Many individuals are in search of affordable health insurance coverage that meets the Affordable Care Act (ACA), commonly known as Obamacare. However, it should be remembered that not all plans offer equal value.
Consumers should only enroll in an Affordable Care Act exchange plan during Open Enrollment or during Special Enrollment Periods. Individuals with major preexisting conditions are strongly encouraged to enroll.
1. They ask for personal information
As is typical with major policy shifts, the Affordable Care Act’s launch attracted scammers in droves. According to Christopher Budd, threat communications manager of Trend Micro security. this “is an absolute goldmine for cybercriminals.”
Be wary of anyone offering to enroll you in a health plan over the phone. If they claim they provide Medicare Advantage or Affordable Care Act-compliant plans, insist on receiving a statement of benefits from the insurer and ensure it satisfies state standards like Minimum Creditable Coverage.
Keep in mind that the Affordable Care Act established an annual open enrollment period, so any coverage outside of it must meet specific qualifying events (like losing your job, moving or getting married). Don’t provide personal data to anyone claiming they represent government or marketplace agencies without verifying who they really are as this could expose you to identity theft attempts.
2. They ask for money
As with anything related to Obamacare, confusion about Obamacare exists – and scammers have taken advantage of that confusion by targeting individuals. The Affordable Care Act exchanges were intended to be one-stop shops for purchasing individual health insurance policies via marketplace (though Medicare Advantage and Medigap plans can still be obtained through private brokers).
Consumers must keep in mind that Obamacare plans can only be purchased during open enrollment (October 15 to December 31) or special enrollment events such as losing their job, moving states or getting married.
Many consumers fall prey to salespeople offering discount medical cards and buyers clubs that do not qualify as health insurance under the Affordable Care Act (ACA). Although not regulated as insurance products, selling these may not be legal in your state – be sure to contact your state’s insurance commissioner before doing so. Recently, the FTC brought actions against health insurer Benefytt Technologies, two subsidiaries belonging to it and CEO Gavin Southwell for misleading consumers with fake health products while charging illegal junk fees that misled them into purchasing.
3. They offer non-Obamacare plans
Multiple websites claiming to sell Obamacare plans could actually be selling short-term health insurance instead. While not compliant with ACA requirements (the Trump administration has made purchasing these policies harder by restricting duration and outlawing renewal guarantees), these policies do resemble traditional medical plans in that members pay their medical expenses directly through them.
These plans are typically sold by groups that use social media and paid ad placement to make them appear like government-run exchanges, using deceptive marketing tactics which may prove very misleading for prospective consumers.
Usually if you have major preexisting conditions, an Affordable Care Act plan makes more financial sense than purchasing private non-marketplace policies despite higher premiums. Also during open enrollment it should be relatively straightforward switching plans as long as there has been a qualifying event. Before making your selection make sure the insurer is licensed by your state insurance department and that its plans meet minimum creditable coverage standards.
4. They ask for credit card information
FTC enforcement action alleges that a company and its affiliates took advantage of people searching for health coverage under Obamacare (Affordable Care Act). Reportedly, this provider offered plans that do not comply with minimum ACA requirements such as covering preexisting conditions or capping out-of-pocket costs.
Consumers may come across fraudulent salespeople offering discounted healthcare expenses through networks or buyer clubs, although these offers could potentially be legitimate if the seller holds an appropriate license from your state’s insurance commissioner.
Kiplinger recently reported that fraudsters have been targeting unsuspecting victims by impersonating navigators to sign them up for marketplace coverage, creating an urgency to enroll before enrollment periods end. Legitimate navigators won’t require payment or require personal health information; so if a high-pressure visit, call, or email comes your way regarding health insurance, hang up and contact either your state consumer protection agency or state insurance department immediately for advice.