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Scammers Take Advantage of Health Reform Confusion

DISB Warns Consumers to Be On Alert
 
DC Health Link, the District’s health insurance marketplace, opened for enrollment Oct. 1. Since the Affordable Care Act, known as the ACA, was signed into law in March 2010, unscrupulous scammers have been creating ways to take advantage of consumers’ uncertainty surrounding the law. Posing as insurance agents or representatives of the federal government, these scam artists try to sell fraudulent policies or obtain sensitive information like Social Security and bank account numbers.
 
The D.C Department of Insurance, Securities and Banking, also known as DISB, is warning consumers about common red flags and providing tips on how to avoid being the victim of a scam.

Health Insurance Marketplaces 

One of the largest components of the ACA is the creation of new health insurance marketplaces, or exchanges. In D.C., the health insurance marketplace is DC Health Link. The online portal instructs consumers to enter information about themselves and select the level of coverage they desire to receive a list of plans they can purchase. 
 
Don’t be fooled by fake websites claiming to help you or charge you for assistance. Bogus websites that purport to be part of the exchanges have been appearing online for more than a year. The only official website for D.C.’s exchange is www.dchealthlink.com

New “Obamacare” Insurance or Medicare Cards

Another common ploy involves unsolicited calls from scammers who claim to have your new “Obamacare” insurance card – they just need to get some information before they can send it to you. The caller then asks for credit card numbers, bank account information or your Social Security number. A variation of this trick specifically targets seniors on Medicare; the caller claims that in order for them to get their new Medicare card and continue receiving their benefits, they must verify their bank account and routing numbers. Some callers ask for their Medicare numbers, which are identical to Social Security numbers. 
 
You are not required to obtain a new insurance or Medicare card under the ACA. Also, anyone who is a legitimate representative of the federal government will already have your personal and financial information and should not ask you to provide it. 

Don't Be Misled

Here are some other important “red flags” to watch out for: 
  • The salesperson says the premium offer is only good for a limited time. 
    Enrollment in DC Health Link runs through March 30, 2014 and rates for plans in the exchanges have been approved for the entire enrollment period. Be skeptical of someone who is trying to pressure you into buying a policy because the rate is only good for a short time. Remember: if the offer sounds too good to be true, it probably is.  
  • The salesperson says you could go to jail for not having health insurance.  
    Starting in 2014, all Americans will be required to have health insurance. You will not face jail time if you do not purchase health insurance. However, those who remain uninsured and do not qualify for any exemptions will face a penalty of $95 (for each adult) or 1% of family income, whichever is greater. In 2015, the penalty will increase to $325 per adult or 2% of family income, and in 2016 and beyond, the penalty will be $695 per adult or 2.5% of family income.
  • You receive an unsolicited phone call or email from someone trying to sell insurance.  
    The D.C. and federal governments will not be contacting individual consumers to sell them insurance. Do not give any sensitive information to anyone claiming to be with a government entity. 

Protect Yourself   

The best way to protect yourself from insurance fraud is to research the agent and company you’re considering. Always stop before writing a check, signing a contract or giving out personal information. Call us at the D.C. Department of Insurance, Securities and Banking at (202) 727-8000 and confirm that the agent and company are licensed to sell insurance in D.C.  

Call DISB and report anything suspicious  

Reporting to DISB is confidential. If you suspect fraud, please call us at (202) 727-8000, email at disb@dc.gov or visit us at disb.dc.gov to file a secure complaint online.

The D.C. Department of Insurance, Securities and Banking has two missions: to fairly and efficiently regulate financial services in order to protect the people of the District of Columbia and to attract and retain financial-services businesses to the District. For more information, visit DISB at disb.dc.gov or call (202) 727-8000. Visit DC Health Link at www.dchealthlink.com or call (855) 532-5465. This alert was published Sept. 10, 2013 and updated on Nov. 18, 2013.