(Note: The pdf for the issue in which this article appears is available for download: BIFOCAL Vol. 35, Issue 1.)
On September 19, 2013, the Federal Trade Commission (FTC) held a Roundtable event on “Consumer Protection and the Healthcare Marketplace” at its Conference Center in Washington, DC. This conference centered around the recent uptick in consumer fraud to coincide with the roll-out of the Affordable Care Act (ACA). Mila Kofman, the Executive Director of the DC Health Benefit Exchange Authority, noted that historically there has always been an increase in scams after a change to the health care system, as well as when the economy has taken a downturn.
While panelists assured attendees that law enforcement is ready to deal with these problems, the combination of the ACA with ongoing national economic challenges has resulted in a large increase in fraudulent activities.
Seniors are a particular target for scammers. Criminals often use a grain of truth that is “ripped from the headlines” to confuse seniors. Richard Goldberg, the Assistant Director of the U.S. Department of Justice, Consumer Protection Branch, described several scams that law enforcement agencies have already spotted.
In one scam, telemarketers called seniors seeking personal information so that they could send a new Medicare card or a “national health insurance card.” They told seniors they were required by law to give out data such as their social security number or bank account information. In reality, there are no such requirements in the ACA. So how can seniors protect themselves from scammers?
There are places to find good information and get help
- Those looking to shop for legitimate insurance on the Health Insurance Marketplace can go to www.healthcare.gov.
- Anyone who thinks they’ve been the target of a scam can call the Federal Trade Commission at 1-877-FTC-HELP or go to www.ftc.gov/complaint.
- You can also contact your state insurance commission through www.naic.org/state_web_map.htm, and report Medicare fraud at 1-800-MEDICARE.
- Those looking for more information on health care scams targeting seniors can visit the AARP’s website at: www.aarp.org/fightfraud.
Here are a few key tips to help figure out if someone is attempting to defraud you:
- They call you and say they’re from the government
The government will never cold call seniors or sell insurance door to door. Some government agencies may send you a letter, but they will never ask you for a credit card number, or for you to “confirm” your social security number. Anyone calling, sending an email, or a texting a senior and saying they are from the government and want to talk about health insurance is a scammer.
- They try to charge for helping you find insurance
While there are certified Navigators who can assist eligible individuals in finding health insurance in the new Health Insurance Marketplaces, they are specifically prohibited by law from charging fees for their services.
- They say you need to pay a fee for a new “Insurance Card”
There is no such thing as an “Obamacare Card,” or any other new card that seniors need to purchase in order to continue receiving insurance. Some scammers may say seniors need to pay a fee for a new Medicare card in order to continue receiving benefits under the program, but in reality Medicare is unaffected by the ACA.
- They offer a “limited time” insurance special
Some fake insurance agents may claim you need to “act now” to get a special rate on your insurance, to avoid a penalty, or to keep Medicare benefits. If you have Medicare, the enrollment rules and period have not changed. While there are some insurance agents who can help you find a plan through the Marketplace, never give any personal information to someone who contacts you unsolicited. ■