Avoiding Fraud in the Obamacare Exchanges - Healthpocket

Avoiding Fraud in the Obamacare Exchanges

Consumers that are concerned about fraudulent activity within a health insurance exchange can protect themselves by being aware of some requirements and guidelines that have been established under the Affordable Care Act (ACA), also referred to as Obamacare. The exchange has established a call center number to report fraud concerns and the White House has promised rapid response measures to address privacy and cybersecurity threats associated with the state exchanges.

Common sense and education will protect many consumers from becoming victims of healthcare scams or identity theft. If you have any uncertainty about a third party assisting you with health insurance, remember not to sign anything you don’t fully understand. Additionally, never provide personal information such as your Social Security number or banking information if you have any reservations as to whom you are providing this information to or how the information will be used.

The federal health insurance exchange, also known as a “marketplace,” provides call center support that can be reached at 1-800-318-2596. TTY users should call 1-855-889-4325. These phone numbers can be used for general questions as well as the report of fraudulent activity. If you suspect that you may have been the victim of fraud, contact options include the call center, the Federal Trade Commission, or your local police department.

The open enrollment period for Affordable Care Act health plans is from October 1, 2013 through March 31, 2014. Consumers may not enroll in plans from April 1 through September 30 unless they experience special circumstances. Examples of these are moving to a new state, certain changes in income, and changes in your family size (for example, if you marry, divorce, or have a baby).

State exchange websites and printed materials will bear official government seals and logos. Exchanges have trained assisters or navigators in every state to help you apply for exchange health plans at no cost. You should never be asked to pay for this assistance. Additionally, no legitimate navigator will “cold call” to sell you a plan, ask you for your personal health information or threaten you with legal action if you decline to enroll in a plan.

The ACA does not use healthcare “membership” or “Obamacare” cards or require current Medicare enrollees to obtain new Medicare cards. Medicare members will not lose their health coverage or access to their doctors because of ACA requirements.

Examples of fraud related to the Health Insurance Marketplace include activities like the following examples:

  • A stranger contacts you about getting health insurance and asks you to pay or asks you for your personal financial or health information
  • Someone contacts you claiming to be from the government or Medicare and asks you to pay for a new “Obamacare” or Medicare insurance card
  • You give your bank account information or Social Security number to someone who calls you and says they’re from the government

If any of the above occurs or a similar situation arises, the events should be reported immediately. If you fall victim to one of these scams, it is advised that, in addition to alerting authorities, you should contact all three major credit bureaus and place a fraud alert on your credit report.




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