Health-care fraud is big business. Various studies suggest that Medicare alone is bilked out of more than $60 billion a year in fraudulent and questionable claims. The federal government has been rooting out these fraudsters over the past decade, but they’re still out there — and much of this cost is passed on to you, the consumer, in the form of higher copayments or even full payment for the service or product if not approved by Medicare or your insurer. Common scams and what you can do to avoid them…
“Free” medical equipment. Beware of offers for free medical equipment such as canes, scooters or walkers. Many of these offers come via phone calls, door-to-door salespeople or e-mails from equipment manufacturers. The equipment is free, they tell you, because Medicare or insurance will pay for it, and the company will take care of all the paperwork. They then ask for your Medicare or insurance number. They may send you the product but then bill Medicare or an insurance company (and you for a copay) for other products that you never received. My advice: Never give your Medicare or insurance number over the phone or on the Internet unless you know that you’re dealing with a nationally recognized company or it’s someone you’ve done business with before.
Doctors who sell medical products. The American Medical Association has a very strong policy discouraging doctors from selling supplements or any other such products and cautioning doctors not to make unproven claims about products they do sell. No studies show that doctors sell higher-quality products than those available elsewhere. My advice: If your doctor tries to sell you a product, be especially leery of anything that you could easily buy at your local pharmacy.
Expensive “discount cards.” Have you seen those commercials or ads claiming to save you up to 70% on doctor visits, hospital stays, eyeglasses and medications? If you can read the very small print, you’ll find out that these promises are not coming from health insurance plans, as many consumers mistakenly believe. Instead, the programs are really for “discount cards” that bill your credit card $19.95 a month or more. The Federal Trade Commission has put out a warning that while some of these programs are legitimate, others charge much more than you’ll ever save. My advice: Before you sign up, check to see if your doctor, pharmacy or local hospitals will accept the card. Also, find out exactly what the discount is at those places that accept it. Consider the card only if you’re sure that you will save more than what you’ll pay annually.
Padded bills. Over the years, consumers and insurers have been frequently billed for health-care services that were never received. This is a growing problem with nursing homes, home-care agencies and even hospices. My advice: Carefully review all of your health-related bills and insurance statements. Challenge the provider on any charges that seem questionable. If you have any concern about the legitimacy of a charge, call your insurer or the Inspector General’s Fraud hotline (800-447-8477).
