Buyer Beware! Fake Health Insurance Plans Can Bankrupt You

The Affordable Care Act was implemented in January 2014. Since then, rates have steadily increased each year making major medical policies very expensive. Not everyone qualifies for government subsidies which  forces them to spend thousands of dollars each year in premiums. Because of this, consumers are looking for alternate insurance options to help reduce insurance costs. Some of these alternate options look appealing due to low premiums. Unfortunately, these fake health insurance plans do not cover the 10 essential health benefits. Without the 10 essential health benefit, you can be left hung out to dry when facing a catastrophic medical bill.

Qualified Individual and Family Plans

In Northern Nevada, there are only three insurance companies in 2019 offering Qualified Health Plans to individuals and families. The three insurance companies are Hometown Health, Health Plan of Nevada, and Silver Summit (Ambetter). Depending on where you live in Nevada, you may only have one carrier available to you. Federal laws require these insurance carriers to offer the 10 essential health benefits. Also, they cannot deny claims based on preexisting conditions. Even though the premiums for these plans are high, these policies will protect you from bankruptcy unlike fake health insurance plans.

Short Term Coverage

In the state of Nevada, consumers can have a short term plan for a maximum of 6 months per year with an insurance company. These plans ask health questions and can deny benefits based on preexisting conditions. These plans can also impose limitations on your maximum out of pocket. Your maximum out of pocket protects you from catastrophic exposure. Having a fake health insurance plan that does not have a true maximum out of pocket can cost you thousands in medical bills and potentially lead to bankruptcy.

Cost Share Ministries

Cost Share Ministries require members to become a member of a church group to qualify for ‘coverage’. These fake health insurance plans do not always follow through with their promises. The Division of Insurance has confirmed that some Cost Share Ministries in Nevada denied claims because they could not afford to pay the bills. These policies have appealing membership fees, but impose even less coverage compared to the Short Term Plans outlined above.

Indemnity Plans

Indemnity Plans reimburse members based on eligible medical services received. Consumers are enticed by these plans since they do not use network lists of doctors. Because of this, members can receive health care wherever they want to and the Indemnity Plan will reimburse them for eligible medical services. Unfortunately, these fake health insurance plans do not protect consumers. Since there is no network list, members do not receive the discounted contracted rate for medical services. Furthermore, these plans usually reimburse a small amount for the services received. They also do not cover every medical service like a major medical plan. For example, the insurance company may give you $500 per day in cash for a hospital stay, regardless that the hospital stay will cost you tens of thousands of dollars per day. Indemnity plans are great policies when enrolled in a Qualified Health Plan since they will help pay for out of pocket costs. We do not recommend having an indemnity plan as your sole source of coverage.

Concierge Doctors

Due to lower reimbursement rates for physicians, some practitioners now participate as Concierge Doctors. This means that you will have to pay a membership fee to see your concierge doctor since they will not contract with any insurance plan. If you have a real health insurance plan, electing a concierge doctor can help you avoid long wait times in the physician’s office. Unfortunately, Concierge doctors do not provide insurance to protect you from major medical claims.