Attorney General Chris Koster and the Missouri Hospital Association (MHA) are teaming up to educate Missourians about possible scams surrounding the new federal Health Insurance Exchange plans that begin enrollment on October 1st. As part of the Affordable Care Act, an insurance marketplace, commonly referred to as an exchange, will provide individuals with options for private health insurance coverage to comply with the law’s minimum essential coverage requirement.
"As with any new system, scam artists may prey upon consumers who are attempting to comply with the law," said Koster. "My concern is that scammers will use the insurance coverage enrollment period opening on October 1 as an opportunity to commit fraud."
Consumers seeking insurance coverage through the exchange will need to provide personal information in order to determine which plans are available to them and to sign up for health insurance coverage. Missouri Hospital Association President and CEO Herb Kuhn warns that scammers may attempt to con people into thinking that they are enrolling in a marketplace insurance plan when they are not.
"Scammers may trick consumers using phony websites, mailings, calls, or visits to the home," said Kuhn. "We want Missourians to be on the lookout for fraudsters asking consumers to provide personal information or to take steps that are not actually required."
Scammers could use personal information to commit financial identity theft, medical identity theft, or insurance identity theft. Financial identity theft is when a scam artist steals your information to access your accounts or to open a line of credit in your name. Medical identity theft happens when the scam artist gets medical treatment by using your information. Insurance identity theft is when someone uses your information to sign up for coverage.
In an attempt to prevent Missourians from becoming a victim of these types of identity theft, Koster and the MHA offer the following tips:
- Beware of people asking for money to enroll you in the Marketplace, "Exchange," or "Obamacare" insurance. Legitimate enrollment assisters will NOT ask for money. Especially be wary of anyone offering to sell Obamacare insurance cards. Scammers could try to sell you an insurance card without enrolling you in an insurance plan.
- Check Credentials. Ask anyone who wants to help you enroll to verify their affiliation. In addition to your licensed insurance agent, there are two new types of licensed assistants who can also help you take the steps necessary to sign up: Certified Application Counselors and Insurance Navigators.
- Certified Application Counselors are part of organizations, such as hospitals, that have been certified by the Center for Medicare & Medicaid Services.
- Insurance Navigators are licensed with the Missouri Department of Insurance, Financial Institutions and Professional Registration (DIFP).
- To learn whether the person assisting you is legitimate, call 1-800-318-2596, the number for the CMS Marketplace assistance. It is available 24 hours a day, seven days a week. There are two Missouri websites that provide legitimate information only – enrollmissouri.org operated by the Missouri Hospital Association and covermissouri.org operated by the Missouri Foundation for Health.
- Don’t be swayed by high-pressure visits, mail solicitations, e-mails, and phone calls from people pretending to work for the government. No one should threaten you with legal action if you do not sign up for a plan. Always ask for identification if someone comes to your door.
- Only provide personal information if you initiate the contact. People who contact you seeking personal information may be trying to steal your identity. No one from the government will call or email you to sell you an insurance plan or ask for personal information. Be careful when giving out personal information, such as credit card, banking, or Social Security numbers.
- Communicate directly with the Official Exchange. Unless you are using a licensed insurance agent or assistant, the only way to ensure that your personal data is not going to a scammer is to sign up using the official website atHealthCare.gov or by calling 1-800-318-2596. Avoid sham websites and look for official government seals, logos or website addresses. Look for internet sites with a .gov on the end of the website address.
- Watch for "fake" products. Some scammers will try to sell you a prescription card. These can be phony. Some appear to be real but are only discount cards and not really insurance.
Suspected fraud should be reported to the Federal Trade Commission through the Marketplace Call Center at 1-800-318-2596 or on FTC.gov/complaint. All suspected fraud should also be reported to the Attorney General's Office online or 1-800-392-8222. Koster said Missouri consumers should not hesitate to report anything suspicious because scams can only be stopped if law enforcement learns of them.