Open Enrollment scams: what North Carolina Marketplace shoppers should verify

Photo by Vitaly Gariev on Unsplash. Stock photograph.

Why scam reports rise during Open Enrollment

Scams built around health insurance happen all year, but WRAL's 5 On Your Side reported on October 15, 2026 that they rise during Open Enrollment for both Medicare and the Marketplace. Paid placement is one route: dishonest sellers sometimes buy their way to the top of search results. Others use web addresses that look close to a government site, plus keywords and official-looking logos, so a shopper can believe they have landed on HealthCare.gov when they have not.

The report lays out what that costs a household. Following a link or phone number from an ad can end with paying for something that is not health insurance, or with medical identity theft.

Verify the address before you click

This takes seconds, not technical skill.

• Type HealthCare.gov directly into your browser instead of clicking a sponsored result.
• Look for small “Ad” or “Sponsored” labels beside search results, and scroll past them.
• Check that the web address ends in .gov before you enter any information.
• To compare plans, look up your current coverage or see whether you qualify for savings, go to HealthCare.gov or call 800-318-2596.
• For local help, use the “Find Local Help” tool on HealthCare.gov, which lists Marketplace-approved enrollment partners.

What legitimate Marketplace help will never do

HealthCare.gov's fraud guidance is blunt. Neither the Marketplace, nor assister organizations, nor your state will threaten you or anyone in your household, and none of them will ask for a credit card number or a payment as the price of getting or keeping coverage. Premiums go directly to the plan you choose, not to an agency, an assister or a caller.

Treat social media ads that offer cash, gifts or other perks in exchange for your information with suspicion; what you hand over can be used without your consent. If someone calls saying they are from the Marketplace, official calls come from 1-855-997-1890 or 844-477-7500, with caller ID showing “Health Insurance MP” or “InsMarketplace,” and the caller should give a first name and agent ID. If anything feels off, hang up and call the Marketplace Call Center yourself.

Be careful with plans sold outside the Marketplace

Some insurers sell private health plans outside Open Enrollment, and the Marketplace neither lists nor offers them. In limited cases, such a plan counts as qualifying health coverage. HealthCare.gov notes that a plan bought outside the Marketplace — whether during Open Enrollment or at another time of year — comes without premium tax credits or other income-based savings. Most health plans sold outside Open Enrollment fall short of qualifying coverage, so ask the insurer whether a specific plan counts.

Check dates and eligibility through official sources

For 2027 coverage, Open Enrollment starts November 1, 2026. December 15 is the last day to enroll in or change plans if you want coverage to begin January 1, and January 15 is the last day of Open Enrollment. After that, enrollment depends on whether you qualify for a Special Enrollment Period; certain life events may qualify. Eligibility for premium tax credits depends on your household and income, so check through the current HealthCare.gov application rather than a sales page.

If you suspect a scam

• Report it to the FTC at ReportFraud.ftc.gov and to your state attorney general.
• If the scam involves Medicare, report it at Medicare.gov or 800-633-4227.
• If you may have shared personal or banking information, also contact local police and the Marketplace Call Center.

ZAVIA helps North Carolina individuals and families under 65 compare Marketplace plans, including checking your doctors, prescriptions and networks with you. ZAVIA does not charge customers an additional fee for Marketplace enrollment assistance. If you want a second set of eyes before you share information or choose a plan, call 919-237-1977.

Frequently asked questions