Medicare is a type of health insurance that is extremely susceptible to fraud, but you can prevent Medicare fraud by being involved in your health care. Examples of being involved in your health care include knowing what your policy does and does not cover, using other kinds of insurance when appropriate, and keeping your Medicare and Social Security numbers safe.
What Does Medicare Cover?
Medicare is federal health insurance that gives policyholders many coverage choices. All forms of Medicare cover inpatient hospital care, skilled nursing facilities, hospice, lab tests, surgery, and home health care for patients over age 65 or with certain disabilities. Some forms of Medicare also cover routine medical care and prescriptions.
What Is Medicare Fraud?
Medicare fraud happens when providers overbill you for services, bill you for products or services you did not receive, bill you for appointments you did not show up to, or make illegal referrals.
After a car accident, for example, you might go to the hospital. Medicare would cover your hospital stay, but a fraudulent provider might charge Medicare $500 for a $300 visit. A provider committing Medicare fraud could also refer you to a chiropractor after an accident that did not affect your neck or back in any way.
How Can I Prevent, Detect, and Report Medicare Fraud?
Make sure to record all your doctor’s appointments and tests in your calendar, and never accept medical treatments you do not need. Avoid giving your Medicare card, Medicare number, Social Security card, or Social Security number to anyone other than your doctor.
If someone offers you free medical care, money, or gifts for seeing a certain doctor, say no. Keep your medical records private.
Sometimes, Medicare patients end up in complex situations with multiple insurance companies. Even when this is the case, you should always be aware of the medical treatments you are receiving and how much you are being billed for them. According to Medicareplans.com.
“The best recommendation to prevent fraud is to be involved in your health care and review all your explanation of benefits and provider bills… Being diligent in reviewing your care and claims as they happen is the best habit to develop in preventing fraud.”
If you notice something unusual, contact your insurance company immediately. You can report suspected Medicare fraud by calling 1-800-MEDICARE (1-800-633-4227).
Being involved in your health care can have other benefits, as well.
The Benefits of Being Involved in Your Health Care
In addition to helping you prevent, detect, and report Medicare fraud, being involved in your health care can help you avoid medical malpractice and strengthen your claim if you ever need to file a personal injury lawsuit.
Dealing with insurance companies can be difficult, and if you ever need help after a serious injury, Hall & Collins Injury Law is here for you. With over 50 years of combined experience, our team can help you navigate your medical bills and interact with insurance companies. We pride ourselves on timely and honest communication and offer personalized care in every case we handle.