Stay Legal! Avoiding Insurance Fraud

Everyone knows that the health insurance industry is continually raising monthly premiums, and many feel this is unjust to you as the consumer. However, the health insurance industry has had to fight increasing health insurance fraud. The amount of money spent on investigating and prosecuting fraud is then passed on to policyholders. Many people do not understand what health insurance fraud entails, though. With reports estimating health insurance fraud is a $30 billion to over $100 billion industry per year, the topic should not be taken lightly. Every health insurance policyholder should understand what health insurance fraud is and its consequences. By doing so, you are more able to recognize and fight fraud.

Health insurance fraud is typically defined as intentionally deceiving, misrepresenting, or concealing information to receive benefits from the insurance company. Essentially this means that you assert that you paid for certain medical procedures or expenses out-of-pocket which you have not actually received, and you are submitting claims to the insurance company to receive reimbursement. Another example of member fraud is to conceal pre-existing conditions or to alter medical documents so that non-policyholders or ineligible members receive medical benefits under your policy. Perhaps your sister does not have insurance and needs medical attention. Having her use your name and policy to cover the expenses is health insurance fraud. While you may think that this is a small issue in comparison to your sister receiving treatment, it is actually very serious to your health insurance company and industry, and will result in fines and possible imprisonment if your are caught.

Not only policyholders commit fraud, but providers (physicians, hospitals, etc.) do as well. Since physicians and hospitals bill the insurance company for services they provide for you, they are also receiving reimbursement from the insurance company. When providers commit fraud, they may be billing the insurance company at higher rates for services rendered or they may bill for services you never received. In these cases, you will probably be asked to cooperate in the insurance company's investigation.

Another type of health insurance fraud that has developed recently targets the policyholder more than the insurance company. Schemes have developed where fake insurance companies or agents sign unsuspecting customers for coverage at surprisingly low premium rates. They often act much like a regular insurance company for the first few months, paying for smaller medical claims like physicians visits. But once you have a more serious medical condition that needs treatment, the insurance company will disappear - along with the money you have been paying in premiums.

The rule with health insurance fraud is much like that of any other scam: if a deal seems too good to be true, just remember - it probably is. Remember to be honest in your dealings with health insurance companies and expect the same in the return from these companies, as well as your health care providers. Stay legal to avoid fines and prison and to continue receiving health insurance coverage.

Health Insurance

Something Old, Sometime New: Insurance When You are Getting Married

Health insurance providers are not created equal. Before a couple is married, the option of sharing coverage is extremely unusual unless one of your insurers offers domestic partner insurance. As you become engaged, if you both have separate insurance it is important to talk about the both of you switching to the better plan once you are married. There are a few factors consider, which include deductibles, co-payments, and the benefits of each separate plan. Marriage is a big step, and it can be done with ease if the two of you settle important decisions such as your health insurance plan before you take the big leap.

Your deductible is the amount you must pay each year to start your policy. Once this payment is made you will be responsible for whatever amount of co-payment your insurance company requires for you to pay for the health expenses that are covered in your particular policy. The amount of co-payments that you will be responsible for is established at the time you agree to your health insurance policy. It is going to be a certain percentage of health expenses; for instance, you pay 10% while your insurer will be paying the other 90%. You and your fiancé should compare both of your plans and figure out which deductible and co-payment plan seems most appropriate for the two of you.

Married couples are usually eligible for certain benefits that unmarried couples are not. Being insured separately by the health care provider sponsored by your employers may no longer be the most beneficial option for you. If you or your fiancé has insurance, and the other does not, once the two of you are married they can be added to the other partner's plan. Cost of adding an additional person is definitely something that should be examined. You should not be required to pay more for adding a spouse or even a child in the future because most plans are offered to immediate family at no extra cost. The best way to compare policies is to estimate a yearly amount of normal health expenses, emergencies, co-payments, and deductibles. Whichever plan has the lowest cost to you will almost always be the best choice.

In addition to sharing health insurance with your new spouse, you may also want to consider switching the rest of your insurance plans, such as the policies you have for your separate automobiles. This is because most companies will give you a discount on having more than one vehicle insured. You may also be interested in finding a company that can insure you home, automobile, and health in one place. If you carry more than one policy with a company, they will also usually give you some sort of discount on them. It is important to sit down and discuss insurance with your fiancé because the two of you could be saving money and stress by figuring out what decision is best before the time comes.

Health Insurance

Shop 'Till you Drop: Shopping for Health Insurance

Shopping for health insurance can be a frustrating hassle. There are so many companies with so many rates to compare. However, it is important to take your time and find the best company for your money. Although it may be frustrating, health insurance is a necessity. In any area, there are usually quite a few health care providers that can supply you with a quote over the phone. You could also use the Internet as a resource. By using these tools, you can make the shopping process go more smoothly.

The first step is going to be deciding which type of insurance you should be shopping for. If you have a family, it would be in your best interest to find a company that will give you one decided premium and co-payment plan no matter how many children you add to the plan at any time. Without a family, you would be shopping for individual health insurance but will need to decide if you are in need of short-term insurance or insurance for an extended period. Short-term insurance is for people who are in-between jobs and expect to enroll in whichever health insurance plan their future employer sponsors.

Once you have established what type of insurance you need, it is time to make some calls. Go through your local phone book and start calling down the line. After answering a few simple questions, you can get a quote and move on to the next company. Cost is one of the most important factors. If you find two or more of them with very similar premiums and a low co-payment amount, you should compare the benefits. Can you add immediate family at no charge? Will this health insurance include dental, emergencies, prescriptions, or doctor visits? This may help you find one that appeals more to your needs and is within your budget. Using the services of the Internet to find a company will be a very similar process. Some reputable web sites out there will ask you to fill in a few blanks and then give unbiased quotes from many different health insurance companies.

Whether you are going to be doing your shopping over the phone or on the Internet, you should use your best judgment of the information that you get on each company to decide on one that makes you comfortable. The Better Business Bureau can also help you be sure that you are not being scammed. Health insurance is a cost that is necessary to save you money in the long run on prescriptions, doctor visits, and unforeseen emergencies. Don't get left with bills that you have no way of paying because you didn't have insurance.

Health Insurance

Say Cheese: Dental Benefits

Dental insurance is often an afterthought when obtaining health insurance for a number of reasons. Some people may simply dislike the dentist and use the lack of dental insurance as a reason to not visit the dentist; others may feel that dental insurance is not worth the added cost to their monthly health insurance premium. Still others may simply feel that their teeth are in good shape and there is little need to spend the extra money to cover a part of their body that does not currently have any problems. Nevertheless, dental insurance is important because of several benefits.

When people think of the cost of dental work or procedures, they often think of costly bills. Even simple procedures like getting your wisdom teeth removed can average in the hundreds of dollars per tooth! However, one obvious benefit to dental insurance is the coverage of simple but costly dental procedures such as getting a tooth removed. In the end, the slight increase in a monthly premium may be worth it to avoid a high dental bill. Moreover, dental insurance also helps financially if a dental emergency develops. Perhaps you are in need of a root canal or dental implants - both extremely costly procedures that you often do not anticipate. Dental insurance will most likely cover a portion, if not all of these expensive procedures.

Also, while many feel that brushing and flossing daily is all the dental care they need this is simply not true - even for young, healthy adults. Dental disease is common and can affect your body in a number of ways. For instance, some dental diseases left untreated can lead to more serious medical issues such as kidney infections or even diabetes. Most people do now know of the connection between dental diseases and other illnesses. Thus, having dental insurance that covers routine visits to the dentist, which can help uncover dental diseases early, is extremely important. Dental insurance is designed to encourage preventative care, because spotting dental diseases or dental problems early reduces the overall cost of treatment.

Dental insurance may seem like just another gimmick to get a few more dollars out of you, but it is essential for your health. Your regular health insurance plan, whether it is through your employer as a group plan or an individual plan, should offer you the option of buying dental insurance coverage, and you should consider this piece of the plan thoroughly when purchasing health insurance.

Health Insurance

Protection during the Golden Years

Protection during the Golden Years: Health Insurance and Retirement

Health insurance for retirees or senior citizens can be confusing, especially with so many options and requirements. However, health insurance is crucial for retirees. As you grow older, your health obviously becomes more of an issue; you may visit the doctor more, need to fill more prescriptions, or even receive in-home care. Before you retire, prepare for health insurance to ensure that you receive the best benefits.

The first step in planning your health insurance coverage in your retirement is to see if your employer offers insurance coverage after you retire. If the company does, you should certainly consider it. Look at the plan, the deductible, and the coverage. Many near-retirees believe that Medicare will cover their medical payments, but this is not always the case. With this sort of coverage, you will most likely receive better health care but at a more expensive cost. As a retiree, you will certainly have a health insurance budget to maintain, and you will have to decide if the cost of your employer's insurance is too expensive.

If your employer does not offer coverage, Medicare will be an important and integral part of your health insurance if you are 65 years of age or older. Medicare works like traditional health insurance plans in that you have been contributing a small portion of every paycheck you earn into this plan. Once Medicare begins, you will make co-payments for office visits or treatment. Medicare will also cover the expense of certain medical equipment or needs.

However, Medicare did not cover a number of items that are typical of health insurance. The government recently updated Medicare and divided it into three parts: Part A, B, and C. Part A covers hospital care, such as home health care, hospital stays, and hospice care. This part does not require a premium. Part B covers the more routine medical expenses, such as office visits and laboratory tests, while Part C enrolls you into a fee-for-service or managed care plan that reduces your out-of-pocket costs. Despite these different options, Medicare restricts your coverage by not covering certain kinds of care or illnesses and diseases. Thus, there is also Medigap coverage, which helps fill in the gaps in health insurance that Medicare leaves. Medigap coverage differs from state to state and has different payments.

Beyond Medicare and Medigap, there are also long-term care insurance plans that you can buy. You often see these plans advertised on the television at very low prices. These plans can help cover the costs of a nursing home or home health care. With so many different options and limitations, if you are retiring soon, you should take a look at your budget and what you can afford as well as what sort of coverage you feel you will need.

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