NAIC fraud alert highlights consumers' PPACA ignorance

One worrisome trick can quickly be parried by remembering something a bit unsettling for many consumers these days: “(A)nyone 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.”

That’s what the NAIC says in its consumer alert in response to what it calls a common ploy that 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. 

In this ploy, the caller then asks for credit card numbers, bank account information or your Social Security number. Sadly, a variation of this trick specifically targets seniors on Medicare.

No, citizens, you are not required to obtain a new insurance or Medicare card under PPACA.

Another misconception that may make consumers vulnerable is that the premium a fraudster may offer is only good for a limited time.

“Be skeptical of someone who is trying to pressure you into buying a policy because the rate is only good for a short time,” the NAIC is telling consumers. 

The best way to protect yourself from insurance fraud is to research the agent and company you’re considering through one’s state insurance department and confirm the agent and the company are licensed, the NAIC says.

However, if someone claims to be a health insurance exchange navigator, he or she won’t necessarily be licensed because the navigator is not acting in all instances as an insurance agent, but as more of a guidepost for consumers in the exchanges. 

PPACA requires state health insurance exchange to hire navigators – who are not paid by health insurers – to help consumers understand how to use the exchange system. Navigators will be hired in the 34 states in which the federal government is running the marketplaces or where the state is engaged in a partnership with the federal government. The administration has said that navigators do not have to be licensed agents or brokers and may not be paid by insurance companies.

The Department of Health and Human Services (HHS) did not respond when asked what it is doing to alert consumers of fraud pertaining to the exchange enrollment, although it is heavily involved in Medicare and Medicaid fraud prevention and awareness.