Breast cancer is one of the top killers of women in America. A mammography is the most common method of detecting early stage cancer, using an X-ray to examine for any irregularities. In women between 65 and 74 years old, these tests have been shown to reduce the number of cancer-related deaths.
Cervical Cancer Screening
The most common test associated with cervical cancer is known as the Pap test, which is performed on a sample of cells from the cervix to test for abnormalities. While it is optional to stop Pap tests after the age of 65 if you have no history cervical dysplasia or cancer and have consistently tested negative in your previous tests, it is always a good idea to discuss your decision with a doctor as some surveys indicate that they are still beneficial.
Human Papillomavirus Testing
Human Papillomavirus is one of the leading causes of cervical cancer. It is so common that almost everyone who is sexually active will become infected with one of the more than a hundred types of HPV known today. Testing for HPV even among senior women with no history of cervical issues has proven to be a lifesaver, as Pap tests alone miss up to 40% of precancerous lesions.
While there is much debate as to whether it is a matter of genetics or environment, African Americans are statistically much more likely to be diagnosed with a number of illnesses, even if they have never engaged in high-risk behaviors: African American men, for instance, are 50% more likely to get lung cancer than white men, even with lower tobacco exposure.
While many outside of the LGBTQIA might associate these populations with an increased chance of HIV, there are other ailments that disproportionately affect those communities. The list includes physical maladies such as diabetes and anal cancer, and also a much higher rate of mental illnesses such as depression, especially among the older populations.
How Does Part B Cover Preventive Health Services?
While Medicare Part A does not cover preventative care, Part B covers a large number of preventative procedures that are especially of concern to seniors.
What Kinds of Services Are Covered?
The number of services and screenings offered by Part B are actually fairly extensive. They range from screenings for life threatening ailments like HIV and Cancer, to more long-term ailments like Chronic Obtrusive Pulmonary Disease, Diabetes, and Glaucoma; some programs are even geared towards mental illnesses like depression.
Medicare open enrollment season, which runs between October 15 – December 7, 2017, is fast approaching. During this time thousands of Americans will be applying for benefits. While Medicare and Medicare Advantage offer benefits to millions of people, fraud and abuse are two issues that adversely affect Medicare and the people who depend on it. In fact, a 2015 report found that as much as $60 billion was lost through Medicare fraud in 2014.
In this three-part post, we will take a close look at health insurance fraud and abuse, how they happen, and what you can do to prevent them. In this first post, we will explain what Medicare fraud and abuse are and, more importantly, why they matter.
What Is Medicare Fraud?
To put it simply, one type of Medicare fraud occurs when someone knowingly makes a false claim for services and procedures that never happened. That means your doctor or another party is charging the Medicare system for services never rendered. Because health care providers are reimbursed by the government for treating Medicare patients, it is a potentially lucrative form of fraud that costs taxpayers billions every month. We will dive deeper into the types of Medicare fraud in post two.
What Is Medicare Abuse?
Medicare abuse is a little different. One example is when a doctor administers treatments or procedures that do not truly benefit a patient. These procedures can range from unneeded but harmless prescriptions to potentially deadly surgeries. In this case, work is being performed by the doctor, but the work was not necessary. Medicare abuse exposes patients to unnecessary risk.
Why Should Anyone Care?
People seem to care more about Medicare abuse because it can have a negative impact on a person's life, even resulting in death. But fewer people seem worried about Medicare fraud. All too often, it's seen as a victimless crime. That simply isn't true. As tax payers, it's your money being stolen and wasted.
Plus, every unnecessary cost to Medicare results in an undue burden on the Medicare system as a whole, which then results in higher premiums and health care costs for everyone who relies on the program.
That's why Medicare fraud should be a concern for every American, whether they pay for private insurance or are on Medicare. In the next post, we will examine the most common methods of Medicare fraud and abuse.
ABC News, "Medicare Funds Totaling $60 Billion Improperly Paid, Report Finds," July 2015
Medicare Consumer Guide, "Preventing Medicare Fraud"
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Medicare is one of the most popular government run programs in the nation. Every day, 10,000 Americans enroll in Medicare and around 37 million rely on Medicare for their preventative health services like flu shots and cancer screenings.
According to the Kaiser Family Foundation, 6 in 10 Americans report that the program is working well. That number climbs when you look at seniors, 8 out of 10 of whom believe Medicare works well for them. But working well and working perfectly are two separate things.
A major flaw in the Medicare program is the risk for both fraud and abuse. Fortunately, there are ways for concerned seniors to help combat both, thanks to the Senior Medicare Patrol.
What Is the Senior Medicare Patrol (SMP)?
The SMP is a network of specially trained volunteers who seek out evidence that abuse or fraud has occurred and report it to the proper authorities. In doing this, the SMP helps to prevent undue burden on the Medicare system that could potentially cause a rise in the price of senior health care.
Who Are the Volunteers?
The vast majority of the roughly 5,000 nationwide volunteers are civic-minded Americans who are retired and on Medicare. Like a neighborhood watch, these volunteers are among the first defense against the sort of fraud that could have devastating effects on the Medicare system.
What Do SMP Volunteers Do?
SMP volunteers are responsible for a number of services geared towards improving the life of Medicare beneficiaries and their families. Among the most common tasks are:
Whether you are looking for a way to help combat the issues of insurance fraud and abuse, or you are looking for a way to find out if you yourself might be at risk, SMP offers a number of services and opportunities that might interest you. To learn more about this important program, visit the official website.
This concludes our three-part series on Medicare fraud and abuse. Knowing what to watch out for can make a real difference in your risk of being taken advantage of.
If you have any additional questions, give us a call at Bankers Fidelity at (866) 458-7500.
The Commonwealth Fund, "Medicare's Numbers Game," April 2015
The Henry J. Kaiser Family Foundation, "The Public's Health Care Agenda for the 113th Congress," January 2013
Senior Medicare Patrol, "Become a Volunteer"
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Understanding Medicare Supplement
Neither Bankers Fidelity Life Insurance Company® nor its Medicare Supplement policies are affiliated with or endorsed by the U.S. Government, the federal Medicare program, or the Centers for Medicare and Medicaid Services. This is a solicitation of Medicare Supplement insurance and an independent agent may call on you. The Medicare Supplement products issued by the Company are insurance policies. Policy form series B 21092 is issued by Bankers Fidelity Life Insurance Company®, Atlanta, GA; policy form series B 21492 is issued by Bankers Fidelity Assurance CompanyTM, Atlanta, GA. Limitations and exclusions apply; actual policy provisions control. Rates subject to change on a class basis. Individually underwritten; application to determine eligibility required.
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