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Home > Health Plan Problems? > Scams and Fraud

How to Avoid and Report Health Insurance Scams

Health care reform provides a great opportunity for millions of Californians to get affordable health insurance coverage. Unfortunately, these new laws may be used by some to scare you into buying unnecessary health insurance or to get access to your personal financial information. So you need to be cautious.

Be informed

To help protect yourself and your family from being scammed, get the facts about the new changes in health care and about Covered California, the state's health insurance marketplace.

How to protect yourself from scams

  • It is important to know that only certified individuals are authorized to assist you with enrollment in Covered California. Covered California's certified enrollment counselors are required to wear ID badges. To verify if someone is a certified enrollment counselor, you can call Covered California at 1-800-300-1506 or visit the Covered California website.
  • Insurance agents and brokers must be licensed before they can sell insurance in California. Ask the person selling you an insurance plan to show proof that he or she is  licensed. You can check his or her license by contacting the California Department of Insurance at 1- 800-927-4357 or visiting the Department of Insurance website.
  • Verify that the health insurance plan you are being offered is licensed in the State of California:
    • To check for HMO and some PPO plans, contact the Department of Managed Health Care (DMHC) at 1-888-466-2219 or view an online list of DMHC licensed plans.
    • To check for a PPO plan or other type of insurance, contact the Department of Insurance at 1-800-927-4357 or check its website.

Report a scam

If you think you have been scammed, you can report it to one of the following agencies:

  • If a scam involves Covered California, call 1-800-300-1506 or email consumerprotection@covered.ca.gov
  • If a scam involves Medi-Cal, call 1-800-822-6222 or email stopmedicalfraud@dhcs.ca.gov
  • If a scam involves Medicare, call the Centers for Medicare & Medicaid Services at
    1-800-633-4227, report it to the Office of the Inspector General online, or visit the Medicare fraud website for more information
  • If a scam involves deceptive practices in the marketing or sale of a health insurance product, call 1-888-466-2219 or report it using DMHC's fraud complaint form.
  • If the scam is related to something else other than those listed above, report it to the Federal Trade Commission online or call 1-877-438-4338

If your identity has been stolen

The California Office of the Attorney General offers these helpful resources:

The Federal Trade Commission also offers a step-by-step guide on what to do if your identity has been stolen.

Health Plan Problems?

Call 1-888-466-2219

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