Medicare and Medicaid Waste, Fraud, and Abuse

​As seniors, we are often times worried about being scammed by insurance agents, and insurance companies. Ben Franklin formed the very first insurance company way back in 1735. It was a fire insurance company and is the oldest insurance company in the U.S. still in existence. There wasn’t very much oversite, if any, over insurance companies back then. Over the decades more insurance companies were formed and taking advantage of people was pretty much overlooked. In 1871, the National Association of Insurance Commissioners (NAIC) was formed. The Insurance Commissioners from each of the States would, as a body, seek to regulate and standardize the insurance industry.

​In today’s world the NAIC makes sure that insurance plans of all kinds are up to par. For example, let’s look at a Medicare Supplement policy. If you look at a plan G anywhere in America, it will be exactly the same. There are many different companies that offer plan G, and every one of those plan G policies are identical. The only difference is what you pay for them.

Medicare and Medicaid fraud is a very real threat for seniors today, but not in the way you would think. With all the rules and regulations in place by Medicare and the Federal Government, as well as the insurance carriers, it is still possible for agents to commit fraud through misrepresentation of the policies they are trying to get you to buy. That is the very reason you need to read the fine print before you even start an application. Don’t get me wrong, most agents today want to do things the right way. It is so very important that you trust your agent and feel comfortable when it comes to making decisions about your insurance. So, where does the waste, fraud, and abuse come into play? If you look at: https://www.texasattorneygeneral.gov/news/categories/medicaid-medicare-fraud  you will see that the vast majority of fraud comes from pharmaceutical companies, ambulance  companies and lots of other behind the scene providers. These people aren’t stealing from you personally, but they are stealing from Medicare and insurance companies, which makes YOUR rates go up.

Each year you should meet with your agent and review your coverage. Look at things like rate increases, drug coverage, your doctors, specialists, and hospitals.  If you have a good agent, they will keep you informed of changes that might affect you in adverse ways. A good local agent is what you need to be looking for. Who do your friends and family trust for their insurance? I know during the pandemic it was extremely hard for us seniors to talk with an insurance agent. Everything was done online or by phone. We didn’t know who we were talking to or where in the world they were! Now that things are getting back to normal, it is important to find a good, honest, ethical agent to help you with your insurance.
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We, here at The Seniors Group of Texas, pride ourselves in being good, honest, ethical agents and we have for more than 20 years. We would deem it an honor to assist you in your Medicare insurance journey. We are your local, hometown agency and we look forward to building a lasting relationship with you.      
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Barry Collinsworth
Vice President Sales and Marketing
Phone: (972) 814-8990 
Email: [email protected]
Web: www.tsgotinsurance.com