People here in Syracuse as elsewhere are vulnerable to health insurance scams as criminals try to exploit consmers' confusion about the new health care law. Parija Kavilanz has reported for CNNMoney.com, http://money.cnn.com, "Health reform's side effect: Scams".
Most of these schemes are not well organized. James Quiggle, spokesman for non-profit group Coalition Against Insurance Fraud, has said "So far there's no major criminal organization behind them." However, Quiggle is concerned that as more of the provisions mandated by the new law are phased in over the next four years, these scams "could grow to become an all-encompassing tsunami." The government has been taking note of this problem. Health and Human Services (HHS) Secretary Kathleen Sebelius has warned state insurance commissioners about new schemes to sell bogus insurance policies.
And last week, HHS announced grants to states in order to strengthen ongoing efforts to protect consumers from some of the worst insurance industry practices. Sally Hurme, who deals with consumer fraud issues at AARP, said seniors are particularly vulnerable to these new scams. Hurme said "We're making a concerted effort to get the word out to our 40 million members."
However, seniors aren't the only targets. Lou Saccocio, head of the National Health-Care Anti-Fraud Association has said people who buy insurance out of pocket, which includes unemployed individuals, underinsured individuals, as well as individuals who do not get dependent coverage through their work, are also vulnerable. Saccocio has also said while citing anecdotal information that the most common scams involve selling fake health plans, fraudulent medical discount plans and Medicare rebate checks scams.
Quiggle advises consumers to watch out for phantom government coverage. Many scammers, claiming they represent the government, go door-to-door selling fake policies. Quiggle said "These crooks tell people without insurance that the law requires them to buy a policy immediately. They also say there's a limited enrollment period to sign up." But, there is no actual enrollment period in the individual market. And the new law gives uninsured individuals until 2014 to buy coverage before having to pay a penalty.
Kim Holland, Oklahoma's insurance commissioner, has said crooks have also been taking advantage of heightened concerns about health insurance costs to sell people "discount plans" disguised as insurance plans. Holland has pointed out that these medical discount plans are not insurance policies. These plans only provide discounts on a limited number of medical services. The Federal Trade Commission has reported that 24 states have filed 54 lawsuits this year to stop this deceptive practice.
There are also crooks taking advantage of the $250 Medicare rebate scam. The new law has created a program where the government mails a $250 check to cover the gap for beneficiaries who've fallen into the prescription-drug coverage gap known as the "doughnut hole". Quiggle has said scammers are exploiting this opportunity by calling up seniors, asking for their Social Security and Medicare beneficiary numbers, and promising to expedite the checks. These crooks then use this information to bill Medicare for false services. There is also the Medicare card scam. Hume has said "Scammers are telling seniors that because of the changes in the law, they will have to send them a new card," she said. And they ask for their personal information. This is identity theft.
In order to protect yourself from these health insurance scams Parija Kavilanz advises that you be careful about of fax, email, telephone poll solicitations. Also, check to see if the insurer is legitimate. And keep copies of all of the paperwork you sign and a copy of the payment receipt or check for your initial premium payment. Also, call the the insurer if you don't receive a copy of your insurance policy outlining your coverage within 30 days of your purchase. And remember do not give any personal information to anyone you don't know.
People here in Syracuse and elsewhere are advised to therefore be very careful about health insurance scams.
Photographer: jscreationzs
Mandel News Service: www.mandelnews.com
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