Consumer Alert: James warns of health insurance scams

New York Attorney General Letitia James on Tuesday issued a consumer alert warning New Yorkers about common health insurance scams as open enrollment begins for insurance plans through New York's Affordable Care Act marketplace.

James said New Yorkers have until Dec. 15, 2024, to enroll through the New York State of Health marketplace for health coverage taking effect Jan. 1, 2025.

She said health insurance scams spike during open enrollment periods, and that the Office of the Attorney General (OAG) is providing consumers with tips to protect themselves against potential scams.

"New Yorkers must be able to secure health insurance free from predatory scammers trying to take advantage of them," said Attorney General James. "As New Yorkers take advantage of this year's open enrollment period, I urge everyone to be cautious and contact my office if they think they are the target of a scam or fraud.

"Affordable and accessible health care is a fundamental right, and my office will do everything in its power to protect New Yorkers seeking to secure insurance for themselves and their families," she added.

James said enrollment in New York's public health programs – Medicaid, Child Health Plus, and the Essential plan – is open year-round. However, she said New York state requires enrollees to renew their eligibility for these health plans every year.

The attorney general said enrollees are sent renewal notices well in advance of their coverage end dates with detailed instructions on how to stay covered and their deadline to renew.

To enroll in commercial health insurance for 2025, she said New Yorkers must do so during the open enrollment period, which runs from Nov. 1, 2024 to Jan. 31, 2025. New Yorkers have until Dec. 15 to enroll for coverage that will start on Jan. 1, 2025. Otherwise, coverage will begin Feb. 1, 2025.

James urged New Yorkers to look out for tactics that scammers use to target those who are trying to obtain or keep health insurance: Scammers often use fear by threatening New Yorkers that their Medicaid or other health coverage is at risk of cancellation, or that they have already lost their Medicaid or other health coverage unless they provide hundreds of dollars to reinstate or continue benefits; and scammers will also use false offers of generosity to lure New Yorkers into providing personal information. This is typically done through phishing scams offering people gift cards or money to "update" their health accounts so as not to lose coverage.

She said scammers may ask for money to enroll people in marketplace or "Obamacare" insurance.

James said the New York agencies that administer Medicaid, Child Health Plus and Essential Plan benefits will never use the term "Obamacare" or ask for money from consumers to enroll or re-enroll. They will also not offer New Yorkers rewards to renew their coverage, she said.

In offering tips and reminders for New Yorkers to avoid common scams, the attorney general said: No one can ever charge a fee to renew health insurance in Medicaid, Child Health Plus, or the Essential Plan; and if enrolled in health insurance through the NY State of Health, many people are available to help you renew for free. These include the state's health-certified enrollment assistors (including navigators, agents, and brokers) and customer service representatives.

For information or guidance, visit the NY State of Health website or call 1-855-355-5777. The phone line is available Monday – Friday from 8 a.m – 8 p.m and on Saturday from 9 a.m – 1 p.m.

If enrolled in Medicaid through either your county's Medicaid office or through New York City's Human Resources Administration (HRA), James said there are also many people available to help for free. Contact the office where you enrolled to ask questions and get help with renewing insurance.

James said government agencies will never threaten, demand payment, or ask for credit information in a text message, email, or phone call.

She said many websites will try to make residents think that they are the official New York state health insurance marketplace, but she said there is only one official NY State of Health website.

The New York Attorney General warned that submitting contact information to some websites may lead to calls, texts, or emails from scammers.

She said any New Yorker who suspects that they are a victim of a scam is urged to report it to OAG by submitting a complaint online or calling 1-800-771-7755.