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As the debate rages over who benefits from the Affordable Care Act, one thing is becoming clear: The controversial program is a dream come true for con artists.
Consumer experts warn that the program has created a huge opportunity to swindle people – steal their money and snag their sensitive personal information.
“Any time you roll out a big government program like this, confusion is inevitable,” said Lois Greisman, an associate director in the Bureau of Consumer Protection at the Federal Trade Commission. “This confusion creates a tremendous opportunity for the fraudster.”
Scammers have been at it for more than a year now, but consumer advocates and security experts warn that the problem will worsen as we get closer to Oct. 1. That’s when the millions of uninsured Americans can use a health insurance exchange – set-up by their state or the federal government – to shop for coverage.
“I believe the incidents are going to skyrocket as that date approaches,” said Eva Velasquez, president and CEO of the non-profit Identity Theft Resource Center. “And even people who are smart and savvy could get taken, so we are very concerned about the potential for some serious financial harm.”
The Affordable Care Act created a Health Insurance Marketplace – also referred to as the Health Insurance Exchange. Policies in the exchange have been preapproved by each state’s insurance commissioner.
“There are fake exchanges already up and running on the Internet,” said Monica Lindeen, Montana’s Commissioner of Securities and Insurance. “If you do a search and type in ‘exchange,’ you’ll find all sorts of websites that claim to be in the exchange when they are not.”
These health insurance exchanges don’t open for business until October 1, so no one can sell you insurance through an exchange until then.
Scam artists got an early jump on national health care reform. Since last year, they’ve been calling, faxing and emailing people across the country claiming to be with the Medicare or ‘Obamacare’ or some part of the federal government.
They often say they need to “verify” some personal information – typically a bank account or Social Security number – to ensure you get the proper benefits. In some cases, they tell the victim they need to purchase a new insurance card to be eligible for insurance under the new program.
According to John Breyault, who runs Fraud.org , a project of National Consumers League, these scammers can be very intimidating, especially to seniors.
“We’ve heard about cases where the scam artists have threated people with jail time if they don’t purchase the fake insurance cards,” Breyault said.
Americans don’t need a new Medicare card and no one from the government is calling and asking for personal information or money. Under the individual mandate provision of the Affordable Care Act, people who don’t buy health insurance could get hit with a financial penalty, but that does not take effect until 2014. There is no jail penalty in the law.
A con artist can claim to be anyone, for instance a “navigator” who can help you apply for health care coverage through an exchange. They gain your trust and then ask for personal information to buy non-existent policies. Fraud.org reports that some victims have been convinced to wire money or send funds via prepaid debit card to get their full benefits.
Thousands of “navigators” are being trained and certified to guide you through the process of applying for coverage through the new exchange program. These navigators are prohibited by law from recommending a particular plan. They will never ask for personal information and they will never ask for money in any form. The navigator program hasn’t started yet, so no one is making calls.
Don’t get taken
You can't sign up yet, but you learn about your choices at HealthCare.gov, the site run by The Center for Medicare and Medicaid Services. You also want to start your search here if you live in one of the places (17 states, District of Columbia, Guam or American Samoa), that set up its own insurance exchange. Customer service representatives are available at 1-800-318-2596.
These tips, provided by consumer groups and government, will help you spot a fraud:
- There is no card associated with health care reform.
- There is no new Medicare card and you do not have to update any personal information.
- The Health Insurance Marketplace (those exchanges) doesn’t open until October 1, so you can’t buy coverage under the Affordable Care Act until then.
- Don’t respond to a cold call of any kind, especially one that asks for personal information or money. And don’t trust your Caller ID; it can be spoofed to make it look like the call is coming from a government office.
- Don’t let anyone rush you. The rates in the exchange have been pre-approved and won’t change during the initial enrollment period, Oct. 1 to March 31. Anyone promising a “special price” or “limited time offer” or who tells you “spots are limited” is lying to you.
The FTC’s Lois Greisman urges you to file a complaint if you spot a problem, get a suspicious call or fall victim to a health care insurance con artist.
- Health Insurance Exchange Scam Alert: Beware of Fake Websites
- Obamacare confusion providing opening for con artists