How to Avoid Health Insurance Fraud

One of the biggest ways that seniors and elderly are taken advantage of is through health insurance fraud. After all, it’s no secret that as we age, we require more and more medical assistance, hospital stays, or certain equipment to help us live a better, more fulfilling life. Just like the various other ways we’ve talked about previously, there are those out there who would seek to use health care and health insurance as a way to scam or harm seniors. Let’s briefly look at some examples of what health care or health insurance fraud actually is, and see some tips and ways to help us avoid it altogether.

Examples of Health Care/Insurance Fraud

Medical Equipment Fraud: This occurs when equipment manufacturers offer seniors “free” products. The fraud happens when insurers are then billed for equipment that wasn’t needed and/or may not have even been delivered.

“Rolling Lab” Schemes: Unnecessary and sometimes fake testing is done to individuals at places like health clubs, retirement homes, or shopping malls and billed to either insurance companies or Medicare.

Services Not Performed: Customers or providers bill insurances for services that weren’t even given to people by changing bills or turning in fake ones.

Medicare Fraud: This type of fraud can take the form of any of the things we described above. Elderly people are frequently targeted by Medicare schemes, and especially by equipment manufacturers who offer “free” equipment to seniors who provide their Medicare numbers. Since a doctor must sign a form certifying that either equipment or testing is needed prior to Medicare paying for it, scammers fake signatures or bribe corrupt doctors into signing forms. Once a signature is obtained, the manufacturers bill Medicare for merchandise or services that were not needed or ordered.

So now let’s take a look at some ways that you or a loved one can better avoid becoming a victim to health insurance fraud:

  • Be sure to never sign any blank insurance forms.
  • Never give any blanket authorization to a medical provider to bill for services rendered.
  • Ask your medical providers what they will charge and what you will be expected to pay out-of-pocket.
  • Be sure to carefully go over and review for insurer’s explanation of benefits (EOB) statement. If you have any questions regarding it, call them.
  • Do not do business with any door-to-door or telephone salespersons who tell you that any services of medical equipment are free.
  • Only give out your insurance or Medicare identification to those individuals who have given you medical services
  • Be sure and keep an accurate record of all of your health care appointments
  • Finally, you should know whether or not your physician has ordered any medical equipment for you. If they have not, or you are not sure, do not accept any free equipment.

If you follow these tips, you can be on your guard against those who would seek to take advantage of you or someone you love, and you can rest easy knowing that both you and your loved ones are safe.