“Ask a Social Worker” is a regular column featuring questions from the community and answers from members of NBDF’s Social Work Working Group. If you have questions for our social workers, send them to [email protected].
Dear Alice,
I need to choose a health insurance plan because I don’t have insurance through my employer. How can I recognize and avoid fraud or scams when looking for a plan?
Whenever you are looking for health insurance outside of an employer-sponsored health plan, you will most likely face many questions. What insurance should I choose? How do I choose? And where do I start? What should I know if I’m changing health insurance companies?
Unfortunately, this is the stage when you may be most vulnerable to scams and fraud as finding insurance can be confusing and overwhelming, especially when you need coverage for a bleeding disorder. These tips can help ensure that you obtain legitimate health insurance:
Most, but not all, government websites end in .gov.
If you’re looking for health insurance through the government’s Health Insurance Marketplace, the web address is HealthCare.gov. The official site for Medicare is Medicare.gov. However, keep in mind that the website for your state’s health insurance exchange may not end in .gov. Be cautious of websites that display .gov on their pages but not in their address bar, as these are often the telltale sign of a scam.
A low premium is likely too good to be true.
If you go to sign up for insurance and the premium (the amount that you pay for health insurance per month) seems too good to be true, it probably is. Health insurance premiums are not in the $2- to $15-per-month range. In 2024, the average monthly premium for an individual through the Health Insurance Marketplace was $635. (This average doesn’t consider premium tax credits and subsidies that can reduce plan costs based on household income.)
Watch out for telemarketers.
Be wary of people who call you and say they are insurance agents, as they’re usually not legitimate. These “agents” often use tactics to try to persuade you to sign up for a fraudulent or nonexistent plan. The strategies include verbally pressuring you to decide on a plan quickly, demanding payment or personal information, and giving evasive answers regarding deductibles, copays, and premiums.
Talk to your hemophilia treatment center (HTC) social worker.
If you’re unsure if the insurance policy you’re being offered is a scam, your HTC social worker can help you navigate the situation. They can also help you connect with a reputable insurance broker or navigator, and help determine if your state’s Medicaid program offers specific support or exemptions for individuals with chronic health care needs.
Report fraud promptly.
If you do fall victim to or come across a fake health insurance plan, you can report it to the Federal Trade Commission at ReportFraud.ftc.gov. They will help you with the next steps.
- Alice Cakebread, MSW, LMSW
Cakebread is a social worker at the University of Michigan Hemophilia and Coagulation Disorders program in Ann Arbor and a member of the Social Work Working Group.