- Marketplace Overview
How can I protect myself from fraud in the Health Insurance Marketplace?
When you apply for health coverage through the Health Insurance Marketplace, you can protect yourself from fraud by following a few simple guidelines.
IMPORTANT: After you complete an application, you may get a phone call from the Marketplace to verify or ask for more information. See “If you get a call from the Marketplace” below.
Be informed about your health care choices
- Spend some time with HealthCare.gov to learn the basics about getting health coverage. It’s the official Marketplace website.
- Compare insurance plans carefully before making your decision. If you have questions, call the Health Insurance Marketplace call center at 1-800-318-2596. TTY users should call 1-855-889-4325.
- Look for official government seals, logos, or web addresses (which end in “.gov”) on materials you see in print or online.
- Know the Marketplace Open Enrollment dates. No one can enroll you in a health plan in the Marketplace until Open Enrollment begins or after it ends unless you have special circumstances.
Protect your private health care and financial information
- Never give your financial information, like your banking, credit card, or account numbers, to someone who calls or comes to your home uninvited, even if they say they are from the Marketplace. (See “If you get a call from the Marketplace” below.)
- Never give your personal health information, like your medical history or specific treatments you’ve received, to anyone who asks you for it. (If you apply for certain Marketplace exemptions, you may be asked for medical documentation.)
Ask questions and verify the answers you get
- The Marketplace has trained assisters in every state to help you at no cost. You should never be asked to pay for services or help to apply for Marketplace coverage.
- Ask questions if any information is unclear.
- Write down and keep a record of the name of a salesperson or anyone who may assist you, who he or she works for, telephone number, street address, mailing address, email address, and website.
- Double check any information that is confusing or sounds fishy. Check out HealthCare.gov to verify things or call the Marketplace at 1-800-318-2596. TTY users should call 1-855-889-4325.
If you get a call from the Marketplace
After you apply you may get a phone call from the Marketplace asking you to verify or provide more information. If we don’t have this information we may not able to process your application.
Follow these tips to help prevent fraud:
If your phone has caller ID, check the number. The display may show one of these:
- Health Insurance MP
The customer service representative will say they are calling from the Marketplace and provide a full name and agent ID number. Write them down.
A Marketplace representative may leave a message on your answering machine. If this happens, you won’t be able to call back. If the Marketplace can’t reach you after 3 tries, you’ll get a letter in the mail telling you what to do next.
The Marketplace representative may ask you the following:
- To verify your identity, using information you provided on your application
- To provide or verify the last 4 digits of your Social Security number. If you didn’t put your full Social Security number on your application, they may ask for the full number.
- To verify or provide income, household, and employment information, but NOT personal financial information, like a bank name and account number. They will also not ask about any personal health information, like your medical history or conditions. (If you’re applying for certain Marketplace exemptions, you may be asked to provide medical documentation.)
If you don’t want to answer over the phone, ask the representative to mail you a letter with instructions for completing your application.
In certain cases, the Marketplace may request additional documentation. If you need to mail any information to the:
Health Insurance Marketplace 465 Industrial Blvd. London, KY 40750-0001
Don’t mail any information to a different address. The Zip code may end with 4 extra numbers the representative provides.
When to report suspected fraud
It’s time to take action if:
- Someone other than the insurance company you’ve chosen contacts you about health insurance and asks you to pay – or asks for your financial or personal health information
- Someone you don’t know contacts you about getting health insurance and asks you to pay – or asks you for your personal financial or health information
- Someone contacts you and claims to be from the government or Medicare – and asks you to pay for a new “Obamacare” insurance card
- You give your personal health, bank account, or credit card information to someone who calls you and says they’re from the government
How to report suspected fraud
You can report suspected fraud one of 2 ways:
If you suspect identity theft, or feel like you gave your personal information to someone you shouldn’t have, use the Federal Trade Commission’s online Complaint Assistant.
You should also contact your local police department.
Visit www.ftc.gov/idtheft to learn more about identity theft.
Call the Health Insurance Marketplace call center at 1-800-318-2596. TTY users should call 1-855-889-4325. Explain what happened and your information will be handled appropriately.