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THE PRACTICAL SIDE OF BEING MULTIPLY SCLEROSED / Surprise health plan switches
« Last post by agate on April 06, 2024, 10:03:48 pm »From MedPage Today's "investigative Roundup" (April 3, 2024):
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Surprise Health Plan Switches
Some patients with health coverage through the Affordable Care Act (ACA) are finding out that someone else has switched their health plan -- without their permission or knowledge, according to KFF Health News.
This "unauthorized enrollment or plan-switching" is rampant in some parts of the U.S., the report found. The new plans might not offer the same coverage, which means that patients can show up for appointments or procedures only to find out the care isn't covered or that they'll have to pay more.
Agents told KFF that Texas, Georgia, and Florida are "switching hotbeds," and states that have their own marketplace are more successful because state ACA markets often require more information. But otherwise, rogue agents only need a person's name, date of birth, and state to access a person's health coverage.
Take for instance Florida resident Michael Debriae, who canceled his ACA plan when he got insurance through a new job. A broker in Florida signed him up for another plan without his knowledge, and Debriae may be on the hook for the $2,445 in tax credits paid to the insurer on his behalf, according to the report.
Adam Bercowicz, a licensed independent broker in Fort Lauderdale, Florida, told KFF that he has literally watched his dashboard of clients and seen some being switched to different plans in real-time. He's lost 300 to 400 clients this way.
"If I saw one of my clients was stolen from me at, let's say, 11:57 p.m., I put myself back on," Bercowicz said. "And by 11:58 -- a minute later -- they were already switched back."
As of last June, brokers are supposed to be required to record policyholders' consent before making changes, but that's rarely enforced, experts told KFF and NPR.
A CMS representative didn't answer KFF's specific questions, such as if protection like two-factor authentication would be added to the site.