Home > Identity Theft and Scams > Watch Out for These Blue Cross Blue Shield Scams

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These days, when your phone rings, it’s often a call from a scammer trying to get your information. Now two phone scams are targeting those who have Blue Cross Blue Shield health insurance. The first is a phishing scam, the second is a product scam. Daniel Crowell, director of corporate and financial investigations for Blue Cross Blue Shield of Michigan, told Credit.com he is seeing scams unfold in two different ways.

Phishing Scam

If you’re targeted for a phishing scam, you might receive a phone call from someone claiming to be your health insurer. As you speak with the caller, their questions will become increasingly invasive.

“They’re trying to get your Social Security number, they’re trying to get your date of birth. They’re hoping, if they get that information, they’ll be able to open some sort of credit account,” said Crowell. “So it would be identity fraud.”

With your Social Security number, they could be able to apply for credit cards and get loans in your name. You may never know you’re getting stung if you never check your credit report or your credit scores to look for signs of identity theft. (You can get a free snapshot of your credit report, updated every 14 days, on Credit.com.) Fraudulent debts in your name could take time to reverse and negatively affect your credit score, hurting your ability to get loans in the future.

Product Scam

With the product fraud scam, callers are trying to get your Blue Cross Blue Shield contract number in an effort to get reimbursed from your insurance for a product that may not be effective. They will even have a doctor sign off on prescriptions for you, even though he’s never met you. The doctors are typically located out of the state, so they’re harder to track, said Crowell, and “the doctors have no idea what your medical history is.” The doctors may even be making a commission fee, he said.

The scammers send you the product and bill your insurance company. Sometimes it will cost thousands of dollars, which “99.9% of the time is covered by your insurance company,” said Crowell, but still could cost you money, depending on whether you have a deductible, prescription coverage or out-of-pocket expenses with your insurance coverage, he says. Their goal, in some cases, is to send you an endless supply of whatever it is they’re selling, he said.  

“The scams evolve. They’re always inventing new ones,” said Crowell.

Currently, Crowell is investigating scammer calls peddling topical creams. “It’s usually for a pain cream or a scar cream,” said Crowell. “After they get your approval, you will receive one of these creams in the mail with the prescription. The scammers will usually ask if you want automated prescription refills. “Usually the member will say, ‘No, I don’t want that,’ but for some reason, they just start getting refill after refill,” said Crowell.

Once they get your information, the orders are very difficult to reverse, he said.

The price for one of the pain creams runs $2,200 per tube and “really has no medical value whatsoever,” said Crowell. But the scammers are very good at what they do, he said. “They know how to get the right answers,” said Crowell. Those who receive the creams would be far better off by getting an over-the-counter cream at the drugstore, said Crowell.

Why it Matters

Healthcare is low-hanging fruit for many scammers. In addition to being on the hook for out-of-pocket expenses or having your credit scammed, The National Health Care Anti-Fraud Association (NHCAA) estimates that healthcare fraud can cause financial losses in the tens of billions of dollars each year, which “inevitably translates into higher premiums and out-of-pocket expenses for consumers, as well as reduced benefits or coverage.”

What to Do

There are ways to protect yourself against these would-be scammers. 

Be Suspicious. “Any time you get a call to your house asking if you’d like to try this [medication or] piece of equipment, really the first thing you should be doing is reaching out to your doctor to see if it’s something that would help you medically,” Crowell said. Callers have no connection to your medical history, so these things should be discussed with a medical professional, he said. Even calls for medical braces are suspicious, said Crowell.

Protect your Information. Make it a rule to never give your personal information over the phone or over email. “Blue Cross Blue Shield would never call our members up and ask for their personal information,” said Crowell. They might ask you for your zip code, but they’re not going to ask you for your member number or Social Security number.

End the Phone Call. If you do get one of these calls or you’re ever unsure of who’s on the phone, “just hang up,” said Crowell. It’s the quickest way to end contact with these silver-tongued scammers. Otherwise, their sly skills just might keep you on the line, and that’s when the problems begin. 

Call the Insurer Directly. If you’re slightly uncomfortable with the questions the caller is asking, you can hang up and continue the call by dialing the insurer directly. On the back of your Blue Cross Blue Shield card is the company phone number. Some states even have a fraud number on the card. Don’t dial any numbers given to you by the caller.

File a Police Report. If you feel you’ve become a victim, let law enforcement know.  

Put a Freeze on Your Credit. If you’ve unwittingly given your information to a suspicious person, notify the credit bureaus and consider putting a freeze on your credit. This blocks requests for credit pulls, even when they’re coming you, which can be cumbersome, but also helpful with regards to preventing new fraudulent accounts from being taken out in your name. 

Contact Your Attorney General. You can often file a complaint online through your state’s Attorney General website.

Check Your Credit Report These days, it’s wise to keep tabs on exactly what loans are being taken in your name by monitoring your credit. Under federal law, the three major credit reporting agencies must provide consumers with one free copy of their credit report each year. You can request your free report from all three of them — Equifax, Experian and TransUnion — once a year at AnnualCreditReport.com. 

Image: Tomwang112

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