Usually, health insurance agents work for an insurance company that sells that company's insurance. Some may work for a brokerage firm. During enrollment in the ACA, fraudsters pose as representatives of the government-run health insurance marketplace. They'll tell you that they need personal information to verify a request or that they can help you choose the right plan for a fee.
Treat these requests and any heavily discounted coverage offer with a healthy dose of skepticism. Navigators and brokers won't charge you any kind of commission for their services (in some states, brokers may charge fees if the insurer doesn't pay them a commission; but these commission-based brokers are rare and there are extensive rules regarding the disclosure they must provide to their clients). This accounting disclosure form lists everyone to whom your provider sent your medical and insurance information. If a certified broker or agent helps you with your change plan request, you will continue to submit your application on the exchange's official website (unless the broker uses an improved direct enrollment website, which will be discussed in a moment).
The Coalition Against Insurance Fraud says that, in some cases, civil lawsuits can send a strong message and help stop insurance fraud. Often, victims actually purchase medical discount plans, in which consumers pay a monthly fee to get reduced prices on specific services and products from participating health care providers. In addition to the need for coverage, there is also the fact that obtaining insurance is often a complicated process that leaves room for people to be taken advantage of. Keep in mind that scammers often prey on older people, so it's a good idea to consult a trusted friend, family member, or financial advisor before enrolling in a new health plan.
Working with an online health insurance agent or broker can help you get the insurance you need at the best price. To protect your identity, never give out your personal information, including your social security number and insurance number, especially if the supposed company or agent contacts you by phone or email to request that information. Some discount cards are legitimate, but according to the NAIC, they're not insurance and won't pay for medical claims. In addition, before you throw anything in the trash, you should shred all forms that contain personal information, such as bills and health care statements, and remove labels from prescription drug bottles.
What to do if you become a victim. Short-term health plans can be useful in some situations and are better than nothing if you don't qualify for real health coverage. If you suspect that you have been a victim of fraud or that an insurance company or provider is committing fraud, the FBI recommends first contacting your own health insurance company's fraud reporting number. Community healthcare fraud generally involves billing patients and insurance companies for unnecessary or incomplete services.
What has changed as a result of Obamacare is the affordability of real health insurance for people with low and middle income. When in doubt, state and federal government resources exist to help ensure that you are a legitimate representative and a health plan.
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