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Consumer Alert: Federal Health Exchange

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By: Governor Corbett and the Pennsylvania Insurance Department
October 28, 2013

The following consumer alert has been issued from Governor Corbett and the Pennsylvania Insurance Department:

Now that the federal health exchange is online and has experienced well-publicized issues, scammers may pose as insurance agents or representatives of the federal government and try sell to fraudulent policies or obtain sensitive, confidential information.

Neither the federal government nor the state insurance department will be contacting individual consumers to sell them insurance. Do not give any sensitive information to anyone who claims to be with the federal government, your state insurance department or a navigator for the exchange.

Beware of unsolicited calls from scammers who claim to have your new “Obamacare” or Medicare insurance card and need personal information in order to send it. You are not required to obtain a new insurance or Medicare card under the Affordable Care Act. A legitimate representative will already have that information.

Here are some scenarios where healthcare scams could occur:

  • Not using the appropriate website for the federal exchange. The federal exchange website is www.healthcare.gov. Don’t trust any other website that asks you to enter personal data such as a Social Security Number, bank account number or credit card information.
  • Callers posing as navigators or certified application counselors trying to “sell” you an exchange policy. A navigator or a certified application counselor can be an individual or an organization trained to help you learn about the available choices and guide you through the application process once open enrollment begins. These parties cannot sell you a policy, nor can they recommend a specific insurance plan to you. Navigators are certified and trained by the federal government.

Lastly, do not be misled or tricked into believing everything you hear. Here are some “lies” to watch out for:

  • “Premium offer only good for a limited time.”  Enrollment in the exchanges will be open from Oct. 1 to March 31, and rates for plans in the exchanges will have been approved for the entire enrollment period.
  • “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 percent of family income, whichever is greater. In 2015, the penalty will increase to $325 per adult or 2 percent of family income, and in 2016 and beyond, the penalty will be $695 per adult or 2.5 percent of family income.

The Insurance Department has an educational website, www.pahealthoptions.com, which focuses on health insurance questions and all coverage options.

Consumers wishing to shop on the new federal exchange should use www.healthcare.gov.  

Insurance consumers with questions, comments or concerns can visit the department’s website at www.insurance.pa.gov to check licensed entities and file complaints. They can also use the department’s toll-free consumer services number at 1-877-881-6388.