Medical identity theft occurs when someone uses a person's name and insurance information without their knowledge or consent to obtain medical services or goods. Medicare fraud is when an individual or corporation tries to collect Medicare health care reimbursement under false pretenses. There are ways that you can protect yourself from both.
The fact is that we are all vulnerable. And while identity theft in general is believed to be on the rise, with medical identity theft you have more to lose than just your confidential information. Losing medical information to an unscrupulous thief puts your health at risk as well.
However, there is a bigger problem. Yes, these thefts can cost the victims money. But more importantly it puts them at risk of physical harm because inaccurate medical information, such as blood type and medications, may end up recorded in their patient records.
Too many people think it won’t happen to them. An estimated $60 billion or more annually to fraud. And from 2000 to 2007 the Center for Medicare and Medicaid Services (CMS) paid 478,500 claims totaling up to $92 million to dead physicians.
A recent report indicated that a 57-year-old Fresno woman is facing a decade in state prison after being found guilty of Medicare fraud. She targeted low-income seniors telling them they needed to purchase expensive powered wheelchairs and Medicare would foot the bill. Instead she turned over the patients' insurance information to an equally fraudulent Los Angeles clinic for bogus wheelchair orders in exchange for a cut of the profits.
It’s up to each person to protect themselves against Medicare fraud and identity theft. Here’s how you can do it:
Protect your Medicare number by keeping your card in a safe place. Share it only with your medical provider. Closely monitor your Explanation of Benefits (EOB) sent by your health insurer. It describes the services you have received and what is and isn’t covered under your plan. Notify your provider if anything looks out of place. Request a copy of your medical files from each health care provider and review them for errors. Be sure to report incorrect information immediately. Monitor your credit report to see if there are any unpaid accounts that might have been created by someone other than you.
While about 500,000 working Californians have lost their insurance due to the recession, another 100,000 more will likely become uninsured over the next four years if there are no changes in health policy.
This growing number of uninsured is likely to take its toll on already financially strained cities by creating higher costs and lower productivity and earnings. In addition, it will probably mean higher costs to those individuals who do have insurance coverage, as insurance rates are likely to continue to increase annually.
“Fewer and fewer California employers are even offering health insurance. In fact, recent reports have shown that the rate has declined from 61.7 percent in 2000 to 58.6 percent in 2007. This is lower than the national average of over 64 percent.
In the meantime a second report recently made available which underscores the growing number of jobless and uninsured in California found 12.1 million Californians were uninsured for some part of 2007-2008. That's more than one out of every three residents under 65 years of age, or 37.4 percent.
While the picture of increasing health premiums and decreasing employer-supported health coverage looks bleak, seniors can feel confident that they have options when it comes to selecting the right Medicare supplement insurance for their individual needs.
You currently have a Medicare supplement insurance policy (also known as a Medigap plan). You are totally satisfied with the cost, coverage and customer service. Congratulations!
However, if you are not one of the fortunate ones and are thinking about switching to a different Medigap policy, then you may want to consider your options before you make a move. There are federal laws that control when and what you can do.
When You Can Switch to a New Medigap Policy
Knowing your rights when it comes to Medigap insurance allows you to plan for the best health care coverage for you. That’s why it is important to have access to Medigap insurance information that allows you to compare rates, plans and benefits.
There are several reasons you might want to change you plan. Perhaps your needs have changed and you require less or maybe more coverage, or maybe your current Medigap policy has the right benefits, but you’re just not happy with the insurance company due to customer service or expense. These are all valid reasons for wanting a different Medigap plan.
Once you have purchased a Medicare supplement insurance policy you generally won’t have a right to switch policies until you reach your Medigap open enrollment period or when you are eligible for guaranteed issue rights.Guaranteed-issue rights periods include when:
Your employer-sponsored retiree plan is terminated, reduced or you lose eligibility. Your Medicare Advantage (MA) plan increases your costs, reduces your benefits or a medical provider treating you leaves the plan. You move out of your MA plan or Program for All-Inclusive Care (PACE) organization service area. Your provider commits fraud, ends or loses its contract with Medicare, misrepresents the plan you bought or fails to meet contractual obligations. You joined a MA plan or PACE organization when you first became eligible for Medicare at age 65 and you want to switch to a Medigap policy (must occur during your first 12 in your MA plan or PACE). You switch from a Medigap policy to a MA plan, PACE organization, Medicare SELECT plan or any other health care organization contracting with Medicare, for the first time since becoming eligible for Medicare and you disenroll from that plan within the first 12 months.
Keep in mind that if you don’t purchase your Medicare supplement policy at the right time, an insurance company can use medical underwriting. That means they can decide whether or not to accept you or set different terms such as waiting periods and premiums.
Switching Policies When You Have an Older Medigap Policy
Making the decision to switch is particularly important if you bought your Medigap policy before 1992 because it may offer coverage that isn’t available in a newer Medicare supplement plan. However, older policies might not be guaranteed renewable and just might have bigger premium increases than newer standardized Medigap policies.
Before you cancel your old Medigap policy and switch to something new, take a free look. On your application for the new policy you can promise to cancel your first Medigap plan within 30 days. The free-look period requires you to pay both premiums for a month. But it’s worth it to give yourself the opportunity to decide if you want to keep the new Medigap policy.
While you’re not required to switch from your old pre-1992 Medicare supplement insurance, if you do you won’t be able to go back to your old policy. So be sure you want to make the change.
Press Release: an Fransisco, CA -- (SBWIRE) -- 06/22/2012 -- With the ever-increasing costs of medical care, even Medicare coverage can leave too many unpaid medical bills for the typical consumer to afford. Although Medicare was once considered an effective way to meet the medical care costs of older Americans and people with disabilities, today it simply isn’t enough, which leaves consumers seeking Medicare supplement insurance plans to cover additional costs.
MedicareSupplementPlans.com recently launched its redesigned website to provide greater support, in-depth information and quotes for the best Medicare supplement insurance plans available. Also known as Medigap, Medicare supplement insurance plans are private health insurance plans designed to pay some of the health care costs not covered by Medicare, such as co-payments, co-insurance and deductibles.
Visitors to MedicareSupplementPlans.com can simply fill out the form available on the site’s landing page to find and compare the best Medicare supplement insurance plans and rates from all of the top insurance companies. After filling out the form and clicking Get Quote, a licensed Medicare supplement insurance agent follows-up with a no pressure, free insurance quote with detailed information about plan options and benefits to meet individualized needs.
“The advantage of choosing a supplemental Medicare insurance plan over Medicare Select or Medicare Advantage is that with a Medigap plan you have absolutely no network restrictions; in other words you can go anywhere for your health care as long as the provider accepts Medicare,” explained a MedicareSupplementPlans.com spokesperson.
The site connects consumers with highly trained licensed agents. The agents help consumers cut through the jargon so they can select the plan that is most appropriate for them at the best possible price.
The site offers a whole host of reference material with brochures, rates and applications for the top suppliers available to download.
To assist consumers in choosing the correct plan the site offers a detailed but simple to follow Medicare supplement insurance plan benefit comparison chart. The chart details the benefits of different Medigap policies so consumers can quickly identify which plan is appropriate for their circumstances. Editorialized content accompanies the chart guiding consumers through the technicalities of the policies.
About MedicareSupplementPlans.com MedicareSupplementPlans.com is Health and Life Insurance Services, LLC, one of California’s largest independent insurance agencies specializing in the best Medicare supplement insurance plans from leading brands. Visitors to the site can easily access comparison quotes, full customer service and detailed information about Medicare supplement insurance plans, as well as in-depth editorial content to guide them through the decision-making process. Learn more at http://www.medicaresupplementplans.com
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