During Open Enrollment, Beware of Health Insurance That Seems Too Good to Be True

While shopping around for healthcare plans, you may encounter organizations offering a high level of service with premiums that are too good to be true. Many of these organizations promise “alternative arrangements” or claim to “think outside the box” to justify their claimed offerings. Unfortunately, these fraudulent organizations can look very convincing, and many unsuspecting people fall prey to their false promises each year. To keep yourself safe from being taken advantage of by one of these organizations, it is important to know what to look out for when shopping around for health insurance.

Fake Insurance Companies

These are companies that claim to offer health insurance and may provide convincing brochures or sales collateral, but do not actually provide any services and are only there to collect premiums. They also might take the form of brokers who pretend to be authorized by an insurance company and sell policies without permission. The best way to determine if an insurance company is legitimate is to contact the agency that oversees insurance sales in your state before deciding to purchase information. You can also check with your state’s insurance marketplace directly instead of purchasing through an agent that contacts you out of the blue. The National Health Care Anti-Fraud Association also may be a valuable resource on a national level.

Identity Theft

Other bad actors may not actually be interested in collecting premiums but may rather be after your sensitive information. Collecting personally identifiable information such as name, address, and Social Security number is a routine step when it comes to enrolling in a healthcare plan, but scammers may take the guise of an insurance provider offering amazing coverage at rock-bottom rates, only to collect your personal information for nefarious purposes. Be aware of telemarketing calls coming out of the blue, especially if they seem threatening or pushy, as aggression is a common tactic to try to obtain sensitive information.

Misleading claims on coverage or offerings

Be wary of organizations that claim to be “alternative providers” to the health insurance market, with an example being healthcare-sharing groups. These organizations are often faith-based and pool the resources of their members with the advisement that they will help pay for the costs of medical procedures borne by their members. While these organizations are legal, they are also not insurance, and are not regulated by insurance law. These groups may require you to contribute for a certain number of months before you are considered vested, or may choose to allocate their resources in such a way that does not help you, even if you have what would be a covered need. If an organization is not bound by insurance regulations, then you are at the organization’s mercy in how much or little support they decide to give you. These organizations are also not bound to comply with Affordable Healthcare Act legislation, such as not refusing or charging more for pre-existing conditions.

Even if the provider is accredited, you also need to review any claims made by an insurance agent and compare them against the documented coverages and limitations before you sign up for a plan. Unscrupulous insurance agents may use high-pressure sales techniques to get you to sign up before you’ve had a chance to review all the fine print. This tactic may be especially prevalent near the end of an open enrollment period because these agents know that there is a time crunch to sign up before the window closes, and may attempt to leverage that for their benefit.


When it comes to purchasing health insurance, the best way to protect yourself is by doing your research. Be sure that you are aware of who regulates an insurer and make sure they have a good reputation in their field before signing up for any plan. Additionally, take extra caution when dealing with telemarketers or brokers as they may not always be legitimate entities. Lastly, review all claims made by an insurance agent and compare them against the documented coverages and limitations before committing to anything so that there won’t be any unexpected surprises down the line. By keeping these tips in mind, you can ensure that you find a reliable provider who will give you quality coverage at a reasonable cost.

Healthcare Solutions is a wholly-owned subsidiary of the National General Insurance Group, so rest assured you’re getting quality service. For more information, contact us today, and our teams will be more than willing to help.