CalOptima warns of scammers stealing private info from O.C. senior and low-income Medi-Cal beneficiaries

Fraudsters pretending to offer free cellphone service apparently stole social security numbers and other sensitive data in a scam that has been targeting beneficiaries of subsidized healthcare throughout Orange County since last fall.

The victims received a knock on the door from someone posing as a representative of CalOptima, the agency providing health insurance to Orange County residents who qualify for Medi-Cal. The scammers tell potential victims they can use their benefits to get a free phone and wireless service. Some of those targeted shared their driver’s license, health insurance documentation and other personal records to sign up, according to CalOptima officials.

But no such program exists through the health insurance provider. The setup is “pure fraud,” Cal Optima Chief Executive Michael Hunn said Monday.

“Unless we had a prearranged appointment with you for some reason, we would never come to your apartment,” Hunn said. “We would never knock on your door. We would never come to your house. We would never ring your doorbell.”

Those getting caught up in the scheme represent Orange County’s “low-income population: a family of four making under $38,000 a year or an individual making less than $18,000,” Hunn said. They are among the roughly 984,000 people insured by CalOptima, just under one-third of the county’s 3.1 million residents.

There are publicly funded programs that offer phone and internet service. But CalOptima has nothing to do with those, nor any door-to-door solicitors.

One woman claiming to be a representative of the agency told a victim she had been sent from the government to provide them with a new phone, according to summarized reports shared by CalOptima. She took information from the resident’s driver’s license and health insurance ID card, entered it into a tablet and told them the phone should have been delivered. But they never received one.

Another person was approached by people who said they were supposed to sign their brother up for a free cellphone, but they didn’t even know his name. When the resident declined, the solicitors said they’d keep coming back unless the would-be-victim changed their mind.

“It’s alarming that people are lying about who they represent and gathering all this personal information,” supervising attorney for the Consumer Health Action Center, Sara Lee, said Monday. “Obviously, in this day and age, they can do a lot with their Medi-Cal ID number, their driver’s license, the last four digits of their social [security number].”

CalOptima began hearing about these and similar cases last fall, Hunn said. The agency immediately began alerting their members, and the number of reports appeared to subside temporarily. But new cases started popping up in January.

The publicly funded health insurance provider began operating in 1993, and has steadily gained the trust of the communities it serves over the past three decades, Hunn said. He’s concerned that the damage done by bad actors posing as CalOptima agents might cause people to mistake legitimate aid programs as a scam.

“We may reach out about a benefit that could help the [CalOptima] member and their family and their children tremendously, and they may think ‘oh this looks like fraud to me,’ and delete [that message],” Hunn said. “So when you have people knocking on doors, they’re undermining the public’s trust in us.”

Last year, Gov. Gavin Newsom signed a bill making all Californians over the age of 50 eligible for Medi-Cal regardless of their immigration status, and announced a policy that would allow all adults to file for state-subsidized health insurance. CalOptima has worked especially hard to earn the confidence of immigrant communities and hopes to increase the number of undocumented people they cover, Hunn said. Those efforts are particularly jeopardized by apparent bad actors posing as the health insurer’s employees.

Hunn and Lee urged anyone who thinks they may have been contacted by phony CalOptima representatives to reach out to them immediately to file a report and discuss methods to secure their health insurance account. However, they acknowledged that can be difficult to do for people who feel like they have been duped.

“They might feel so embarrassed they might not do anything and think ‘I was at fault for being a fool,’” Lee said. “But no, all of us are vulnerable, especially when people are pushy or trying to take advantage of you by building trust, making you feel bad or saying they’re offering all these services, whatever.”

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