Last Updated on by Ed Harris
Beware of Ohio medical insurance scams and discount plans. Fraudulent and dishonest healthcare coverage in the Buckeye State seems to be increasing, as many Ohioans are out of work or without benefits. These scams come under the disguise of providing “real health insurance benefits,” when typically, they are nothing more than cheap discount plans. Often, these plans are sold from companies that are not local, and you are pressured from the beginning of the conversation to buy the program as quickly as possible.
Recently, many state insurance departments have been cracking down on these questionable companies, and in some instances, seizing property and closing them down. Unlicensed discount prescription cards and fraudulent claims are two of the most common misrepresentations. Actually, it is likely that you may know someone who has purchased one of these plans. Of course, they may not want to admit it.
Medical Discount Plans
Occasionally, a medical discount plan may be helpful, especially if you are uninsurable, on an extremely tight budget, and missed the Open Enrollment deadline, which is typically January 31st. Assuming you do not qualify for an SEP (Special Enrollment Period), your options will be very limited, unless you obtain full-time employment with a company that offers group medical benefits.
But since “discount” plans are NOT health insurance, you can expect to pay large out-of-pocket expenses for most submitted claims. Usually, you have to pay your medical bills in advance and wait for reimbursement. And sometimes, you’re just receiving a list of providers that may offer you a small discount on their services.
In most situations, purchasing a legitimate open enrollment policy from a reputable insurer is the better option. Benefits are more robust, and you can more easily customize a policy to fit your existing conditions. Also, you will not have to pay a 2.5% household income tax penalty for not complying with ACA legislation. If you need assistance with finding a review of Ohio health insurance companies, we constantly review and update data, so you keep informed.
Common Warning Signs Of Medical Insurance Scams:
- You are required to pay an application fee of $50 or more. And often, it’s non-refundable.
- Mysteriously, you can’t seem to get any information sent to you in the mail. The information is available online or someone has to stop by your residence to deliver it.
- You don’t recognize the name of the company offering coverage or there are multiple companies offering different benefits under one plan.
- They are not located here in Ohio, and are not familiar with your specific area.
- You are asked to provide credit card or checking account information over the phone before you understand all terms.
- Your doctor and dentist have never heard of the company or are not familiar with them. Local hospitals also do not recognize their name.
- You are encouraged to buy the policy “now,” since tomorrow the rate will be increasing and a special offer will no longer be available.
Fraud Unit Help
The fraud unit of the Ohio DOI (Department of Insurance) is a criminal justice agency that investigates suspected fraud attempts involving carriers in the state. Although they don’t actively help with the enforcement of questionable policies offered to the public, they can refer cases to state and federal authorities for possible prosecution. If you suspect you have been a victim, the unit should be immediately contacted. Several common “red flags” are listed below:
Business transactions are handled in person and are always involving cash.
Contact person does not answer phone calls or respond to emails.
You are requested to keep details of transactions private.
Claims are denied by phone notification, and not via email or US mail.
In most situations, these types of “discount plans” cost you more in premiums than the actual coverage you are about to receive. The “negotiated discounts are often available to you without paying for this type of plan. And if you qualify for standard Ohio medical insurance, the benefits will far outweigh the “discount plan” benefits and you’ll likely pay less too! And just as importantly, federal subsidies (if you qualify) do not apply to these types of policies.
Government Agencies Help
The Federal Trade Commission (FTC) is constantly monitoring questionable companies that attempt to defraud the consumer through deceptive and unfair business practices. They continuously provide information to the public and manage a secure online database that is utilized by criminal and civil enforcement agencies in the US. If you would like to contact the FTC, we’ll provide current contact information.
We only represent the reputable major medical insurance companies. No “discount plans” are ever used. In fact, currently, we do not use “limited benefit” plans in our quote engine software. Our rates and plan information are updated daily to ensure your information is accurate and reliable. When you click on the “get Instant Quote” button, you will only view options from the top Ohio health insurers.