Her voice is cheery. Her pitch sounds promising.
But insurance experts warn that health insurance robocalls offering low co-pays and premiums to all are often misleading or false.
“If it seems too good to be true, it probably is,” says Heidi Sterner, president-elect and legislative chair for the Nevada Association of Health Underwriters, a group for licensed health insurance professionals.
With the annual open enrollment period for health insurance through the state exchange now open and running through Dec. 15, Nevadans are being bombarded by canned sales calls offering the opportunity to sign up at great rates.
One recent phone call claimed to offer Blue Cross Blue Shield and Aetna plans that would help consumers “save up to 50 percent.”
“Enrollment is easy, approval is guaranteed and all ages are accepted,” a female voice says. “Press ‘one’ to be connected.” It came from a local area code, but when a Las Vegas Review-Journal reporter tried to call the number back, it was disconnected.
Blue Cross Blue Shield did not respond to a request for comment, but an Aetna spokeswoman said in an email the company wasn’t responsible for the call and stopped selling individual plans in the non-Medicare market over a year ago.
Experts say the caller’s claims are misleading at best.
Nevada Division of Insurance Deputy Commissioner David Cassetty said he’s noticed an increase in the frequency of such calls since the Trump administration announced a rule in February extending short-term, limited-duration policies.
“That prompted a lot of internet marketing and robocalls regarding those plans, not all of which were providing good information,” he said.
Heather Korbulic, executive director for Nevada Health Link, the state’s health insurance marketplace, worries these calls are taking advantage of consumer confusion over health insurance to market two types of non-comprehensive coverage: short-term, limited-duration plans and health sharing ministries.
“It’s kind of nonsense that everybody is eligible. That’s actually not true,” Korbulic said. “I think it’s a buyer-beware market.”
Short-term, limited-duration plans are meant to be exactly as their name describes. They don’t have to comply with Affordable Care Act rules and can discriminate based on pre-existing conditions. They were created to be used when a person has a gap in insurance coverage, such as when someone is between jobs.
The Trump administration expanded those plans for up to 364 days and allowed them to be renewed for three years, making them not so short-term, experts say.
Nevada’s regulations are stricter, allowing a short-term, limited-duration plan to last up to 185 days, with no renewal allowed. But Sterner said the limits still leave room for patients to be largely uncovered by their health plan for an extended period.
“My personal opinion is that short-term, limited-duration plans are good for short term. We’re talking less than 90 days,” she said.
Health sharing ministries
Health sharing ministries, on the other hand, are geared toward practicing Christians and don’t offer insurance at all. They ask consumers to pay the organizations a lump sum that they say will help pay for medical care when members get sick.
A news release from one such group in Peoria, Illinois, contrasts the “difficult and frustrating” process of open enrollment with its health care ministry.
“‘Will Other People Really Help Me Pay My Medical Bills?’ The Answer is ‘Yes!!!!!’” an email subject line reads.
That has Korbulic worried, because there’s no guarantee medical bills will get paid, she said.
“I’m very concerned consumers are going to be led into products that are not right for their needs,” she said. “And that could potentially leave them high and dry for their medical costs.”
Recommendations from the FTC
According to the Federal Trade Commission, which regulates robocalls, legitimate marketplace providers don’t cold-call consumers. In a 2016 post to its website, the agency warned that these calls might be scams seeking private information.
It’s possible to try blocking your number from telemarketers by opting out of robocalls on the Federal Trade Commission’s Do Not Call registry. According to the agency’s website, prerecorded calls are only legal if the recipient has given prior written approval. But getting on the list doesn’t necessarily stop the phones from ringing.
If you get such a call, the agency recommends hanging up. Don’t respond to directions instructing you to press any numbers on your phone, even ones directing them to add you to their “do not call” list. And report the call to the FTC.
Open enrollment under way
If you need to sign up for health insurance, Sterner and Korbulic recommend calling a licensed insurance agent.
“Everybody’s situation is different, and they should be making sure, (whatever) their anticipated needs are going to be, that they’re covered,” Sterner said.
Health plans are subsidized on the Nevada exchange for residents who make up to 400 percent of the federal poverty line, or $48,560 for an individual.
Visit healthcare.gov to sign up for a plan, or check the Nevada Health Link website at www.nevadahealthlink.com for enrollment assistance.