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Buyer Beware: 'Cheaper' health insurance leaves couple on hook for around $500K

Posted at 5:50 PM, Oct 09, 2019
and last updated 2019-10-10 10:11:46-04

LAS VEGAS (KTNV) — Buyer beware: a couple looking to save money by switching health insurance is now on the hook for around half a million dollars.

The Martins are learning that the devil is in the details when it comes to choosing the right plan.

"I mean, who really reads their whole insurance policy typically and do we all understand it?"

For Kelly Martin, that is suddenly a $500,000 question.

Last year, he shopped around for a new insurance company looking to save some money.

He called one agency he saw in a newspaper ad, asking about major medical and if his wife's hospital was covered in the plan.

Kelly Martin says the agent offered reassurance.

"That should be okay. He's saying it's major medical so it should be fine. So I went on his word, being an insurance agent knowing the profession knowing more than I know."

But when his wife Vickie Martin needed two trips to the ER, they learned something different.

What they thought was fully covered wasn't.

"The bills just keep piling right now. I'm probably in debt of half a million dollars. And to get out of that at my age, there's just no way."

Patrick Casale of Multicare Group USA has been helping clients for decades.

"Buying over the phone is dangerous. You really want to meet your agent in person."

And ask the right questions.

"The main question you should be asking any agent or professional is, 'Is this a qualified health plan? Does it cover the essential benefits?' If the answer is no, then you don't have to buy the plan."

Kelly Martin says anyone shopping for insurance needs to be careful and persistent.

"Make sure they look over the policy. Make sure that if something major goes on, [ask] 'Hey I have a heart attack, I need surgery, how much am I going to walk away with owing?'"

Casale is now helping Martin and is requesting voice recordings of the initial conversation from the agency to hear what was promised.

13 Action News reached out to both the agency and the insurance company but we have not heard back.