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Protect yourself from fraud while signing up for health insurance

Posted at 9:42 PM, Nov 19, 2019
and last updated 2019-11-21 15:58:29-05

RACINE — Dennis Bobholz said as soon as he logged off healthcare.gov, his phone rang. He said the caller on the other end had an offer that seemed too good to be true.

"The caller said that he could offer me health insurance with zero deductible," Bobholz said.

Bobholz said the caller wanted Bobholz's medical history and more of his personal information.

Racine man believes he was targeted while shopping for health insurance

“Before the end of the interview, he asked me for my credit card information,” he continued.

“And he started to become very irate and insistent that I shouldn't hang up the phone, I should give him my credit card number,” he said.

Bobholz got off the phone and filed a complaint with the Better Business Bureau.

“If it's high pressured at all, stop and take a step back,” said Lisa Schiller with the BBB.

Schiller said with so many consumers shopping for health insurance during open enrollment, it's a good reminder to be extra critical of a caller especially if they're being pushy.

“You want to know who you are speaking with, you want to know the company, where they are located, their phone number, complete address, street address and look that information up,” Schiller said.

In Bobholz's case, the company the caller claimed to be with, "Priority One Healthcare" is a legitimate business based in Saint Louis. A spokesperson for the company told me it doesn't even offer healthcare plans to people outside of Missouri. A representative for the company also provided the statement below to TODAY’S TMJ4:

Thank you for giving us an opportunity to voice our side of the story you are currently working. My business partner and I started our company in 2011 for the sole purpose of helping the elderly and disabled in their homes. We started out with one contract from the state of Missouri covering 3 counties and have grown to working 7 counties in the state of Missouri and we have added 4 more contracts with the state and we are currently opening an adult daycare. All of our business is done through the state therefore, we do not take any money from our clients. It is a Medicaid based program, so all of the home care that our clients receive come from the benefits of Medicaid. We provide home care service and the state reimburses us for the time we are in client’s homes. We do not provide any insurance policies and would never ask for any money from a client for any service we provide. We provide service in 7 counties only and cannot service anyone outside of those 7 assigned counties in Missouri let alone reach out to anyone in Wisconsin to solicit for home care service. We have an A+ rating with the BBB and would not do anything to jeopardize that rating. We follow all rules and regulations from Missouri and send in quarterly audit reports on our clients. We are not in the business of cheating and/or scamming anyone for any reason and definitely not the elderly or disabled. If you have any additional questions, please let me know. Again, thank you for your time in this matter.

“Phone numbers as we know can be very easily spoofed. So, you can't even trust that who is on the other end of the line is who they are saying they were,” Schiller said.

TODAY’S TMJ4 reached out to U.S. Centers for Medicare and Medicaid Services. The federal agency manages healthcare.gov. A spokesperson provided the following statement:

“CMS takes protecting the privacy and security of consumer information when using HealthCare.gov very seriously. The agency does not sell any information entered into HealthCare.gov. For more information on HealthCare.gov privacy policy, visit their website.

Periodically, consumers may receive prerecorded phone calls from the Marketplace with important information such as deadlines and actions they may need to take about their coverage. Messages from the Marketplace are always identified as coming from a Marketplace representative or the Health Insurance Marketplace. We would not represent ourselves as “Priority One Healthcare.” If consumers suspect they may be receiving spam or fraudulent calls from other entities, they can report that to the Marketplace Call Center or the Federal Trade Commission (FTC). HealthCare.gov provides additional tips and resources for consumers to protect them from fraud.