How to Protect Yourself from Healthcare Insurance Scams in 2026

By Misa Bailey, Healthcare Project Manager at SC Appleseed Legal Justice Center

If you are no longer shopping on the Marketplace or you cannot afford the plan that you had in 2025, you may be feeling overwhelmed by potential options. Maybe you’ve looked at prices and thought, I can’t afford this. Do I have to go without? Isn’t there anything cheaper out there? 

You’re not alone. Health insurance is complicated and expensive.

The expiration of the enhanced Premium Tax Credits and the passage of H.R.1, also known as the One Big Beautiful Bill Act (OBBA), left many people facing higher costs for their monthly premiums. The spike in costs force many to consider cheaper, low-quality healthcare options – some even called “junk” health plans.  Unfortunately, these cheaper options offer less coverage, leaving you to pay out-of-pocket for most of your care. Rising costs and confusion also make it easier for scammers to target people looking for affordable coverage.

In this blog, we’ll share how to spot these problematic plans and how you can protect yourself from scams or costly coverage.

What is the Affordable Care Act (ACA) Marketplace?
The Affordable Care Act (ACA) Marketplace (Healthcare.gov) provided health insurance to more than 600,000 South Carolinians in 2025 who could not get health insurance through their employer, Healthy Connections (SC Medicaid), or Medicare. Unfortunately many have lost coverage due to the increased costs.

Note: The Marketplace is not for Medicaid or Medicare. To apply for Medicaid, go to SC DHHS’ Healthy Connections page . To apply for Medicare, go to medicare.gov 

What Do Scam/Junk Health Plans Look Like?

These private health plans are health insurance options sold outside the Affordable Care Act (ACA) Marketplace that are often referred to as “junk” health plans. These plans provide very limited coverage and less protection than an ACA plan sold through the Marketplace. They’re designed to look affordable but may leave you with large medical bills.

Common types include:

• Short-term limited duration insurance
• Fixed-indemnity policies or hospital indemnity coverage
• Health care sharing ministries

Spotting a Scam/High-Cost Plan: 6 Red Flags to Watch For

These plans generally offer less coverage and protection than ACA plans. Knowing what to look for can help you avoid one.

1. Low monthly cost, high costs when you need care
   • You may pay less each month but will end up paying much more for your actual care
2. Short-term coverage
   • Plans only last a few months and often lack the protections you would get with a plan under the ACA.
3. Limited coverage
   • Many services may not be covered, including:
     • Preventive care (annual checkups, cancer screenings, and vaccines)
     • Routine doctor visits
     • Prescriptions
     • Mental health or maternity care
4. Emergency-only coverage
   • Little to no help unless something serious happens.
5. Limited provider network
   • Very few doctors or hospitals accept the plan.
6. Can deny or charge more based on your pre-existing health conditions
   • You can be denied coverage or charged more if you have a condition like diabetes, asthma, or cancer.

Watch Out for Scams

As costs rise, scammers are targeting people looking for affordable coverage. Beware if someone:

• Uses official-sounding terms like “Obamacare” or “ACA” but isn’t selling a real ACA plan
• Sends you to a website that looks like HealthCare.gov but is an alternative site
• Pressures you to sign up quickly or change your coverage
• Tells you that you don’t need certain types of coverage like mental health care
• Charges you for checking your options or enrolling in a plan

Final Tips Before You Enroll

• Start at Healthcare.gov
  • This is the official Marketplace website to shop for ACA plans. Avoid shopping outside of Healthcare.gov. When looking online, make sure you are not sent to a site that is selling non-ACA plans.
    
• Get free help from a certified Navigator, Assister, or licensed Agent/Broker
  • You should never pay for help reviewing your ACA plan options. Find an assister or agent/broker near you.
    
• Beware of “bundle” plans
  • This is when the seller combines multiple limited plans to make them seem like full coverage, but they’re not.
    
• Ask yourself these questions before enrolling:
  • Will this plan cover services for my existing health problem (such as asthma, cancer, diabetes)?
  • Are annual checkups, vaccines, cancer and other screenings covered?
  • Are my prescriptions covered?
  • How much will the plan pay if I need emergency care?
  • Does my doctor or a doctor near me accept this insurance?

Thanks for reading. If you have questions, please feel free to email us at [email protected]. Stay tuned for more information on the ACA and healthcare changes ahead in our future blogs.

Further Reading:
Changes to SNAP for 2026
ACA Enrollment Changes 2026