The National Health Care Anti-Fraud Association estimates that healthcare fraud adds up to nearly $68 billion every year. These costs equal about three percent of the nation’s total spending on health care. Not only do these scams drive up the cost of healthcare for everyone, but they can be devastating to individuals that fall prey.
Healthcare insurance can be complex and scammers take advantage of this.
Common Health Insurance Scams
According to the Federal Trade Commission (FTC), here are some of the most common insurance scams you should be on the lookout for.
We’re From the Government
Government agencies don’t call people and ask for money or personal information. They will not ask you to provide your social security information, bank account details, or credit card number. They won’t ask you to pay for something using gift cards or ask you to wire money.
You’re About to Lose Your Medicare Coverage
Scammers may attempt to get you to pay for a new Medicare card or threaten that you will lose coverage if you don’t sign up for their program.
Fake Medical Discount Plans
While there are some legitimate discount plans, such as those for prescriptions, many discount plans sign you up for a plan but deliver little in the way of benefits. Even if the plan is legitimate, you need to verify that it’s accepted by your pharmacy or doctor.
Many states also require discount programs to be registered or licensed. You don’t want to sign up for a plan that you can’t use. You can check with your state’s Attorney General’s office.
Requiring Information for Price Quotes
Any reputable company will provide you with a price quote based on information you provide. This may include medical information or verification of insurability, but will not require sharing social security numbers, bank accounts, or credit cards for health insurance quotes.
Protecting Yourself Against Healthcare Insurance Scams
The FTC recommends consumers take several steps before providing any information or signing up for any health insurance programs.
Do Your Research
Search online for the name of the company and use keywords such as complaints, scams, or fraud. This can help surface reviews and give you insight into a company’s legitimacy.
Make Sure It’s the Real Company
If you get an email offer or phone call, you need to verify the authenticity before signing up. Instead of calling the number they provide, emailing them back, or committing on the phone, look up the company online and use that information to connect with them.
Many scammers use fake email addresses and spoof phone numbers to make them look legitimate. Others create fake logos, websites, or marketing materials that look like the real deal. Yet others say they act as an agent for a well-known health insurance provider. If you’re not 100% sure, call the company directly and ask yourself.
Get Everything in Writing Upfront
Always ask for written documentation, such as a benefit statement or a complete copy of any service or policy you consider. Everything a salesperson tells you should be included in writing. If they won’t provide that, it’s likely a scam.
Beware Vague Answers
If you can’t get clear answers to your questions, be wary. A legitimate health insurance provider will be able to provide details on deductibles, copays, in-network doctors, etc. If you get vague or conflicting answers, the information they provide may not be true.
Reporting Health Insurance Scams
If you suspect someone is trying to scam you, report it to the Federal Trade Commission at ReportFraud.ftc.gov.
You can also report scams pertaining to Medicate at the FTC’s 1-800-MEDICARE fraud hotline.