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Wednesday, September 11, 2013 2:26 PM

Obamacare Fraud Free-For-All Now Underway; "ObamaMarket" Enrollment Starts October 1

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Rick Newman, writing for Yahoo!Finance Exchange says Obamacare Could Be a Fraudsters’ Free-For-All

Have any idea where to find a health insurance exchange? Up to speed on what a healthcare “navigator” is? Know whether you'll need a new government-issued ID card to qualify for Obamacare when it goes live on October 1?

Scam artists hope you're as clueless as possible, because they're counting on widespread confusion about the Affordable Care Act to tap fresh opportunities for milking the unwary.

Scams are nothing new, but three factors make the Affordable Care Act a uniquely rich opportunity. First, the law affects nearly every American in some way, since it requires most people to have health care coverage. Second, it won’t be standardized nationwide, the way Medicare and Social Security are, since states have the freedom to administer the law in different ways. Third, the law is brutally complex, which has sown confusion even among health care experts. The result is a sweeping new law that’s shrouded in confusion and varies based on where you live, which is an invitation for abuse.

The proper response to fraudulent marketing, of course, is to hang up, delete or slam the door and then contact the FTC. But Obamacare comes with a few wrinkles that make it a bit harder to tell who’s legit and who’s bogus. The law, for instance, requires each health-insurance exchange to develop a network of “navigators” whose role is “to educate the public about qualified health plans, distribute information on enrollment and tax credits, facilitate enrollment, and provide referrals on grievances, complaints, or questions.” Among other things, navigators will make sure people know they need insurance, and help enroll them in Obamacare if necessary.
Network of "Navigators" = Network of Fraud

Newman cited several instances where "navigator" had an icon for "healthcare.gov" that instead landed on a page where people could get "navigator help" for $40.

One site was shut down, two others changed the logo following complaints. But $40 is small potatoes compared to those out to steal your personal information and credit cards.

Overseas operators have already started their phone calls.


For those interested, here's the real link to HealthCare.Gov. Plan and cost information will be available October 1.

I went through a series of questions that I answered honestly. Here was the bottom-line result for me: Don't expect to save any money.

Specifically ...

"You may be eligible to get quality health insurance through the Health Insurance Marketplace. But based on the information you provided, you probably won’t qualify to save money on your monthly premiums or out-of-pocket costs. You'll find out for sure when you apply for coverage starting October 1, 2013."

Pre-Existing Conditions

I do not have Pre-Existing Conditions. For the purpose of this article, however, I checked a a box stating that I wanted information about them.

Here are some snips:

  • Being sick doesn't keep you from getting coverage
  • Starting in 2014, being sick won't keep you from getting health coverage. An insurance company can't turn you down or charge you more because of your condition.
  • Once you have insurance, the plan can't refuse to cover treatment for pre-existing conditions. Coverage for your pre-existing conditions begins immediately.
  • This is true even if you have been turned down or refused coverage due to a pre-existing condition in the past.

The Pre-Existing Condition Exception

Grandfathered individual health insurance plans--the kind you buy yourself, not through an employer, do not have to cover pre-existing conditions. And I suspect they won't.

ObamaMarket Insurance

People with pre-existing conditions and their own healthcare plans will be forced into "ObamaMarket Insurance" either because of rising costs or because the plans will drop people with pre-existing conditions.

ObamaMarket Open Enrollment

  • You can apply for Health Insurance Marketplace insurance when open enrollment starts on October 1, 2013. Coverage starts as soon as January 1, 2014.
  • Open enrollment ends on March 31, 2014. Outside of open enrollment, you can't enroll in Marketplace coverage unless you have a qualifying life event.

Qualifying Life Event

The ObamaMarket glossary defines "Qualifying Life Event" as follows:

A change in your life that can make you eligible for a Special Enrollment Period to enroll in health coverage. Examples of qualifying life events are moving to a new state, certain changes in your income, and changes in your family size (for example, if you marry, divorce, or have a baby).

Curiously, the QLE glossary says nothing about change in job status by you or a significant other, self-employment changes, massive hikes in insurance rates, or other such events.

Mike "Mish" Shedlock

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