Medicare Health Care Insurance – How to Spot A Fraud?

Health Insurance scam

Medicare fraud is a form of insurance fraud, which is any type of illegitimate claim to receive health benefits for personal gain. It can take many forms.

Medicare fraud can be charging for additional or more expensive services than the patient actually received, charging for missed appointments, increasing patient sales on unnecessary services to fill bills, or paying for Medicare patient referrals.

Penalties for Medicare Fraud

Medicare fraud is illegal and considered a felony. Anyone committing it could face criminal, civil, or administrative consequences, including jail time, fines, or penalties – such as loss of medical licenses or exclusion from participation in any federal health programs. Medicare frauds operated in different countries.

Medicare Fraud in the US

In 2011, a US government program called Medicare, have been charged with fraud. The company used to bill the US government for services that “were given” to people that were dead.

91 businessmen and entrepreneurs, including nurses and doctors, were charged over $295 million US dollars of health fraud.  The arrests took place in 8 different US cities and occurred for 3 weeks.

In April 2022, just 2 months ago, 21 people were accused of fraud in 150 Million USD worth of missing government money

during the time Covid-19 occurred. According to the Daily Mail, arrests were made in nine districts across the United States.

Medicare Fraud in Portugal

We’ve been getting a lot of information about A company called Medicare.pt that operates in Lisbon Portugal. Medicare is owned by MED&CR – Serviços de Gestão de Cartão de Saúde, a one-person company.

Allegedly, many people that got involved with the company got false advertising and misleading information. Moreover, there have been charges for services that were never provided by the Portuguese company that they did not agree to cancel the contract with their customers.

Medicare.pt tell their clients that the health plan costs 22 EUR a month and that includes dental treatments (how come?!) and that there is no grace period for any of the health services.

Furthermore, a doctor will come to your house within a few hours’ time. Sounds really amazing isn’t it? well, their promises turned some red lights to many people that were interested in their services, most of them foreigners that relocated to Portugal and were looking for a private health plan.

Although the customers did not give any written confirmation to the company, medicare.pt rely on a phone call with the customer. Seems like many people fell into this scam when wanted to get private health insurance but then they understood they were scammed.

A few Portuguese complaint portals indicate difficulties of canceling the contract with medicare.pt., along with problems with withdrawing from the service, as several people write on this Complaint Portal.

In 2020, there were already more than 800 complaints about the company. In 2019 619 complaints. All the details can be found in this post. So far the company still operates in Portugal which is very surprising.

Medicare Fraud – How to Beware of It

With all being said above, we really hope that such frauds will be taken care of by governments and law firms.

Before agreeing to anything, it’s important to perform well research about a company that offers health insurance and other services. Especially if you are a foreigner or a digital nomad traveling the world.

We really recommend using trustpilot.com for any kind of service you are interested in. That includes insurance of any kind, travel services such as car rentals, online stores, legal services, beauty, well-being, and more.

On Trustpilot, there are reviews from all over the world that was added by customers that share their opinions. That gives customers a powerful voice that can save others from making mistakes and also help businesses improve.

 

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