Transcript for: Undercover GAO Special Agent Seeking Health Insurance for the
Pre-Existing Condition of Diabetes - Audio Recording 2

Description: The sales representative we spoke with engaged in
potentially deceptive marketing practices by misrepresenting and
omitting information. 

Related GAO Work: GAO-20-634R, Private Health Coverage: Results of
Covert Testing for Selected Offerings

Released: September 2020

[ Title on on screen: ]
Undercover GAO Special Agent Seeking Health Insurance for the
Pre-Existing Condition of Diabetes

Audio Recording #2

[ Title on screen: ] 
The sales representative we spoke with engaged in potentially deceptive
marketing practices by misrepresenting and omitting information. 


[GAO Special Agent:] Did you find anything?

[Sales Representative:] Now, the one, the cheapest one I've got here is
$201 a month, and 31 cents.

[GAO Special Agent:] That's fine.

[Sales Representative:] Okay. This is what you qualify for based upon
your income, which you just qualified for, you barely qualified but you
did. For all your emergency rooms and medically necessary services, you
qualify at 100 percent coverage, no deductible. That's all through your
local hospitals there, for all your medically necessary services and ER
visits. Okay.

[GAO Special Agent:] Okay.

[ Title on screen: ] 
Plan documents we obtained stated that there were no benefits for
emergency room treatment.

[Sales Representative:] Now, medications are zero to $25 copays, 90-day
supply. So -- and your medications, taking diabetic meds are 100 percent
free for you. You just get a 90-day supply. The only thing is you'll
have to go to the doctor's office that prescribes the medications
because that's where they will send your meds to, because it is
refrigerated medication. But you've got to pick them up, but it's free
for you. You don't pay nothing. It's a free program. So zero cost for
your meds. 

[ Title on screen: ] 
Plan documents we obtained stated that we were enrolled in two
non-insurance prescription discount programs that would not provide us
with our prescription for free.

[Sales Representative:] Okay. Doctor visits, if your doctors are part of
the local hospital there, that's fully - that means they fully work for
and pay through them, you pay between zero to $10 copay. Outside of
that, if it's outside of the hospitals, then you're looking at between
20 to $50 a visit. 

[GAO Special Agent:] But let's say my doctor, I go to his office, which
is outside the hospital, but he still works in the hospital at times,
how's that work?

[Sales Representative:] If he works for it, though, as long as he's
affiliated with the hospital, he's 100 percent affiliated, he could be
an - he could have his own outpatient, as long as he's still networked
to them, yes, if he is. 

[GAO Special Agent:] Okay.

[Sales Representative:] or she. 

[GAO Special Agent:] Okay.

[Sales Representative:] But if he's out of that network, it's 20 to $50
a visit. So he's still covered, no matter what.

[ Title on screen: ] 
Plan documents we obtained did not guarantee the amount we would be
required to pay for doctor visits that the sales representative quoted
us.