Consumer Alerts for ACA Enrollment: Watch Out for Half Truths and Scams

False Notices:  Some health plans in Washington State are sending letters to their current individual policy subscribers to tell them their current plan will end and they will be transferred to another one at the end of the year.  Some suggest simply calling the insurance company and not referring enrollees to the health insurance exchange.  See press release from the Insurance Commissioner’s Office:

CONSUMER ALERT - Do you have an individual health plan? Know your rights and options

 OLYMPIA, Wash. – Thousands of consumers who buy their own health insurance will soon receive letters from their insurance company telling them their old health plan is going away and that they will have to pick a new one.  Knowing your rights and options will help you get the best plan to meet your needs.

All of the insurance companies selling individual health plans are replacing their current plans with plans that have these new consumer protections. They must give their policyholders a 90-day notice that outlines their options, including:

·         Buying a new plan from a different health insurer either directly or through theWAhealthplanfinder.org

·         Buying a new plan from your current health insurer either directly or through theWAhealthplanfinder.org

If you’ve received a notice from your insurer about picking a new plan and you do not take action, your insurer will automatically move you to the plan that most closely resembles what you have today. This new plan could cost more, but it’s not your only option.

“Companies are required to give you notice if they’re replacing your plan,” said Insurance Commissioner Mike Kreidler. “But, unfortunately, they may not include all of your options – including your right to pick a new plan from a different company or buy through the new exchange, WAhealthplanfinder.org. “

Starting Oct. 1, everyone – including people with individual health insurance plans – can shop for a new plan in Washington’s new exchange, WAhealthplanfinder.org

Under health reform, all health insurance plans must include new consumer protections including paying for at least 60 percent of medical costs and covering 10 essential health benefits, such as prescription drugs and maternity.

Currently, most plans in today’s individual market – where people go to buy their own health insurance – have very high deductibles, cost-sharing limits of up to $10,000 a year, do not cover many crucial benefits, such as prescription drugs, and only pay for 40 percent to 50 percent of medical costs – leaving the rest to the consumer to pick up through high deductibles and large cost-sharing limits.

“For years, people who buy their own health insurance have been paying more and getting less,” said Kreidler. “Starting Oct. 1, they’ll have new and better plans to choose from, with limits on out-of-pocket costs and the possibility of tax credits to help pay their monthly premium.”

Kreidler added that in the past, people who received a rate increase and wanted to shop around were limited if they had a high-deductible plan unless they could pass a health screen again.

“Don’t just take what your insurance company says, make sure you shop around. You have the right to buy any plan inside the new exchange or in the outside market.”

Map of plans and their costs by county

Release No. 13-26  Office of the Insurance Commissioner

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If you get such a notice, be sure and check to see if it includes reference to:  WAhealthplanfinder.org

For complaints and fraud in Washington State go to: http://www.insurance.wa.gov/complaints-and-fraud/

Or call:

  • 800-562-6900 or
  • 360-725-7080
  • TDD 360-586-0241

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 Avoid Being Scammed:  Here’s What to Watch for For

Never answer questions about personal information, such as social security number, income or medical information from an unsolicited phone call or visit. Watch for scam websites with a similar name. If you are eligible for Medicare, you are not eligible for the consumer health exchanges.  If you have questions contact your state insurance commissioner’s office. 

Read here about warning signs from Health and Human Services. It includes their hot line to report fraud.

https://oig.hhs.gov/fraud/consumer-alerts/alerts/marketplace.asp

Please feel free to share this with friends and relatives in other states.

Kathleen O’Connor (c) September 19, 2013

 

 

 

 

 

 

 

About Kathleen

Kathleen O’Connor: 30+ year health care consumer advocate, non-profit executive and author. For more information about Kathleen, please see "About" on the main content bar above.
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