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Protecting Yourself from Medicare Fraud
By Anita Hoy, Cove
(reprinted from "To Your Health", published by the
Coalition on Substance Abuse and Older Vermonters)
Medicare beneficiaries may be especially vulnerable this winter because of the new Medicare Part D prescription drug programs which will be more susceptible to errors and health care scams.
We encourage beneficiaries to pay attention to any suspicious marketing activity and to take steps to protect themselves from errors and abuse. Health care scams hurt all of us through premium increases and reduced benefits. We need to be vigilant about keeping our costs down and to report incidences of error, fraud and abuse.
Take charge -- protect yourself! You can reduce your chances of being a victim of health insurance fraud. Here are a few useful tips:
Check out insurers and agents. Make sure the insurance company or agent you've signed up with is legitimate. If a company tells you it doesn't have to be licensed or registered with the state, don't do business with that company.
Protect your health insurance information. Never give your Medicare number to telephone or door-to-door solicitors.
Do not do business with a company that pressures you to sign up immediately because it's your "last chance". Talk with a family member or friend about the company who is making the offer.
Carefully review the details of a drug plan or other insurance product offered before providing your signature, especially sales promotions you receive in the mail since signing can invite marketers to come to your home or telephone you. Make sure you know what you are signing up for.
Watch out for "too good to be true" low rates and terms.
Beware of any policy that costs "pennies a day." The low rate could be effective for only a short time -- usually 30 days -- after which the cost increases dramatically.
Be suspicious if an insurance company requires you to pay your premiums in cash, pay
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for a year's premium in advance, or asks that you sign a blank insurance form.
Generally, you shouldn't need to give out your health insurance information for a legitimate free screening or treatment. Sometimes seemingly free medical treatments are a way for scammers to acquire your name and health insurance information to use in fraudulent billing schemes.
Read your Explanation of Benefits (EOBs) and billing statements to look for incorrect charges or services that you don't recall receiving. If you believe you have been billed for a procedure that you did not receive, contact your insurance company ASAP to report the suspicious charges.
Suggestions for
VT Pharmacy Program Participants
Know which plan you are on.
Keep all the letters and information you receive pertaining to your plan.
If you only have a letter regarding your plan, be sure the BIN, Group and Personal ID numbers appear on the letter. If those numbers are not there, call the toll-free number for the plan and get those numbers. You will need those numbers to get your medications.
If the pharmacy tells you to pay any charges that you have not been asked to pay before, don't pay it. Have the pharmacy try to bill it to the State of Vermont. If the pharmacy still wants a co-pay, call the Senior Helpline at 1-800-642-5119.
Call your plan if you aren't sure if it will cover all of your medications.
Help the EMTs Help You
Take a look around your home. If you needed to call for an ambulance, would the crew be able to get you out on a stretcher? Too often, furniture creates an obstacle course and can cost valuable time in an emergency.
Consider rearranging the furniture near your door and hallways to allow as much open space as possible. Be particularly aware of big pieces, such as a china cabinet, that would be difficult to move in a hurry.
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