Health insurance fraud in the United States is becoming increasingly common. Unscrupulous agents use clients' personal information to earn commissions and create policies without the client's authorization.
Similarly, they deceive people with the idea that they will have cheap health insurance by declaring lower income than reality, and this brings severe consequences for the client when it comes to filing taxes.
Sincerely, we advise you to read this post. At Dulcinea Insurance, we have always preached truth and honesty, and that's why thousands of clients certify our services in most states across the country. Here you will find described, at your fingertips, the tricks that agents and agencies use to steal client information. And we will teach you the steps you should take to report such an illegality to the Insurance Marketplace.
If you have any questions left, we will gladly help you at the phone number 786-910-9487. A licensed insurance agent will guide you through each of the matters you need. And we will help you with three important weapons: in Spanish, for free, and with total transparency and sincerity.
Most Common Health Insurance Fraud
One of the most common frauds in health insurance is omitting the client's actual income so that they receive low-cost health insurance. Since everything in the Health Marketplace is based on the Obamacare income chart, where a lower price and better coverage are granted if income is lower, some dishonest agents decide to declare an income for the client close to 100% of the Federal Poverty Level so that they receive the highest possible tax credit.
Now, if the client declares, for example, $15,000 in income on their health insurance and actually earns $30,000, they are receiving a larger subsidy than they should receive, and when filing taxes the IRS will notice the difference and will ask the client to return the excess subsidy received for the health insurance on their taxes.
Another fraud in health insurance is entering the client's incorrect immigration status. For example, a person who does not have legal status in the country cannot qualify for Government subsidies within Obamacare insurance.
However, many dishonest insurance agents fail to comply with this rule and provide coverage by inserting a false immigration status into the policy declaration without the client's authorization. With this the client is receiving a subsidy that they are not entitled to, and by not providing proof that justifies the declared immigration document, after three months the Health Marketplace cancels their coverage. This health insurance scam is also very common, because with it agents guarantee their commission for three months.
Insurance agent strategies that scam customers
Dishonest and fraudulent medical insurance agents exist. Many risk their licenses, commit serious fraud, and scam clients in pursuit of a commission. Here's a summary of the most common cases of insurance fraud and scams committed by some «thieving agents»:
- They call the customer and pretend to be their current authorized agent to obtain their personal information and modify or create a new policy.
- They mislead the customer by saying their current health insurance has certain problems and that they are responsible for fixing them.
- They pose as the Health Market and the medical insurance company to deceive the customer.
- they obtain customer information and create applications in the Insurance Marketplace without the customer's consent
The saddest part of the situation is that there are some dishonest health insurance agencies and agents who duplicate policies in the marketplace. They create these by changing the customer's phone number, email, and address so that the customer doesn't receive confirmation that they have an active insurance policy. Therefore, the only time the customer finds out they had this unauthorized health insurance is when they file their taxes and have to repay the tax credit.
Ways to Avoid and Report Health Insurance Scams
We advise you to avoid health insurance fraud in the United States in the following ways:
- Verify the license of the agent and the agency that will be providing your health insurance application. Confirm that they are legitimate, honest, and possess actual knowledge of the subject.
- Save your health insurance agency's phone number, email, and address so you can contact them in any situation.
- Do not answer calls or give personal information to anyone other than your insurance agent, the company, or the Health Insurance Marketplace.
From Dulcinea Insurance, we are here to help you. As you can see in this post, our mission is to always be transparent with our clients. We hope we can help you as you need, whether it's to get an insurance quote, make a change to your policy, or sign up for one from scratch. We will gladly help you for free from the 786-910-9487.
