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Protecting Yourself from Health Care Scams

Posted 9/13/2016 by UHBlog

Health care fraud can occur in many ways, and can even endanger your health. If you have questions, we can help.

Protecting Yourself from Health Care Scams

Chances are good you’ve read or heard a story about health care fraud recently. After all, scammers are always busy, especially when you consider that they charge billions of dollars each year for health care services and supplies their victims never receive or order.

Unfortunately, everyone is susceptible to health care scams, even young people. It just seems that you hear a lot more about older people falling prey, says geriatric medicine specialist Taryn Lee, MD.

“Plenty of younger people get scammed, but we don’t hear about it as often,” she says. “And with younger people, we’re not threatening to take away their independence. There's more at stake for an older person.”

While seniors do have good insurance through Medicare, there are other factors that make them more vulnerable, she says. Among these reasons are:

  • Bombarded with mail and/or phone calls. The volume of mail and phone calls that Medicare-eligible people receive can boggle your mind. Sometimes a piece of mail or a caller sounds legitimate.
    “It’s important to ask questions whenever someone contacts you out of the blue,” Dr. Lee says. “You want to be very careful about what you agree to or sign. If in doubt, ask a family member, trusted friend or your doctor before making a decision.”
  • Less savvy on the Internet. Most seniors didn’t grow up with computers and may be newer to accessing the World Wide Web. Seniors – like teenagers – can become trigger happy about clicking links and end up agreeing to something they don’t fully understand.
    Be cautious and protect your identity online, Dr. Lee says. Don’t input your medical and financial information if you’re not sure it’s a safe site or someone you know. Otherwise, you risk compromising your health care coverage, finances and more. Once again, seek help from someone trustworthy when you’re uncertain.
  • Insurance providers who switch services mid-year. It’s not unusual for an insurance company to begin working with a new service provider, which can impact your health care and prescriptions. Sometimes these can look like a bait-and-switch scheme, but may be justifiable. Other times, a provider is billing you for services or equipment you've never received.
    “A lot of unnecessary medical equipment and services get ordered,” Dr. Lee says. “The forms come to me to sign. On the occasions when I call my patients and say, ‘Did you order this?’ they’re just as likely to say no. If it’s a medicine they need on an ongoing basis – for instance, to treat their diabetes – this can affect their health.”

If you want to protect yourself and/or your loved one from falling victim to health care scams, follow this advice:

  • Keep up on the latest scams. Many government sites post information about current health care scams designed to get you to reveal personal information. Learn about the latest frauds by checking sites such as the Federal Trade Commission, the National Health Care Anti-Fraud Association and/or Stop Medicare Fraud.
  • Question the red flags. Trust is important and if the older patient brings up concerns, their doctor listens and takes steps to help.
    “I’ve had patients who come into see me and their money, credit cards and other possessions are hidden in their clothing or on their person,” Dr. Lee says. “When I ask why, they say, ‘It’s because I don’t trust the caregiver.’ If we think the person is being exploited, we contact adult protective services or the appropriate agency.”
    Whether the caregiver is a family member, a boarder or a paid service, make sure your finances and medical information are protected.
  • Be aware of your limitations. “When people are struggling to manage their finances and are overwhelmed or anxious or don’t think they have enough money, we gently suggest if there are family members, to get them involved,” Dr. Lee says. “If no family is available, we refer them to agencies that can help.”

Some ways that adult children or family members can help are by:

  • Direct-depositing all checks into bank accounts
  • Setting up automated bill payments
  • Viewing bank accounts online, which can be done from afar
  • Visiting the older person weekly, during which time you review mail together and pay bills. Also, portion out medicines into daily containers and if a prescription is low, get it refilled.

For seniors suffering with dementia, make their physician aware, Dr. Lee says. In situations where the senior’s finances are low, their doctor can guide them to an agency that can help.

“Involve your doctor,” she says. “We do a lot of education and counseling, and know a lot about the resources available to help.”

Taryn Lee, MD is a geriatrics medicine specialist and the Geriatrics Fellowship program director at University Hospitals Cleveland Medical Center, Case Western Reserve School of Medicine. You can request an appointment with Dr. Lee or any other doctor online.

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