The Center for Medicare and Medicaid Services (CMS) has released a new set of fraud prevention tips for individuals interested in accessing health coverage in the new Affordable Care Act's (ACA) Health Insurance Marketplace. Click here to read the tips.
Starting on October 1, 2013, people who lack health insurance could start signing up for coverage through the new Internet-based health insurance marketplaces set up under the Affordable Care Act (aka Obamacare). Most of those who don't already have insurance will have to buy coverage by March 31, 2014 or pay a penalty.
But, if you already have Medicare, you have nothing to worry about. You have coverage that will continue as before (better than before, in fact) and you don't need to do anything. Any stranger who tries to tell you otherwise is likely trying to steal your personal information.
It's all somewhat confusing because Medicare's enrollment period for choosing or changing prescription drug or Medicare Advantage plans begins October 15 and ends December 7, overlapping with the Affordable Care Act's enrollment period. Scammers are taking advantage of the confusion to steal personal and financial information from Medicare recipients and others.
Some con artists, claiming to be from Medicare, are calling Medicare beneficiaries and telling them that because of Obamacare, they need to get "a new Medicare card," which requires them to divulge personal and banking information. If they don't provide the information, the beneficiaries are told that their Medicare benefits will stop.
In point of fact, people age 65 and over who are on Medicare don't need to do anything to continue getting their government benefits. Medicare coverage satisfies the new insurance requirement and a new "health care card" is not required. (And, those under age 65, who already have health coverage don't need to do anything, either.) Moreover, Medicare, like the IRS, will never contact beneficaires about any personal issues by phone or e-mail, but rather through regular mail.
"We want to protect Medicare beneficiaries and remind them their benefits aren't changing, and the marketplace doesn't require them to do anything differently" a Medicare spokesman said.
It's also against the law for someone who knows that you have Medicare to sell you a marketplace (also called an "exchange") plan. Anyone who violates the law can be fined up to $25,000 or imprisoned for up to five years, or both.
If you receive a suspicious call, contact the Illinois SMP (Senior Medicare Patrol) Program at AgeOptions. As we have mentioned in previous issues of YOUR Legal Update, this is a great resource. Through outreach and education, SMP works to empower Medicare beneficiaries to fight fraud, including publishing a weekly Fraud Alert.
Medicare coverage will actually improve for many beneficiaries as a result of the Affordable Care Act. Those receiving prescription drug coverage and stuck in the coverage gap known as the "doughnut hole" will get a 50 percent discount on brand-name prescription drugs covered under Medicare Part D. And, health reform added some free preventive services to Medicare.
The new health care marketplaces should be a big boon to the near-elderly -- those ages 50 to 64 -- one-fifth of whom went without health insurance for at least part of 2012. These individuals can sign up for coverage through the marketplaces without fear of being rejected for preexisting conditions, and the insurance should be more affordable than before. Many others in this age group are clinging to their jobs simply for the health insurance. The availability of affordable, guaranteed health coverage could allow them to start their own business, change employers, or retire.
Remember that, if you have Medicare, you have health insurance and do not need to buy insurance from the Marketplace. If you or a loved one need information about the Marketplace, the official website and best place to find out more is www.healthcare.gov.