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With Healthcare.gov and Medicare open enrollments in swing, many Texans are shopping for health plans. The Texas Department of Insurance offers these tips to avoid scams and guard against deceptive marketing.

Verify all plan costs.

A low premium may be a sign of fewer benefits, higher out-of-pocket costs, or poor customer service. To avoid problems:

  • Ask about the deductible, copays, and coinsurance amounts. These are amounts you’ll pay when you get services.
  • If you want an Affordable Care Act (ACA) plan, go to Healthcare.gov or ask the agent to verify that’s what you’re buying. Some websites or salespeople use terms like “gold, silver, or bronze” to make plans sound like ACA plans, but they may have fewer benefits or not have to meet certain requirements for coverage. 

Be wary of cold calls.

If you didn’t make the call, don’t provide any personal information, including Social Security, Medicare, or credit card numbers. The call could be from a legitimate plan or a scammer. If you’re interested in the plan, ask for information in writing. Other ways to protect yourself include:

  • Remember that scammers can “spoof” a phone number to make it show up as another business on caller ID.
  • Ask the agent to record your discussion about plan benefits and provide a transcript or record the conversation yourself.
  • Be suspicious if anyone tries to pressure you to buy quickly or offers you a gift.

Shop smart

TDI created a shopping guide and checklist with questions to ask before you decide on a health plan.

Check complaint records.

Visit www.tdi.texas.gov and use the “See if a company has complaints” link. You can also:

  • Ask what state or federal agency regulates the plan or can help with complaints if you have a problem.
  • Get the agent’s Texas insurance license number. You can check their status at www.tdi.texas.gov or by calling TDI at 1-800-252-3439.
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