WATERLOO — Attorney General Tom Miller warned Iowans 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.
Under the Affordable Care Act’s Health Insurance Marketplace, all health plans offered through the Marketplace must meet the requirements of “qualified health plans.” 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.
Discount Health Plan
The 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.
Marketplace & Medicare
Miller also warned Iowans not to confuse the Marketplace with their Medicare coverage. “If you have Medicare coverage, the Marketplace does not affect you. Medicare is not part of the new Marketplace.”
Marketplace & Veterans
Veterans enrolled in VA health care programs have health coverage that meets the new health care law’s standard and do not have to take any additional steps to have health coverage.
Scammers Seeking Personal Information
While the Consumer Protection Division has not received complaints about scammers seeking personal information under the guise of the Affordable Care Act, Miller says 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,” Miller said. “Anyone who is legitimately with the federal government already has the information they need and won’t call you to provide it.”
Advice from Iowa Insurance Commisssioner
Iowa Insurance Commissioner Nick Gerhart urges 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. “That includes their phone number, address and other information about them,” Gerhart added. “Stay in charge of any transactions. If anything doesn’t sound right or feel right, I encourage people to check with our office or the Attorney General’s Consumer Protection Division.”
Iowans can learn more about the Health Insurance Marketplace and Iowa’s Qualified Health Plans through several authorized sources:
• Website: www.HealthCare.gov. This is the federal government’s official and only authorized Health Insurance Marketplace website. Here consumers can get information, compare plans and coverage options, and enroll.
• Help Center: 1-800-318-2596. The Help Center is open 24 hours a day, seven days a week. Consumers can talk with a customer service representative, obtain the same information you’ll find on the website, and can enroll for coverage.
• Navigators: Navigators, who are government trained and certified, can help answer Marketplace questions, discuss eligibility and options, and prepare electronic and paper applications to establish eligibility and enroll in coverage through the Marketplace. Iowa Navigators are listed on the federal government’s website or Help Center (see above). 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: These counselors 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. Certified Application Counselors are listed through the federal government’s website or Help Center.
• Agents and Brokers: 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 state:
• Iowa Insurance Division: www.FraudFighters.gov or 1-877-955-1212
• Attorney General’s Consumer Protection Division: www.IowaAttorneyGeneral.gov or 515-281-5926/1-888-777-4590
• For more consumer protection information on the Marketplace, including the September Attorney General Consumer Advisory, Navigating the New Health Insurance Marketplace,” go to www.IowaAttorneyGeneral.gov.