FTC Cracks Down on Fake Health Plans

Cheryl Clark, for HealthLeaders Media , August 12, 2010

CHBA also said the plan was accepted wherever Blue Cross Blue Shield was accepted and consumers could use their discount card with any health care provider that accepts insurance.

"Consumers paid between $29 and $280 in enrollment fees before they received written information about the plan," the FTC says. "When they tried to use the plan with physicians CHBA claimed were 'participating providers,' the providers said they did not accept the plan.  One consumer who tried to use the plan to buy prescription medicine discovered the 'discounted' price was higher than the price she had paid without the medical discount plan."

In the second case, a U.S. district court, at the FTC's request, ordered Health Care One LLC to stop marketing a discount plan that it "disguised as health insurance," the FTC says.  "Health Care One's promotional material implied that it was affiliated with the federal government and claimed that consumers who enrolled in the plan would receive substantial savings on health care costs."  In fact, those savings weren't possible.

Health Care One also claimed its plan was widely accepted by health providers in the consumers' communities, "but when consumers tried to get discounts from their providers, they discovered that the providers did not accept the plan."

"Health Care One induced consumers to pay hundreds of dollars to enroll by promising '100% satisfaction' and a 'money back guarantee,' " the FTC says.

Additionally, consumers found that it was difficult (if not impossible) for consumers to cancel the plans. If they did get their money back, a hefty processing fee was withheld.

Health Care One LLC and its affiliates were the target of charges in February filed by the California Department of Managed Care, the state agency governing managed care plans, which also accused the company of fraudulently selling discount health plans. The DMHC issued a cease and desist order for operating without a required license and for misleading consumers into thinking they were buying health insurance, which they were not.

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