Navigating health insurance is difficult enough. From understanding terminology to sorting through different plans and options, the industry is complex for most consumers. That complexity also means the industry is ripe for health insurance scams. Criminals can take advantage of confused consumers, and the level of fraud is astounding from health insurance scams.
While it’s difficult to put a number on scams versus other health insurance fraud, studies suggest the combination costs consumers more than $300 billion annually. Most scams happen when consumers shop for health insurance coverage and end up falling victim to a deceptive “health plan” that offers little or no coverage for medical expenses. The result is consumers who face substantial medical bills with no recourse for financial recovery. These are some tips to better understand and avoid health insurance scams.
Signs to avoid health insurance scams
Health insurance scams, particularly those related to Medicare, are prevalent, and scammers use familiar tactics to exploit unsuspecting consumers. Below are five signs that can help you identify a health insurance scam:
1. Government Impersonation
Scammers may claim to be from a government agency and demand money or personal information from you. It’s important to note that government entities do not contact consumers to request money or personal details over the phone. If you have inquiries about Medicare or the Health Insurance Marketplace, ensure that you directly reach out to the government through verified channels, such as Medicare.gov or HealthCare.gov.
2. False Medicare Card Fees
Be cautious of scammers who insist that you need to make payments for a new Medicare card or face the risk of losing your Medicare coverage. In reality, there is no fee associated with obtaining a new Medicare card, and Medicare will not make unsolicited calls regarding coverage status.
3. Bogus Medical Discount Plans
Be extra vigilant when approached with the sale of a fake medical discount plan. While some medical discount plans offer genuine discounts, others are designed to extract money from individuals without providing substantial benefits. Always verify the legitimacy of a medical discount plan, including confirming the participation of your healthcare provider, and insist on obtaining comprehensive details in writing before making any commitments.
4. Solicitation of Sensitive Information
Remain cautious if individuals or supposed entities request sensitive personal information in exchange for a price quote. This is called “phishing” and it’s at the root of all sorts of scams. When exploring health insurance options, take advantage of official government platforms, such as HealthCare.gov, which only require basic details like monthly income and age to generate a price quote. Refrain from giving out personal financial information, such as Social Security, bank account, or credit card numbers, to prevent potential identity theft and unwanted solicitations.
5. Payment for Marketplace Assistance
Stay away from solicitors requesting payment for guidance related to the Health Insurance Marketplace. Legitimate assistance with the Health Insurance Marketplace, often provided by Navigators or certified enrollment counselors, is not associated with upfront charges. Exercise caution and verify the credentials of individuals offering assistance with marketplace enrollment.
The best way to avoid scams, in every situation, is to be informed and vigilant. The best way to avoid health insurance scams is to remain aware of specific signs that are standard in fraud. If there’s even a question whether something is legitimate, conduct a thorough verification before sharing personal information or making payments.
