Health insurance is there when you need it. It helps you go to your doctor, get your medicine refilled, and most importantly, it helps you know that your health is secure. Unfortunately, scammers are aware of the benefits they can receive through health insurance scams.
The fallout of this type of trickery can result in denied claims or leave you with bills you don’t deserve. Health insurance companies and government-run programs do their part to prevent fraudulent abuse. Even with technology and awareness, fraud isn’t always stopped in its tracks until you catch it.
Read on to learn about the top health insurance scams and how to protect yourself!
Health Insurance Scams to Watch out For
Fake: When You Sign up for a Fake Insurance Policy
Health insurance is required for most people in the United States. With the emphasis on HMO and PPO insurance, those looking to purchase a monthly health plan are prime targets. Perhaps you click on a link for an offer in your email inbox, receive a phone call, or are referred to the program through a friend or family member.
Fake insurance policies con everyone from businesses, (particularly small companies) associations, to unions, and individuals. This type of scam isn’t caught until a policyholder attempts to use the insurance, by which time the scammer has racked in a lot of money.
What to Look For: If it sounds too good to be true, it might be a scam. Don’t fall for a flashy email or link. Research if the company has the correct licensing and pay attention to shockingly low premiums or other offers which might be a red flag.
Affordable Care Act: When It Isn’t What It Sounds Like
What many people refer to as Obamacare is called the Affordable Care Act. Hiding behind the lure of a low-cost program, you might not even know you’ve been tricked until you have your identity stolen!
This is because scammers might ask you highly confidential personal information (social security number or other details). They might collect this data devoid of any fees and say they’ll get back to you. Instead, they have taken your information and sold or used it to get fake credit cards and purchases that ruin your credit.
What to Look For: A valid ACA program won’t call you up to solicit your information, nor will they refer to themselves as Obamacare. If you receive emails or calls of this nature, do not respond or hang up the phone. Next, submit your concern or complaint to the Federal Trade Commission.
The M’s: Medi-Cal, Medicare, and Medicaid
Why would someone scam the system in this way? As it is worth millions and millions. Estimates are upward of 20 billion dollars in incorrect payments, annually. While millennial and baby boomers are currently tied as the largest demographics of the population, baby boomers are aging and are using the system more and more.
Contrary to scammers being outside the system, these scams often come from within with medical staff falsely reporting procedures or enhancing their care to bill more. This might mean that you’re denied an operation you need because they have already billed for it.
What to Look For: This is tricky as programs like Medi-Cal are free, and those insured don’t commonly receive a benefits statement. If you do review paperwork for any of these government run programs, don’t be afraid to ask questions and inquire as to the content of what was billed or authorized.
Discount Cards: When Paying Less Is Sometimes More
You can spot discount card scams as they have high fees without being helpful or mimicking the positive benefits of health insurance. Although some discount cards can help save you money on your prescriptions and more, beware of any which require you to provide details or personal information that can be sold or misused.
What to Look For: If you receive a discount card with promises that aren’t delivered on, look further into them and beware of high costs you don’t expect. Stop using cards that end up costing you money and report anything suspicious to the State Department for your State.
Don’t pay for fees that you don’t believe you owe without taking action. Call your insurance company and ask for written explanations and details. Report any stolen information and check your credit report. You can protect your health insurance with awareness and attention to detail.







