Protect Yourself From Medicare Fraud

For those of you who are age 65 or over, you have probably signed up for Medicare and are now enjoying the benefits of this healthcare program.  Now that you are on Medicare, you want to make sure that someone else doesn't enjoy your Medicare benefits, too ... and leave you with unpaid bills and co-pays that could damage your credit until you are able to go through the complicated process of proving that you did not incur these expenses.

These are the type of retirement problems that I never thought about before I retired and they are certainly the type of problems you don't want to bring on yourself.  Fortunately, there are some steps you can take to protect yourself from Medicare fraud.

How to Prevent Medicare Fraud

*  First, it is important that you and your retired relatives know that Medicare will NEVER call you and ask you for your Medicare number or any other personal information.  They will not try to sell you products such as insurance or supplemental drug plans.  Consequently, there is no reason to ever give your number out over the phone to a stranger who calls you.

*  In addition, there is no reason to carry your Medicare card around with you, unless you are going to visit a doctor, hospital, clinic or pharmacy.  Once you have given this information to your regular healthcare providers, you will not usually have to keep showing them your card.  Furthermore, if you get a Medicare Advantage plan, they will provide you with a separate card that has your plan's member number ... which will be different than your Medicare number.  Of course, you'll want to protect your Medicare Advantage number or your Medigap policy number, as well, so that information cannot be stolen and misused.

*  Keep track of your doctor visits, tests, surgeries and any other medical procedures.  Write them down in a calendar or journal.  When you receive your Medicare Summary Notice (MSN) and your Part D Explanation of Benefits (EOB), compare them to your personal records.  Make sure there are no mystery charges on them.  If there are, call your physician and see if they have an explanation for the charges.  For example, they may have sent a test to an outside lab or another physician for a second opinion.

*  If there are unexpected charges on your bill and no one knows why, report the charges to the Senior Medicare Patrol for your state. They will investigate the fraudulent charges.

You can get more information about preventing Medicare Fraud at:

http://www.smpresource.org (Website for the Senior Medicare Patrol)
http://stopmedicarefraud.gov

If you are preparing for retirement, use the tabs at the top of this article for links to hundreds of additional articles on a variety of helpful topics.

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How to Fix Medicare

Something needs to be done about Medicare.  If no adjustments are made to the current program, in another ten years it will no longer be able to cover the full amount of seniors' hospital bills.  Different proposals are being floated by politicians in Washington and by advocates for senior citizens, and these proposals were recently evaluated by AARP  in the October, 2013 ARRP Bulletin.

Here are the two approaches currently being considered to solve the Medicare problem.  They are completely different and, according to the AARP analysis, the second option is by far the most preferable.  Since many of my readers are politically active, I thought I would lay out the choices so you can advocate for the changes that you believe would be best.

Option #1 - Increase Medicare Copays to Seniors

Some Washington politicians have proposed that senior citizens begin to be charged copays for certain services, such as their home health care visits.  For example, the suggested amounts range from about $100 to $600 for each 60 day period of home health care.

AARP points out that this was tried once before and it was later repealed because it placed such a heavy burden on many seniors.  Such a bill would cause some seniors to forego home health care and other services, which could actually cost Medicare more if patients end up being hospitalized.  In addition, it could simply switch the burden for these services to Medicaid, which would then put a heavier burden on the states.  Finally, the premiums for Medigap insurance policies would also increase.

Option #2 - Reduce Medicare Fraud and Abuse

There is a new bipartisan bill before Congress that is known as the PRIME Act - "Preventing and Reducing Improper Medicare and Medicaid Expenditures Act."  This bill is aimed at saving taxpayers an estimated $60 - $90 billion a year in Medicare fraud and abuse.  Here are some of the highlights of the bill:

* It makes it more difficult for criminals to steal the identities of physicians and bill for Medicare services that have not been performed.

* Increases the penalties for stealing the identities of patients.  It outlaws the illegal sale, purchase and distribution of Medicaid and Medicare ID numbers.

* Increases the federal reward for fraud tips and establishes a Senior Medicare Patrol.

* Cracks down on doctors who improperly bill Medicare.  Steps would be taken to close loopholes, stop double billing and generally do a better job of tracking payments.

* Penalizes private companies that handle bill paying for Medicare if they do not meet specific payment accuracy goals.

Share Your Opinion With Congresss

Personally, I believe that every possible effort should be made to decrease Medicare fraud before higher fees are charged to senior citizens.  I cringe every time I hear a news story about doctors being arrested for billing Medicare for treatments that either never took place or that were unnecessary.  Even if fees eventually need to be increased, I believe that the PRIME Act should be passed, first.

What do you think?  Do you have other suggestions for lowering Medicare costs and keeping it more sustainable?

No matter which Medicare option you prefer, you can express your opinion to Congress by calling 1-877-940-1510.

With discussions occurring right now over the budget and debt ceiling, now is the time for you to let members of Congress know how you feel.  Sooner or later, this issue will affect nearly every American citizen.

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