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California Targets Medical Discount Plans

State officials seek new licensing regulations

By Mark Huffman
ConsumerAffairs.com

February 8, 2010

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For the self-employed and the unemployed, finding good, affordable health insurance can be a challenging task. Consumers who mistake a medical discount service for a health insurance policy can wind up losing money and still having no insurance.

In California, state regulators have begun cracking down on discount health and dental plans that consumers say they are led to believe are insurance plans. The marketers of these medical discount plans, meanwhile, insist there is nothing misleading in their pitch.

California is not the first state to take on medical discount plans. In Massachusetts last September, Attorney General Martha Coakley filed proposed new consumer protection regulations designed to protect residents of the Bay State from unscrupulous marketing of plans that claim to offer discounts on medical products or services.

The problem was greater in Massachusetts, perhaps, because the state had passed a law requiring all residents to have health insurance.

“It is critical that companies who offer any kind of medical coverage plans or medical discount card clearly disclose what their plans do and do not offer, and whether they fulfill the individual mandate." Coakley said at the time. "We have received numerous complaints from consumers who have fallen victim to these deceptive discount plan scams."

The complaints are also being heard in California. Health officials say medical discount plans are being pushed the hardest in poor communities. The worst offenders, they say, are fraudulently marketing themselves as low-cost insurance.

"They're basically cheating poor people," Dr. Dev GnanaDev, immediate past president of the California Medical Association, told the Los Angeles Times.

After receiving more than 150 consumer complaints about misleading medical discount pitches over the last four years, the California Department of Managed Health Care is asking for new licensing regulations.

Department officials say a number of plan marketers have promised consumers unrestricted access to medical providers, when in fact the cards were worthless.

At best, a medical discount card will offer patients a negotiated discount for services with participating medical service providers. If you go to a doctor or hospital or doctor that has an agreement with the medical discount plan, you would receive a discount.

However,it is a fact that health care providers routinely discount their services -- often at an inflated price to start with -- for patients who lack insurance, or who must pay a large deductible out of pocket. So in some cases, an uninsured patient might get the same break as someone who had paid for a medical discount card.

The Times reports the industry trade group that represents the medical discount plan industry is also pushing for regulations, to keep "bad actors" out of the business and damaging the industry's reputation. With California's unemployment rate high and still rising, state officials say it's a fertile environment for those tempted to blur the line between health insurance and a medical discount plan.

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