Spotting Medicaid Scams

By Carol Kando-Pineda                    
Staff Attorney, Federal Trade Commission

During the pandemic, states had to keep people enrolled in Medicaid so they didn’t lose their insurance. Now that the health emergency declaration is over, that requirement has been phased out — which means people eligible for Medicaid have to re-enroll in their state’s program or find new insurance, if they’re not eligible. So, where do the scams come in?

When big changes affect millions of people, scams will follow. That means people who’ve been on Medicaid — including people of modest means, children, older adults, pregnant women, and people with disabilities — will be targeted by health insurance scams. Here’s what to know:

• Medicaid won’t charge you to renew or enroll. You may get a call, text, or email from your state Medicaid agency to renew your enrollment in your state’s program. But the real Medicaid program won’t ask for money or personal information like your credit card or bank account number. Learn more about eligibility for Medicaid in your state at Medicaid.gov (scroll down to find the link to your state’s Medicaid agency).

• Visit HealthCare.gov to compare insurance plans, coverage, and prices. HealthCare.gov lets you compare prices on health insurance plans, check your eligibility for healthcare subsidies, and begin enrollment. HealthCare.gov will ask only for your monthly income and your age to give you a price quote. If anyone asks for your bank account or credit card number to give you a quote for health insurance, that’s a scam. Don’t do it.

• Scammers try to sell you medical discount plans that are not major medical. Medical discount plans charge a monthly fee for supposed discounts on some medical services or products from a list of providers. They’re not a substitute for health insurance, though some plans do give actual discounts. But others just take your money for very little in return. If you’re considering one, find out if your doctor participates in the plan. Check what coverage it gives for major events. And be sure to get the plan’s details in writing before you sign up. If anyone pressures you to sign up quickly or insists you’ll miss out on a special deal, say, “no, thanks.”

If you think you’ve spotted a scam, tell your friends and family about it so they can protect themselves. Then tell the FTC at ReportFraud.ftc.gov and your state attorney general.