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Getting the right health plan can feel like navigating a maze, with bewildering coverage and cost choices around every turn. Shady operators count on that confusion to sell insurance products and health services that deliver far fewer benefits than promised — or none at all.
These schemes proliferate when health care is in the news and on our minds. The coronavirus pandemic has brought robocalls and phishing emails peddling bogus “corona insurance” supposedly covering COVID-19 treatment. And scammers get busy during the annual open enrollment periods for Medicare and Affordable Care Act (ACA) plans. Medicare open enrollment is Oct. 15 to Dec. 7. The ACA period is Nov. 1 to Dec. 15 in most states; a few have expanded sign-up options during the pandemic.
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Scammers try to convince you they have a simple solution to the complexity and expense of getting covered. They cold-call potential marks or generate leads through websites, using paid advertising to get to the top of search results, and claim to offer “comprehensive” health plans that meet “Obamacare” or “Trumpcare” requirements.
Some feature the names and logos of well-known insurers or even AARP. People who respond are peppered with pitches promising full coverage with low premiums, deductibles and copayments.
The resulting policies turn out to be, at best, far skimpier than advertised and at worst outright fakes. Often, victims really are buying medical discount plans, in which consumers pay a monthly fee to get reduced prices on specific services and products from participating health care providers. Some discount programs are legitimate, but as the Federal Trade Commission (FTC) warns, they are not a substitute for health insurance.
In one major case, the FTC sued a network of Florida companies called Simple Health Plans, saying it sole more than $150 million from consumers by dressing up limited-benefit plans and discount-plan memberships as comprehensive coverage. Its plans left buyers uninsured and often stuck with big medical bills. A federal judge shut the firm down pending a resolution of the court case, which as of October 2020 was still in litigation.
During ACA enrollment, scammers impersonate representatives of the government-run health insurance marketplace. They’ll tell you they need personal information to verify an application or that they can help you choose the right plan — for a fee. Treat such solicitations and any offers of deep-discount coverage with a healthy dose of skepticism.
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