obamacare-fraud

The Patient Protection and the Affordable Care Act (ACA, aka “Obamacare”) was signed into law in 2010. After five years, most people are not clear about how this program works and how is supposed to lower our health insurance costs. Due to the level confusion and misinformation about this program there is a high risk for fraud to be committed.

For example, last year the GAO released results of their investigation which concluded that it was possible to obtain health insurance coverage with fake ids. Also, there has been reports in Massachusetts, Kansas and Alabama (to name a few) where scammers have marketed fake health insurances policies, created fake Web sites that claimed to sell Obamacare, and posed as government employees to con consumers into divulging their bank account numbers in order to sign up for “Obamacare”. This is just a small sample of the current situation and only of the cases that become public information.

Obamacare scams come in different flavors from scammers offering medical insurance plans for as little as $29.95 per month, to con artists contacting elders by phone, fax, email and even in person. A common version of the scam involve fraudsters claiming to be from the federal government and directing consumers to purchase insurance cards in order to be eligible for coverage under the ACA. Also, these criminals intimidate consumers by using words like “it is the law”, “the government now requires it” or “jail time if they don’t purchase their medical insurance cards.

 

Signs of Obamacare Fraud:

 

1. New Medicare Cards – The ACA doesn’t require new Medicare cards.
2. Medicare calling – Medicare doesn’t call seniors. Also, seniors with Medicare already have insurance, so they don’t need coverage under Obamacare.
3. Jail time – There is a penalty to those who remain uninsured and do not qualify for any exemptions.  However, there is no jail time for not having Obamacare. For more information on the individual shared responsibility provision of the ACA, click here.
4. Unsolicited phone calls – The federal government and state insurance departments don’t contact individual consumers to sell them insurance. Do not give any sensitive information to anyone who claims to be with the federal government, your state insurance department or a navigator for your state’s exchange.
5. Limited time offers – Enrollment in the exchanges will be open from Oct. 1 to March 31, and rates for plans in the exchanges are approved for the entire enrollment period. Be skeptical of someone who is trying to pressure you into buying a policy because the rate is only good for a short time.
6. Request to wire money –  If someone claiming to be with Obamacare or another federal program asks you to wire money, give out your bank account number or load funds onto a prepaid card, it’s a scam.
7. Fake navigators and other helpers – Real navigators, who have been specially trained and certified, cannot charge you for their services. They exist to help you find the best health insurance coverage for your situation. The FTC reminds consumers never to give money to people who contact them.
8. Fake medical discount plans – Beware of discounted health care products to save you money and still meet Obamacare’s minimum essential coverage requirements. These discount health care products are not health insurance, though some companies may illegally advertise them as such. Legitimate medical discount plans are memberships that may get you reduced prices on certain health care products, services and procedures, as well as prescriptions and provider visits. Fraudulent medical discount plans are designed to gather personal and financial information.
9. The “insurance agent or broker” is collecting a fee – Health insurance agents and brokers are paid by health insurance plans, not by consumers. There is no need to pay a fee to obtain health insurance coverage.

 

Protect yourself from Obamacare scams:

 

Remember that knowledge is power. Defend yourself by gaining a better understanding about   qualified health insurance coverage and navigators. Consumers can better protect themselves from Obamacare scams by following some suggested preventive measures:

1. Get informed about how the health reform affects you. The Center for Medicare and Medicaid Service’s HealthCare.gov Web site is a great place to start.
2. If you received an unsolicited phone call, email or fax claiming that you need to purchase a new Medicare card or update your personal information (such as your Social Security number, date of birth or other sensitive information) because “it’s the law,” simply hang up and report the event to the FTC.
3. Be careful of phishing sites made to look like official insurance exchange Web sites. They may contain the actual seal of the real insurance exchanges, but likely simply exist to load malware onto your computer or collect your personal information.
4. In the event that you inadvertently divulge personal information to an Obamacare fraudster, inform your banks, credit card providers and the three major credit bureaus so that they can be on the lookout for potential identity thieves.