Tennessee Department of Commerce and Insurance officials warn of Affordable Care Act scams

Tennessee Department of Commerce and Insurance officials warn of Affordable Care Act scams

November 8th, 2013 by Kate Belz in Local Regional News


The salesperson says the premium offer is only good for a limited time. -- Enrollment in the exchange will run from Oct. 1 until March 31 and the rates have been approved for the entire enrollment period.

You receive an unsolicited phone call or email from someone trying to sell insurance. -- Government officials will not be contacting consumers to sell insurance.

The salesperson says you could go to jail for not having health insurance. -- Americans who do not have health insurance in 2014 may see fines, but no one will face jail time for being uninsured.

You are 65 or over and a salesperson says you must purchase a different kind of health insurance.-- If you already have Medicare, your coverage will not change. If you're newly eligible for Medicare, the traditional enrollment process still applies.

A navigator or certified application counselor says that there is a fee for his/her services. -- That service is supposed to be free. Always ask to see official certification. You can also call the Department of Commerce and Insurance Agent Licensing Unit at 615-741-2693 or 888-416-0868 to verify.

Source: Tennessee Department of Commerce and Insurance


To report any potentially fraudulent activities, call the Federal Trade Commission at 1-877-FTC-HELP (1-877-382-4357). Or contact the Tennessee Department of Commerce and Insurance Consumer Affairs division at 615-741-4737.

Scam artists don't need a lot of special knowledge about the Affordable Care Act to take advantage of their newest round of victims.

They only need to capitalize on confusion.

The law's sheer complexity and the political rhetoric surrounding its rocky rollout have created ample opportunity for scam artists to target people worried about changes in their health coverage -- especially the elderly, state officials say.

"It's the same old routine as other telemarketing scams, it is just in a different costume," said Kate Abernathy, spokeswoman for the Tennessee Department of Commerce and Insurance.

Abernathy said the department's consumer division has been on alert for scams that include bogus Obamacare websites, callers touting "Obamacare insurance cards," and offers to help people sign up for insurance for a fee.

The department has heard reports of cold callers who say they can walk consumers through the application process for a $50 or $100 fee as a navigator.

But navigators and certified application counselors -- who are federally certified guides for the new insurance marketplaces -- are supposed to provide their services free of charge.

Katherlyn Geter, who is overseeing navigator efforts for Erlanger Health System, said her office cannot directly contact an individual about the marketplace unless the consumer has requested it first.

"We cannot phone, email, send letters and use social media messages without a consumer's prior permission," Geter said.

Further, navigators are required to show their federal certification when they meet with a consumer.

Recent emergency rules from the commerce and insurance department also require navigators and application counselors to be registered with the state and have background checks.

The department said rules were passed to prevent "bad actors," but advocates of the law have said they obstruct enrollment efforts.

A federal judge has issued a temporary restraining order allowing social service organizations and churches to assist in volunteer enrollment efforts without going through the registration process, but navigators must still comply.

In other cases, scammers may call and say that everyone in the household needs to have a new "Obamacare insurance card," which can be sent as soon as a person hands over banking information or a Social Security number. Such cards do not exist.

A new incarnation of this trick is aimed at seniors on Medicare, the Tennessee Department of Commerce and Insurance reports.

The caller claims that in order to get a new Medicare card and continue receiving benefits, the Medicare recipient must verify her bank account numbers.

"If somebody calls you on the phone and asks for any of your personal information, that should be a red flag," Abernathy said. "If people don't know that information already, they're fishing."

Scams targeting the elderly have taken advantage of the fact that enrollment for insurance through the ACA started Oct. 1, and enrollment for Medicare beneficiaries began the same month.

"The bottom line is that if you're on Medicare, the new requirements under Obamacare don't affect you at all," said Steve Witt, director of the Southeast Tennessee Area Agency on Aging and Disability.

"I know a couple on Medicare who is just as worried as they can be that they need to go get a new policy through Obamacare. One of their friends got some letter about getting a new policy, and now they are worried that they will be next to get that letter."

Experts have also warned about bogus Obamacare websites, which began popping up over a year before the website went live. Some have looked official, mimicking some of the design features of the official website, HealthCare.gov.

That site is the only online portal where Tennesseeans, Georgians and Alabamians can sign up for subsidized insurance at this time.

While no formal allegations of identity theft related to the ACA have yet been filed with the state, Abernathy says such scams usually take "quite a bit of time" to uncover.

"Unfortunately, we won't be able to start uncovering trends until we have actual victims," Abernathy said.

Contact staff writer Kate Harrison at kharrison@timesfreepress.com or 423-757-6673.