Health care scams

The Federal Trade Commission (FTC) recently updated its warnings to consumers about unethical companies and how health insurance scams can cost you big.

In this article, I’ll share some tips from the FTC and other agencies on how to protect yourself. We’ll also get money expert Clark Howard’s advice on how to stay safe.

Avoid These Health Insurance Scams

Financial losses caused by health care fraud in the United States are estimated to cost as much as $300 billion annually, so it’s clear there are plenty of scams out there. Here are some of the major health care scams to watch for.

Getting Charged To Sign Up for Health Care

Some criminals have reached out to people via phone and offered to walk them through signing up for health care at Healthcare.gov, the official health care insurance marketplace.

There is never a fee to sign up for health care at Healthcare.gov. Here’s what the FTC says about that:

“The people who offer legitimate help with the Health Insurance Marketplace — sometimes called Navigators or Assisters — are not allowed to charge you. In fact, you can’t pay them.”

Needing a New Medicare Card

You may get a phone call from someone who says you need a new Medicare card or you’ll lose health coverage. They then may offer to assist you with getting a new card. Don’t do it!

The FTC says you don’t have to have a physical card to get services under Medicare. And if you lose yours, you can get a new one here.

Before you engage with a person over the phone about your Medicare coverage, call 1-800-MEDICARE first to speak to a representative.

Getting Hit With High-Pressure Solicitations

Imposters pretending to work for the government have been found pressuring people to sign up for “Obamacare” insurance, telling them that they have to do so by law.

These scammers use plenty of different tactics: door-to-door visits, phone calls, emails and regular mail, and sometimes they even threaten lawsuits. What they’re trying to do is get your personal information or charge you to “sign up.”

“No one should threaten you with legal action if you do not sign up for a plan. Always ask for identification if someone comes to your door,” says the Office of Inspector General website.

Falling for ‘Rolling Lab’ Schemes

Vulnerable people, especially the elderly, often fall victim to what the Federal Bureau of Investigation calls “rolling lab” schemes that take bogus tests and examinations at places like “health clubs, retirement homes, or shopping malls” to bill insurance companies or Medicare.

Protect Yourself Against Health Insurance Scams

Here are some strategies that you can use whenever you change or renew your health coverage and when you file a claim.

Always Do Your Homework

It’s your responsibility to find out what type of coverage you’re really getting vs. what the plan advertises. That means you should always have the health plan’s benefits in writing.

That also goes for any health care bill you’ve received.

“Carefully review your insurer’s explanation of the benefits statement. Call your insurer and provider if you have questions,” the FBI warns.

Avoid Health Care Comparison Websites

Clark is a big fan of comparison shopping but not when it comes to health insurance. That’s because there are tons of websites out there that are nothing but lead generators that refer people to plans. And Clark says those plans are usually a terrible deal.

“If you need coverage, go to healthcare.gov, where the subsidies to your plan may actually be free,” Clark says on his podcast. “That’s where you should buy, instead of these fake platforms that supposedly comparison shop but steer you towards coverage that is really pretty lame and excludes so much of what you might need to have covered.”

Ask for the License Number of the ‘Health Agent’

Legit insurance agents are licensed by the state.

If you want to make sure that the person you’re talking to is a real insurance agent, ask them for their license number. You can then visit your state’s insurance department website to look up the agent by their license number.

In my home state of Georgia, you can go to oci.georgia.gov, the website for the Office of Commissioner of Insurance and Safety Fire. Their License Lookup page is where you can verify information about an agent.

Final Thoughts

Remember that you should never give personal information to anyone you don’t know over the phone, via text or on the internet. 

If you have suspicions about a company or encounter what you feel are dishonest marketing practices, report it to the FTC at ReportFraud.FTC.gov.

More Health Care Resources From Clark.com:

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