Don't be duped by fake health discount plans

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Medical equipmentTelevision ads promote health discount plans in a duplicitous way to make them sound like insurance, but in reality, they're no more than a discount off the bill if you go to a member provider. You could still be stuck with thousands of dollars in health costs.

Unfortunately, Mary Lloyd found out the hard way when she and her husband signed up for a plan from Cinergy Health after seeing an ad that she could get health coverage for as little as $5 a day. She checked it out because her husband was set to retire, and health insurance was going to cost them $1,200 a month to continue his coverage. She got a quote for one plan that sounded good at $588, but was switched to a cheaper plan during the sales process when she did not get acceptance from the higher-priced plan. The key problem: The higher priced plan was true insurance, while the lower priced plan turned out to be a discount card.Unfortunately, Mary Lloyd didn't notice the difference until she tried to use the insurance card after her husband had a heart attack. When she showed it to the hospital business office, the agent told her it wasn't insurance--it was just a health discount card. She was stuck with a $67,000 bill. After many calls, she found out she was only entitled to a $15,000 discount. Mary has since signed up for real insurance, but she's still figuring out how to pay the difference on her bill. She asked the state Attorney General's office for help, but hasn't gotten any yet.

How can you avoid getting duped by these make-believe discount plans? First of all, be sure to get a copy of the plan in writing and read all the small print. If you see the phrase "this is not an insurance plan" anywhere, cancel it immediately. Most of these scams will indicate it's just a discount card and give you a list of providers that accept the discounts.

My AARP supplemental health insurance plan comes with a discount plan, but most times I can't even find a provider that will accept the discount. I had to give up my traditional comprehensive insurance when the price jumped from $700 per month to $1,200 month (and that was a Florida small business group) with a $3,000 deductible, but at least the AARP supplemental plan does pay a bit more than the discount plans.

Many people over age 50 get rejected from individual insurance plans because they have preexisting conditions. If they do get acceptance, it's with conditions that don't include coverage for those conditions. In fact, a lot of retirees decide to go back to work when they realize they can't get health insurance.

I live in fear that I will need extensive medical care, but I just keep hoping a health bill passes Congress before that happens that enables me to afford insurance at a more reasonable price. Right now, my medical costs do not exceed $2,000 a year, but if I get sick, I'll be in the same boat as the Lloyds.

So how can you avoid being surprised by these discount plans? Be sure you ask the right questions:

* Ask whether the plan is an insurance plan or a discount card. Be sure your bills can be submitted for payment by the doctor and that you won't have to pay the bills upfront and then get a refund (or discount) from the company.

* Don't get caught up in slippery sales pitches, such as: "Save up to 60 percent on health care," "Affordable health coverage," "Long term care discounts."

* Carefully read the fine print and be sure it matches what the salesperson told you.

* Find out which medical conditions are covered and which aren't. Make sure you're getting insurance for the treatments you'll need.

* If you do knowingly buy a medical discount card, make calls to your area providers and be sure they know the plan and will provide services at the discount promised.

* Be sure there aren't administrative fees each time you use the card. These fees can eat up your discount.

* If the salesman won't answer your questions, or evades them, just hang up the telephone.

* Don't give out your credit card number or checking account number until you understand the details of the plan. Your card could be charged or your checking account debited even if you decide not to sign up for the plan.

* Know the cancellation rules. Be sure your fees are refundable if you decide to cancel and find out how you get that refund before you give them your credit card number or checking account number.

* Contact your state insurance department or the Better Business Bureau to see if there are any complaints.

If you do suspect a scam or fraud, tell your state insurance department and Better Business Bureau. You may find out that your insurance department does not regulate discount cards, but they can refer you to the right authorities.

Lita Epstein has written more than 25 books, including Working After Retirement for Dummies.
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