This article has been updated
Jill Goodridge was shopping for affordable health insurance when a friend told her about O’NA HealthCare, a low-cost alternative to commercial insurance.
The self-described “health care cooperative” promised a shield against catastrophic claims. Its name suggested an affiliation with a Native American tribe — a theme that carried through on its website, where a feather floats from section to section.
The company promises 24/7 telemedicine and holistic dental care on its website. It says it provides more nontraditional options than “any other health care plan,” including coverage for essential oils, energy medicine and naturopathic care. All of that and conventional care, too.
It struck Goodridge as innovative. She signed up for a high-deductible plan, paying more than $9,000 in premiums and fees over 13 months, she said. Yet she could not get O’NA to cover her family’s medical bills. For example, O’NA applied only a small portion of more than $6,000 in hospital-related bills against her $10,000 deductible.
“It almost seemed like we were just spending the premium money every month for really not much,” said Goodridge, whose family runs a Rockland, Maine, restaurant that is temporarily shuttered because of the coronavirus pandemic.
A year-long investigation by the state insurance agency prompted by her complaint concluded she was right, uncovering a business scheme operating in the gray areas of insurance regulation and tribal law to appeal to patients looking to save money on health care.
Hers is a cautionary tale for anyone looking for cut-rate coverage at a time when the cost of commercial insurance is rising and a wide range of alternatives are on offer.
Tempting low premiums may mean skimpy coverage with huge out-of-pocket expenses.
“Health insurance is getting so expensive people are looking for other options,” Maine insurance Superintendent Eric A. Cioppa said. “We tell everybody that if you do business over the internet to call us first and make sure it’s licensed.”