Eldercare Series: Protect Your Elder from Medical and Insurance Fraud

As a member of the sandwich generation, your life involves caring for your growing children as well as your aging parents or relatives. To protect your kids, you inform them about cyber bullying, internet safety, and talking to strangers. To protect your elder, you should be talking about the most common types of schemes that focus on people in their age group. Right now, a huge scam targeting elders is medical and insurance fraud.

What is medical and insurance fraud?

Medical and insurance fraud comes in many forms. It can be something as simple as a company giving your elder non-needed medical equipment so that they can bill your elder’s insurance, or as complicated as stuffing your elder’s medical bills full of additional services that didn’t happen or weren’t needed.

Pay Attention during Office Visits and Ask Questions

When your elder visits their doctor, go with them and pay attention to the services conducted. Ask questions if you feel a service being provided is unnecessary, and get a second opinion on pricy procedures. Later, examine medical bills carefully to make sure that your elder received each service listed, and contact the physician’s office and your insurance immediately about discrepancies.

Go over the following basic safety tips with your aging loved one to help them avoid being a victim of this type of fraud:

  • Never give your personal, contact, or medical information to anyone but your doctor’s office and pharmacy, and then only in person. Anyone with this info can bill your elder and their insurance for services, even if they didn’t happen or weren’t delivered.
  • If someone calls and says your doctor or caregiver asked them to call for insurance or personal info, do not give them the information they request. Remember that your doctor already has your information, and your caregiver would never ask someone else to call for personal information.
  • Do not sign up for services or medical equipment from anyone but your physician. Your doctor will refer you in person to an outside company if needed, and you can contact them directly.
  • If someone calls offering free medical equipment, tell them not to call again and hang up. Many times they will bill your insurance for things you don’t even need and then the equipment never arrives. It’s okay to hang up.
  • If someone comes to your door offering free medical equipment, tell them not to solicit your home again, you are not interested, close and LOCK the door. Never let a stranger into the house. Their goal is to get money from you, and they can quickly go from sweet to pushy in the blink of an eye. The best thing you can do at any age, is to keep all doors and windows locked, and to never open the door to someone you don’t know.
  • Unless you are at your doctor’s office, never sign medical billing forms, especially if they come by mail or someone brings them to your home.
  • If you are signing forms at the doctor’s office and have questions about what you are signing, ask that the forms be explained to you and have your caregiver read them over as well.

There are many scams out there focusing on senior citizens. To learn more about fraud and how to protect your aging loved ones, visit the Canadian Health Care Anti-fraud Association. If you have any thoughts or tips that could help others avoid becoming a victim, be sure to leave them below. We love comments, and yours could help others keep their elders safe from medical scams.

Photo courtesy of Rooftop Mind on Flickr.

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