$12.5B
FTC-reported fraud losses in 2024
FTC says consumers reported losing $12.5 billion to fraud in 2024.
fake health insurance plan scam
Scammers sell fraudulent health insurance plans that collect premiums but deny or fail to pay claims when the policyholder needs coverage.
“insurance scam”
↑ 100%Key indicators
Usually targetsUninsured adults
Often hitsHealthcare workers
Common regionUnited States
Last updated2026-04-04
Estimated impact
$960
median reported loss
Typical range$60 – $6.0K
Recovery rate~15%
Scam breakdown
1
Telemarketers cold-call and advertise cheap comprehensive health coverage.
2
The plan collects monthly premiums but is actually a discount card or limited-benefit plan.
3
When the policyholder files a claim, it is denied or the company has disappeared.
What to do first
Verify any health plan through your state's Department of Insurance.
Related terms
bogus health planfake medical insurancesham health coverageInsurance scamsPhoneRisingUninsured adultsSelf-employed workersFamiliesHealthcare workersRetirees and seniorsParents and familiesUnited Statesbogus health planfake medical insurance
Real-world example
How this scam plays out in practice
Based on reported patterns. Names and details are illustrative.
The setup
Daniel, 35, a uninsured adults, encountered what appeared to be a legitimate insurance scams situation while using Phone. Telemarketers cold-call and advertise cheap comprehensive health coverage.
Step 2
What happened next was calculated: The plan collects monthly premiums but is actually a discount card or limited-benefit plan.
Step 3
The pressure escalated quickly: When the policyholder files a claim, it is denied or the company has disappeared.
The outcome
Daniel realized something was wrong when premium is dramatically lower than comparable legitimate plans. By that point, significant damage had already been done — money sent, personal information shared, or trust exploited.
The lesson
Verify any health plan through your state's Department of Insurance. Daniel's experience shows why premium is dramatically lower than comparable legitimate plans and plan is not listed on healthcare.gov or your state insurance department website are the clearest early warning signs.
How to identify it
- Premium is dramatically lower than comparable legitimate plans
- Plan is not listed on healthcare.gov or your state insurance department website
- Agent pressures enrollment before open enrollment begins
- Pause before paying, clicking, or sharing information. Scammers rely on speed.
- Verify the sender, company, or agency using a phone number or website you already know is legitimate.
- Treat secrecy, urgency, and off-platform payment requests as strong scam signals.
What to do now
- ✓Verify any health plan through your state's Department of Insurance.
- ✓Use healthcare.gov or your state marketplace for ACA-compliant plans.
- ✓Report suspicious health plans to your state insurance commissioner.
What to save before reporting
- ✓Save the message, profile, phone number, email, or URL that was used.
- ✓Keep payment confirmations, receipts, and account alerts before you dispute or delete anything.
- ✓Write down the timeline while the details are still fresh.
- ✓Save the full chat or call log before blocking the sender so the reporting path still has the original context.
How big is this problem
You are not alone — this scam affects millions of people.
These numbers come from government agencies and official reports. If you have been affected, know that this is a widespread problem — not something that only happens to careless people.
FTC 2024 fraud losses
Imposters
Most common FTC fraud category in 2024
FTC says imposter scams remained the most commonly reported fraud category in 2024.
History and evolution
- This scam family tends to persist because the social-engineering pressure works even when the exact scripts, platforms, and payment methods change.
- The specific packaging evolves over time, but the core pattern usually stays the same: create urgency, control the channel, and push action before verification.
- The FTC and state regulators have shut down multiple fake health insurance operations that collected millions in premiums.
Recovery and follow-up
- ✓Save the messages, receipts, account alerts, and transaction details before you block or delete anything.
- ✓Report the scam through the official platform or government channel that best matches where it happened.
- ✓Tell close contacts if a phone or text scam used your identity, so scammers cannot reuse the same story against people around you.
- ✓Verify any health plan through your state's Department of Insurance.
- ✓Use healthcare.gov or your state marketplace for ACA-compliant plans.
Why this pattern keeps working
Even when the story changes, most scams still use the same pressure pattern: urgency, authority, and a request to move money or data fast.
The FTC and state regulators have shut down multiple fake health insurance operations that collected millions in premiums.
FTC Consumer Sentinel 2025
Where to report it
If you have been targeted by this scam, reporting it helps authorities track the pattern and protect others. United States has dedicated agencies that handle fraud reports.
ReportFraud.gov
Federal Trade Commission
Central U.S. consumer fraud reporting portal.
File an IC3 complaint
FBI Internet Crime Complaint Center
FBI portal for internet-enabled crime reports.
Start identity theft recovery
IdentityTheft.gov
Official U.S. identity theft recovery plan builder.
Explore further
Understand the bigger picture
Who is most at risk
Who this scam targets
Primary targets
Uninsured adults, Self-employed workers, Families
Geographic concentration
United States
Primary channel
Phone — Insurance scams
Why this group is vulnerable
Uninsured adults are particularly vulnerable because this scam exploits trust in familiar brands, authority figures, and time-sensitive decisions. The growing number of reports suggests that awareness among this demographic remains low.
Sources and methodology
How we verify this information
OpenScam tracks scam patterns using a combination of government consumer protection databases (FTC, IC3, Action Fraud), platform-specific fraud reports, and verified consumer complaint data. Each entry is cross-referenced against at least two independent sources before publication.
Severity ratings are based on financial impact potential, reversibility of damage, and volume of reports across multiple reporting channels. Trend velocity reflects the rate of change in report volume over the most recent 90-day window.
This page was last verified on 2026-04-04. Red flags, recovery steps, and reporting resources are reviewed quarterly against current agency guidance.
Evidence and indicators
- The FTC and state regulators have shut down multiple fake health insurance operations that collected millions in premiums.
Source notes
- FTC Consumer Sentinel 2025
Frequently asked questions
Common questions about fake health insurance plan scam
How does the fake health insurance plan scam work?+
Telemarketers cold-call and advertise cheap comprehensive health coverage. The plan collects monthly premiums but is actually a discount card or limited-benefit plan. When the policyholder files a claim, it is denied or the company has disappeared.
What are the warning signs of fake health insurance plan scam?+
Premium is dramatically lower than comparable legitimate plans Plan is not listed on healthcare.gov or your state insurance department website Agent pressures enrollment before open enrollment begins
What should I do if I encounter fake health insurance plan scam?+
Verify any health plan through your state's Department of Insurance. Use healthcare.gov or your state marketplace for ACA-compliant plans. Report suspicious health plans to your state insurance commissioner.
Who is most at risk for fake health insurance plan scam?+
This scam primarily targets Uninsured adults, Self-employed workers, Families. It is most commonly reported in United States and typically appears on Phone.
Is fake health insurance plan scam on the rise?+
fake health insurance plan scam is currently on the rise with growing reports. It has been reported across US. Last updated 2026-04-04.
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Help someone avoid this scam.
Scammers succeed because people do not talk about it. If you or someone you know has been affected, there is no shame in it — it happens to millions of people every year. Share this page with friends and family so they know what to look for.
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