Not long ago, a neighbor of mine was persuaded by a telemarketer to buy $50 worth of vitamins over the phone. She then began receiving the same vitamins every month along with a $50 charge on her credit card. When she called to complain, the company told her that she had enrolled in a two-year program with an unbreakable contract. Her credit card company offered little help, and it was only after she called her state’s attorney general’s fraud division that the monthly charges stopped. This is just one example of the health frauds that are costing consumers and health insurers more than $80 billion each year—and the crooks are getting more creative with one costly new scam, even playing off the Affordable Care Act (ACA). My advice on how to avoid getting taken in by these common scams…
- Identity-theft scams. Since passage of the ACA (also known as “Obamacare”), con men have been taking advantage of people’s confusion surrounding the new law. For example, imposters have called people or even showed up at their doorsteps claiming to be representatives of the federal government who need to verify that the people they’ve targeted have health insurance. These crafty individuals ask for your insurance numbers and steal your identity, quickly getting credit cards, driver’s licenses and sometimes even access to your bank or brokerage accounts. Be smart: Never give any insurance, Social Security or other personal numbers to anyone who knocks on your door or calls you on the phone.
- False billing by medical providers. Most health fraud is actually committed by unscrupulous doctors, nurses, nursing home operators and home-care agencies. They often bill insurers, in patients’ names, for services never rendered. While it may appear that this doesn’t directly affect you, it often does in the form of steeper copayments and/or deductibles. Be smart: Keep a record of your medical appointments, and carefully read statements of claims submitted to your insurer (including Medicare). Call your insurer if you suspect something is amiss. And never sign a blank insurance claim form handed to you by a provider.
- Medical-equipment fraud. You’ve no doubt seen TV ads for “free” medical equipment, such as electronic scooters. While some of these companies are legitimate, others are deceiving customers. The truth is, the equipment is not free. Medicare or your private health insurer pays the bill—but only if your doctor has certified that you need the equipment and that you cannot get by with a manual wheelchair without a motor. This important detail is not revealed when the company asks for your insurance ID number and the scooter is sent to you. If the bill for the scooter is then rejected by the insurer—and it often is—thenyou are responsible for full payment. And if you try to return the scooter, the company will often claim that it is now used and not accept it. Be smart: Before ordering any medical equipment, get a prescription from your doctor and check with Medicare or your insurer to make sure that it is covered and that the vendor is eligible for payment. To avoid this type of fraud, insurers now preapprove vendors.