Iowa Attorney General Tom Miller is warning Iowans that confusion over the new federal Affordable Care Act may be providing an opening for scam artists.
Miller, during a stop in Waterloo on Wednesday, expressed concern about scammers who may falsely claim that their health care offerings are affiliated or compliant with the Affordable Care Act.
“We’re concerned about reports of misrepresentations of health plans to Iowans as either government health care plans or government-compliant, when neither is the case,” Miller said in a statement.
The new federal health care law, known as Obamacare, does not affect Medicare or Veterans Administration (VA) health care programs, he noted.
Under the Affordable Care Act’s Health Insurance Marketplace, all health plans offered through the Marketplace must meet the requirements of “qualified health plans,” Miller said. The plans must cover essential health benefits, limit the amount of cost sharing (such as deductibles and co-pays) for covered benefits, and satisfy all other ACA consumer protections.
The attorney general said his office’s Consumer Protection Division and the Iowa Insurance Division are investigating reports of “discount health plan” advertisements that market non-qualified health plans, are not health insurance policies, and may not provide consumers with true discounts.
“Some of these advertisements that we’re looking into, which may be broadcast or printed, might trick consumers into thinking that the discount plans are something they’re really not,” Miller said. “They may even use terms, such as ‘health coverage’ or ‘Obamacare’ to help make the pitch.” But, Miller added, they’re not qualified health insurance plans.
While the Consumer Protection Division has not received complaints about scammers seeking personal information under the guise of the Affordable Care Act, Miller said the potential exists.
“People need to know that the federal employees don’t pick up the phone and ask people for their Social Security number, bank account number, or other personal information,” the AG said. “Anyone who is legitimately with the federal government already has the information they need and won’t call you to provide it.”
Iowa Insurance Commissioner Nick Gerhart is urging Iowans who think they’re being scammed to simply hang up or to ask for the caller’s name and contact information to enable them to verify the caller’s identity.
“Anyone who is legitimately connected with the Affordable Care Act enrollment process will not have any problem with giving you their contact information,” Gerhart said in a statement. “That includes their phone number, address and other information about them.”
Iowans can learn more about the Health Insurance Marketplace and Iowa’s Qualified Health Plans through several authorized sources:
<The www.HealthCare.gov Website, which is the federal government’s official and only authorized Health Insurance Marketplace website where consumers can get information, compare plans and coverage options, and enroll.
<The 1-800-318-2596 Help Center, which is open 24 hours a day, seven days a week for consumers to talk with a customer service representative, obtain the same information that is on the website, and enroll for coverage.
<Navigators who are government trained and certified to help answer marketplace questions, discuss eligibility and options, and prepare electronic and paper applications to establish eligibility and enroll in coverage through the insurance exchange. In Iowa, three recipients have received Navigator grants: Genesis Health System, Visiting Nurse Services of Iowa, and Planned Parenthood of the Heartland.
<Certified Application Counselors, who will perform many of the same functions as navigators, including educating consumers and helping people complete applications for coverage. Counselors might come from community health centers or other health care providers, hospitals or social service agencies and are listed through the federal government’s website or Help Center.
<State-licensed health insurance agents and brokers who meet Health Insurance Marketplace requirements may enroll individuals, small employers, and employees in coverage through the Marketplace.
Consumers who suspect insurance fraud should contact the Iowa Insurance Division via www.FraudFighters.gov or 1-877-955-1212, or the Iowa Attorney General’s Consumer Protection Division via www.IowaAttorneyGeneral.gov or 515-281-5926/1-888-777-4590.