Posts Tagged ‘government’

Health Care Fraud And You

Monday, February 8th, 2010

Millions of Americans feel the effects of health care fraud without ever being aware of it. This is a growing problem that takes each and every one of us to fight. If you know of anyone who has committed this type of crime then you should report them to the proper authorities immediately. This is a problem that will only grow worse unless we work together to put a stop to it.

Even our insurance premiums may be affected. When someone files a false claim and insurance companies pay out on it then they have to get that money back. They don’t get it from the person who files the claim but from everyone who has insurance with them. No matter who files that claim it is all policy holders who pay in the end.

Government run programs are often the target of fraud. These programs are paid for by each and every one of us through tax dollars. When someone commits fraud it not only costs us but it could mean others are not getting the care they need. It may also mean the programs won’t be around when we need them our selves.

Because of fraud in the health care system, some procedures and medications may not be available to those who need them most. Some of these could be life saving but instead people suffer and possibly die because of those who take advantage of the system or abuse narcotics. No person should have to live in pain because of other peoples addictions.

Health care providers are guilty as well. Every time a bill is padded or they charge for a procedure that wasn’t done this is fraud. Some doctors and hospitals have even invented ghost patients to get more money. Fraud of this type could even be as simple as performing procedures that are not medically necessary.

While you may not be able to prove weather or not a procedure was necessary you can prove weather or not it was preformed. What one doctor considers legitimate another may say was unnecessary. This is a gray area and not all doctors will agree on what is best for a patient. More often than not this is left at the doctor’s discretion.

Another form of medical care fraud is medical identity theft. This occurs when a person uses another’s identity to gains access though their medical coverage or you may find huge medical bills in your name that aren’t yours. They can also use your name to get narcotics due to an addiction. This can affect your medical records and be very dangerous.

The simple fact is that fraud affects each and every one of us. Imagine not being able to get medical coverage for your child because of other peoples fraudulent activities. Worse, imagine your child being given the wrong medication because of medical identity theft.

You can help prevent fraud simply by knowing what is in your medical files. Help insure that all people who need medical coverage can have access to it. Report any suspected fraud to proper authorities.

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What You Should Know About Medicare Eligibility And Coverage

Sunday, January 24th, 2010

Medicare is a social insurance program administered by the United States government that provides health insurance coverage to people who are aged 65 or older. Another requirement for Medicare eligibility is having paid money or taxes into the Medicare system for at least ten years. Seniors below 65 years old can also avail of Medicare benefits if they have a disability or have been diagnosed with permanent kidney failure.

Medicare offers several benefits such as hospital insurance, medical insurance and prescription drug plans. There is another part that deals with a type of insurance plan called Medicare Advantage. The following discusses each benefit in a little more detail:

Part A, or hospital insurance, covers inpatient costs at hospitals, clinics, or ambulatory surgical centers. There are additional requirements involved, but Medicare can also be used to pay for home health care, skilled nursing service and hospice care. Most people don’t have to pay for Part A.

Most people pay monthly premiums for Part B, which is optional if one is still working or currently employed. However, once one becomes eligible for Medicare, the premium becomes more expensive the longer one puts off making enrolling for this benefit. It subsidizes outpatient costs and some services and products not covered by Part A.

Part D involves drug prescription plans for medication not covered in Part B. With these, people can reduce their prescription medicine expenses and protect themselves against higher expenses in the future. Private companies administer the plans, but these are approved and regulated by Medicare.

Part C, or the Medicare Advantage plan, allows Medicare beneficiaries to receive their benefits through private health insurance plans, instead of the original Medicare plan (Parts A and B). These plans are required to offer coverage that is equal or greater than that of the original Medicare program, but they do not have to cover every benefit in the same way. The policies usually cover services that are medically essential and the patient can be charged non-standard deductibles, co-payments, or coinsurance for these services.

Some people perceive the fact that Medicare cannot cover all possible medical expenses of its beneficiaries are perceived as a disadvantage. However, of greater concern is the increasing number of beneficiaries versus the working population, which are basically the source of Medicare funds. It may reach the point where the federal government will no longer be able to support the Medicare program. Some people predict that this situation could come as early as 2018.

Still, the advantages outweigh the disadvantages. It is important to learn as much as you can about Medicare eligibility rules and coverage. In the end, education is the key to making the most of your benefits.

There are a variety of Medicare plans to decide on including the Medicare Advantage Plan. If you require coverage research Medicare eligibility to see if you qualify.

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