How to recognise a pressure sales call

Most people who shop for health coverage will, at some point, receive a call that feels rushed or confusing. Some callers are legitimate and simply persistent. Others use pressure, half-truths or outright impersonation to get you to agree to something before you have had time to think. Knowing the warning signs makes it easier to slow the conversation down or end it.

Warning signs

Any of these is a reason to pause. Common signs include:

• The caller says they are from the government, Medicare, Medicaid or the Marketplace, or implies an official connection they cannot show.
• You are told an offer ends today, that a price is only available on this call, or that you will lose coverage unless you act immediately.
• You are asked for your Social Security number, Medicare number, bank details or card number early in the call, before you have chosen anything.
• The caller will not name the insurer or the specific plan, or will not send written plan documents before you agree.
• The plan is described as free, as a government benefit, or as covering everything, with no mention of limits.
• The caller discourages you from checking with anyone else, or talks over your questions.
• You are asked to pay with a gift card, wire transfer or payment app.

You are allowed to slow down

A legitimate plan will still be available tomorrow. Open enrollment and Special Enrollment Periods have deadlines, but those deadlines are published, and no reputable seller needs you to decide in the middle of a phone call. Saying you would like to read the documents first, or simply ending the call, is always an option.

Questions to ask any caller

• What is your full name, the name of your company, and your insurance license number?
• Which insurer offers this plan, and what is the plan's exact name?
• Will you send me the Summary of Benefits and Coverage or policy documents in writing before I decide?
• Is this a comprehensive health plan, or a supplemental or fixed-benefit policy?
• Which of my doctors and prescriptions does this plan cover?

Someone selling legitimate coverage should be able to answer clearly. Evasive or shifting answers are information in themselves.

Verify independently

You do not have to rely on what a caller tells you. Your state's department of insurance can usually confirm whether an agent is licensed in your state. You can look up marketplace plans yourself on HealthCare.gov or your state's marketplace, and compare them using each plan's Summary of Benefits and Coverage.

If someone says they are calling about coverage you already have, hang up and contact your insurer or marketplace using the number on your card or official website rather than a number the caller provides. Caller ID can be faked, so a familiar name on the screen is not proof of who is calling.

Be cautious about agreeing to anything on a recorded line. A spoken yes can be used to enroll you in, or switch you to, a plan you did not intend to choose.

Protecting your information

Personal details are valuable to scammers even if you never buy anything. Avoid giving your Social Security number, Medicare number or financial details on a call you did not expect. If you think you shared information with a dishonest caller, you can review your accounts, contact your insurer, and consider placing a fraud alert with the credit bureaus.

Reporting a call

You can add your number to the National Do Not Call Registry at donotcall.gov, which limits many telemarketing calls. Suspected scams and unwanted calls can be reported to the Federal Trade Commission at ReportFraud.ftc.gov. Your state's department of insurance can also take complaints about agents and insurance sales practices.

Reporting helps even when you did not lose anything, because patterns of complaints are how regulators find the worst offenders.

A calmer approach

The best defence against pressure is time. Read the documents, compare the plan with others, and decide when you are ready. Information that arrives in writing, at your request, is easier to check than anything said quickly on the phone.

This guide is general education about how coverage typically works. It is not legal, tax, financial or medical advice. Plan rules, dates and availability vary by state and change each year.