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Healthcare: Beware of Fake Medical Insurance

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A few weeks ago, I noticed that I was seeing an increasing number of commercials advertising inexpensive "easy to get" health insurance.  The first thing that came to my mind was ... this has got to be some sort of scamOtherwise, wouldn't everyone be getting cheap insurance? It's sad really, with over 46 million uninsured in America, there is no shortage of scammers lining up to exploit them.

It seems I was right.  If it sounds too good to be true, it probably is.

These fake and deceptive health plans are spreading like wildfire across the country, taking advantage of our troubled economy and playing on people's fears.  Victims of this insurance fraud have been saddled with tens of thousands of dollars in medical bills when their bogus insurers refuse to pay.  And this isn't a problem that is going to go away any time soon, so consumers need to learn how to recognize these fraudulent policies and protect themselves.

Medical bill

Here's what AARP is saying about these scams ...

With the recession, rising unemployment and continued debate over health care reform, “there’s a perfect storm of circumstances that resulted in a new proliferation in fake and deceptive health insurance,” says Jim Quiggle of the Coalition Against Insurance Fraud, a Washington-based consumer watchdog group.

“Some of these policies are completely phony, delivering nothing but a piece of paper. Others promise full health benefits, but provide shriveled coverage and expensive hidden costs.

This is from the Coalition Against Insurance Fraud...

Typically, crooked plans aggressively market full health coverage but deliver no coverage at all, stripped-down policies that deliver little or medical discount cards (which require members to pay most expenses themselves). Blast faxes, invasive telemarketing, insurance agents and enticing Web sites are among the marketing tools. Regulators in most states have been forced to crack down over the last two years. But the plans are hard to shut down. Often they simply disappear and resurface under new names without required state licenses.

This is how the scams work, and here are nine warning signs to look for.

If you suspect fraud -- Here is a state by state list of fraud bureaus.

The CBS Early Show asked ... How can they protect themselves?  What are the warning signs that a health plan might be fake?

According to Koeppen: aggressive sales -- such as unsolicited faxes, phone calls or e-mails offering great deals. Also, plans that sound too good to be true -- especially if the premiums are much lower.  Another red flag -- if there’s little information about the insurance company or underwriter backing the plan.

Before you sign up, Koeppen advises, contact your state insurance commissioner to make sure the company is licensed to sell insurance.

There's no safety net for consumers who find themselves with unpaid medical bills.  This is from MSN Money ...

If you do have to file claims and the insurance company doesn't pay, you'll be responsible for the charges.  No governmental safety net exists, as it does for those covered under licensed plans.  If a legitimate plan goes bankrupt, all states have "guaranty funds" that will pay individuals' claims, up to varying limits.  These funds aren't available if you've purchased insurance from an unlicensed provider.

Having a health plan through your employer doesn't always mean you're safe from this type of insurance fraud.

This is from InsideARM ...

Small business operators also are being preyed upon, he said.

“Group health coverage is very hard to get if you’re a small operator and have only a handful of employees.  Scammers know this and are descending on small businesses,” he said.

Quiggle added that even some legitimate insurers have knowingly or unknowingly partnered with fake insurance providers that offered limited or misleading plans.

Some of the most important warning signs of fraudulent health insurance, from an AARP list ...

  • Coverage that promises full benefits but costs much less than
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Catherine Morgan 5 pts

Hi Suzanne...I totally agree.  This isn't a new problem, and it seems like no one is even trying to fix it.  Our country has certainly become the land of opportunity for scammers.

Thanks for commenting Suzanne.

Contributing Editor Catherine Morgan
Also at Catherine-Morgan.com ( http://catherine-morgan.com/ )

Suzanne 5 pts

That the FCC disgusts me.  These ads should not be allowed on TV since they are obviously deceptive. It reminds me of all the fake mortgage refinancing ads that blanketed TV in the wake of Obama's plan for preventing foreclosures.  These people are the vilest opportunists and the FCC is supposed to stop this sort of thing.  It's infuriating.

Suzanne also blogs at Campaign for Unshaved Snatch (CUSS) & Other Rants ( http://cussandotherrants.com ) and is the author of Off the Beaten (Subway) Track ( http://offthebeatensubwaytrack.com ).

Catherine Morgan 5 pts

I know what you mean about "so called" legitimate insurance companies and feeling like there not really on the up and up...I think that's what makes it even earsier for desperate people to be taken in by the fakes...consumers are almost expecting to be taken advantage of by their insurance company, fake or otherwise.  

Even with a good insurance plan, my mother had to jump thru hoops to get many of her hospital bills paid, and she finally gave up the fight and paid much of it herself.  It's really sad what even the "legitimate" insurance companies are doing (and getting away with).  If we don't get some sort or healthcare reform it's only going to get worse.

Thanks for commenting Nordette.

Contributing Editor Catherine Morgan
Also at Catherine-Morgan.com ( http://catherine-morgan.com/ )

Nordette Adams 6 pts

You've done a real service here, Catherine, as usual.

I've been noticing the fake insurance ads since 2006 starting in New Jersey to where I am now Louisiana. I think the number of fakers may have increased. However, I haven't seen an ad for fake insurance in a while down here.

Anyone who's had to buy real insurance should recognize the fake ones because as you say they sound too good to be true. They play on our vulnerabilities, the need for low-cost insurance and good medical care. But yeah, if it combines low premiums with the phrase "regardless of preexisting conditions," then RUN!

The thing of it is that even so-called legitimate insurance begins to feel like fake insurance when the underwriters start questioning everything in search of a preexisting condition to avoid paying for anything. It hurts to pay more than $7000 in premiums over a year and have standard tests challenged. :-(

Nordette Adams ( http://www.bookotopia.com ) is a BlogHer CE ( http://www.blogher.com/haystackprofile/viewprofile... ) & you can find her other stuff through Her 411 ( http://her411.com ).