insurance plan.
  • Watch for "fake" products.  Some scammers will try to sell you a prescription card.  These can be phony.  Some appear to be real but are only discount cards and not really insurance.

Suspected fraud should be reported to the Federal Trade Commission through the Marketplace Call Center at 1-800-318-2596 or on All suspected fraud should also be reported to the Attorney General's Office online or 1-800-392-8222.