Insurance regulators and an industry trade group warn that this month's rollout of the health insurance marketplaces created by federal law opened the door for bad actors at the same time that it gives brokers and agents a business opportunity.
Regulators in Washington state and Pennsylvania have told private agents to change websites that seemed likely to convince consumers they were connecting to government-run sites. Connecticut's insurance department warned agents and brokers this summer that it will take action against agents who mislead consumers or design sites to replicate the state-run exchange.
The following are tips to help you avoid fraud in the health insurance marketplace:
- Don't trust a website that asks you to enter personal data such as a Social Security number, bank account number or credit card information other than the federal exchange website, www.healthcare.gov .
- The services of navigators or certified application counselors are free, but they can't sell you a policy or recommend a specific insurance plan to buy. They can't sell you an insurance policy and should not ask you for money to enroll in a health plan.
- If you have Medicare, it's against the law for someone to sell you a plan on the insurance marketplace.
- No one should ask for your personal health information.
- Don't give your Social Security number or credit card or banking information to companies you didn't contact or in response to unsolicited advertisements. A navigator or other assister may need certain personal information like a Social Security number to help you enroll.
- Never give your personal information to someone who calls or comes to your home without your request, even if they say they are from a marketplace.
- Write down and keep a record of a salesperson's name or anyone who may assist you, who he or she works for, phone number, street address, mailing address, email address, and website.
- Don't sign anything you don't fully understand.
- It's not true that insurance premiums are only good for a limited time. Enrollment in the exchanges will be open through mid-March and rates for plans approved for sale there stay in place until then.
- If someone tells you that you could go to jail for not having health insurance, don't believe it. Beginning next year, all Americans will be required to have health insurance or face a penalty of $95 for each adult or 1 percent of family income, whichever is greater. The penalty will increase In 2015 to $325 per adult or 2 percent of family income, and rise again in 2016.
- Something that sounds too good to be true probably is.
- Consumers who suspect fraud can lodge a complaint with the Marketplace Call Center (1-800-318-2596) which will be entered into a Federal Trade Commission database used by federal and state law enforcement agencies to track potential fraud activity. Federal law enforcement officials will be able to monitor complaint activity for trends within and across all 50 states. Also contact local, state, or federal law enforcement agencies or your state department of insurance.