Medicare Fraud is becoming rampant in health care, and it is terrible. The Centers for Medicare and Medical Services (CMS) proposed the banning of deceitful and misleading advertising from Medicare Advantage plans. Confusing ads using misleading imagery or language are increasing and it's alarming that some providers do not name the health insurance plan which alarmingly misled people to register for plans that do not cover their doctor's prescriptions.
CMS also passed a new law in late 2022 requiring every phone call recorded between beneficiaries and Third-Party Marketing Organizations (TPMOs) discussing healthcare plans, providers, or any personal information between a beneficiary and licensed insurance agent. In this article, you will learn about some tips to protect yourself from identity theft and Medicare fraud, the pros and cons of getting Medicare Advantage plans, how to identify fraud, and what you need to do when it happens.
Tips To Protect Yourself from Identity Theft
1. Protect your Valid Identification Numbers
Safeguard your social security number or your Medicare/Medicaid number by not providing it to anyone unless required by a verified authority, your doctor, your trusted, local insurance agents, or a verified employee of Medicare. Keep your personal identification numbers safe at all times.
2. Veer away from bribe
Do not accept gifts, money, or offerings of any kind in place of promising, free medical care. This is mostly untrue and a bait to lure more identity theft victims.
3. Medicare does not call to sell anything over the phone
Remember that Medicare does not pay a visit to your home for the same reason. They will only call for two reasons: 1) You are already a member of the Medicare health plan and 2) You called 1-800-MEDICARE first and they are returning the call.
4. Report identity theft immediately and get a solution for a recovery plan
Get in touch or call the Federal Trade Commission asap if you suspect that you're a possible victim of identity theft.
Pros and Cons of Medicare Advantage Plans
Medicare Advantage is a medical healthcare plan consisting of both Medicare Part A and Medicare Part B coverage that is sold and offered by private insurance companies.
● Pros: The advantages of these Medicare Advantage plans include the following:
○ Coverage options are all-in-one and more convenient than the original Medicare
○ Its structure is more personalized and tailor-fit to what a customer need. For example, if you need additional services covered like dental, hearing, or vision, Medicare Advantage plans have them.
○ It is cost-effective since most Advantage plans do not include premiums.
○ It ensures the coordination and communication of your healthcare team to provide you with the necessary healthcare and medical services.
● Cons: The disadvantages of these Medicare Advantage plans are:
○ Compared to the original Medicare, Advantage plans offer limited options of available service providers
○ The vast coverage options overwhelm some customers who think that the Advantage plans are complex making it difficult for them to choose which Medicare Advantage plans suits them.
○ Sometimes, you can notice additional fees like copays and drug deductibles.
○ The Medicare Advantage plans are state-specific, and it may not be available to your
new service area.
What is a Medicare Fraud?
Medicare fraud is the intentional act of deception by receiving payments for Medicare when it should not be or charging a higher amount of payment when unnecessary. Any act of committing Medicare fraud is illegal and witnessing or being a victim of the scheme should be reported. Anyone can engage and be involved in fraud even doctors, service providers, and the beneficiaries of Medicare themselves.
To know when you're being a victim of Medicare fraud from your provider, check if your provider is doing the following:
● You are being billed for Medicare services you didn't receive
● You are being billed for more expensive Medicare services which are different from the previous ones you have received
● You are continuously being billed for Medicare for medical equipment rented which you already have returned
Takeaway
As a valued customer, you have the right to choose the best healthcare plan that’s fit to your needs. Get the help you need and consult an insurance expert at Ellis Insurance Agency. We offer our clients a wide variety of policies and select the best products at the best, reasonable prices. Call us today and get a quote.
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