An ongoing scam involving discount medical insurance could leave you with a medical bill according to the Federal Bureau of Investigation. In a warning issued last week, the FBI says the ongoing scam gets people to believe they’ve purchased medical insurance only to later find out their plan did not cover their costs.
“These scams often target people who are looking for more affordable healthcare options and use misleading tactics such as stating to be a legitimate medical insurance provider, pressuring people to sign up quickly due to time limited special rates, or promising free services with hidden fees to lure people to sign up,” reads part of the warning.
“A typical discount medical insurance scam begins with unsolicited contact via calls, texts, or emails from unknown businesses offering special deals or discounted medical insurance.”
The FBI says the state of Washington issued a cease-and-desist against a discount medical insurance company accused of operating under multiple names. The state received more than 100 complaints of fraudulent practices made by the company.
Victims claimed the company misrepresented coverage plans and did not cover medical expenses after leading victims to believe the costs would be at least partially covered. The company is also accused of not issuing refunds to those who cancelled other health care plans in order to sign up for the new plan.
Examples of the scam were provided in the FBI warning and include the following accusations made by victims:
- A couple from Pennsylvania was pressured to sign up for a discount medical insurance plan through what they believed was a national provider. The couple was told to act quickly, or they would lose the temporarily discounted price for the plan. Following an emergency room visit and an appointment with their primary care physician, the couple received an explanation of benefits stating they were responsible for all medical bills as the medical services received by the couple were not covered by their policy.
- Another individual from Pennsylvania was contacted by a healthcare representative claiming that their company could offer a much cheaper plan than the one the individual had. The individual was told he would receive a refund for his current plan once he signed up for the new plan but did not receive any information regarding the refund. The representative indicated the individual had to act quickly or lose the deep discount. After purchasing the new healthcare plan, the individual never received the promised refund and was unable to get any information from the new insurance company.
- An individual in Texas responded to an advertisement offering aid for gasoline and groceries to senior citizens. He was told he had to sign up for a dental policy with a specific insurance company to obtain the aid. After he signed up, he tried to cancel the dental insurance policy but was told by customer service to request the cancellation via email. The insurance company did not respond to his emails requesting to cancel his dental insurance policy, and he had to cancel his credit card to stop the charges.
- An individual in Maryland was told he would save thousands of dollars by purchasing a health insurance policy and paying for the entire year up front. He was told the new policy would cover his current medical providers and hospitals, and he would only be responsible for a $20 co-pay per doctor’s office visit and $50 per urgent care visit. After needing emergency surgery, the hospital informed him that they did not accept his new health insurance, and he was responsible for the $7000 cost of the surgery.
To protect yourself, the FBI says there are several things you can do to ensure you are not a victim. First, verify that the plan is being offered by a reputable source. You can contact the state insurance commissioner or the Better Business Bureau to verify the company.
Next, you should contact your current medical providers to determine if the plan you are considering is accepted by them. Never pay for any of the offerings upfront before you’ve had a chance to review the policy thoroughly.
If the company does not send policy documents, that is a sign of fraud. If policy documents are sent, be sure to review them to understand exactly what is offered by the policy.
If you believe you are a victim of this type of fraud, the FBI asks you to report it to the FBI’s Internet Crimes Complaint Center.
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