With or without the Affordable Care Act, health insurance remains a major expense for many American households. Amid the confusion that many people have about the ACA, fake health insurance carriers have entered the market, looking to capitalize on that problem. The plans they offer are fraudulent, and make no mistake – it is a big business. Insurance fraud exceeds $100 billion in losses every year. When shopping for a policy, consider the following red flags.
The Premiums Seem Too Good to Be True
Everybody wants to keep his or her health budget affordable. With premiums seemingly higher than ever, it may be tempting to purchase a plan on the cheap. Premiums are not coverage, however. Sometimes, low premiums are not evidence of savvy shopping but instead represent a red flag that the plan may give you greater headaches down the road. Review the entire plan, and pay special attention to the extent of coverage it offers.
You Feel Pressured by Their Agents
Health insurance is said to be a product that sells itself, as it is either mandatory or a necessary hedge against spiraling medical costs. You should never feel pressured to buy a policy immediately or without reading the fine print. Legitimate companies want consumers to understand their purchase, as it makes for peace of mind. Happy customers are loyal. A legitimate agent will never employ a hard sell technique.
Company Materials Are Slick But Vague
A fraudulent agent may direct you to a glossy brochure, filled with happy families and elderly folk. It may look appealing, but if it does not offer a summary of benefits in clear terms, be wary. A brochure is no substitute for the actual written policy. Remember that the policy represents a legal, binding contract between the company and purchaser. On this note, you should receive your policy information very soon after signing on the dotted line.
Bills Are Paid Late or Not at All
Whether or not the consumer is responsible for a co-pay at the time of service, insurance carriers should pay bills in a reasonable time frame. If you are receiving past-due notices, inquire as to how responsive the company has been and document this. Get billing information and call the insurer direct with this information. If they do not respond over time to repeated calls and inquiries, you can follow up with federal agencies like the Federal Trade Commission.
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