Different Ways Veterans Can Avoid Healthcare Fraud And Abuse


Veterans are among the most valued citizens of a country. Their service to the nation’s people cannot be denied and taken for granted. The freedom that democratic nations such as the United States enjoys today is due to the selfless act of veterans who have endured countless wars to protect the country’s sovereignty. Hence, it is only fitting that veterans are afforded with the best healthcare assistance during and after their time in service.

However, it cannot be denied that many of these veterans have fallen prey to abuses in the healthcare industry. As of late, there have been numerous cases of whistleblowers reporting Medicare fraud, thereby necessitating veterans to be on guard against these acts of fraud and abuse. Old age and dwindling mental faculties, among other factors, may often make it very challenging for veterans to protect themselves against the abuses committed by those who are supposedly tasked to ensure their good health and well-being.

If you are reading this as a veteran, or if you have family members who are veterans, it is imperative for you to be knowledgeable about this matter to avoid getting swindled by fraudsters.

That said, this article gives you different ways on how veterans can avoid experiencing healthcare fraud and abuse:

  1. Review Your Explanation of Benefits

When you sign up for healthcare services, especially as a veteran, you will be presented with an Explanation of Benefits relating to the healthcare service that you have signed up for. Hence, before releasing any amount for payments, it is best that you review this clause first. Double check that you are getting the service that you are paying for, and whatever the company has promised you to have. Do not be too over-reliant on agents and later on find out that the healthcare services they promised are not a part of the amount that you have already been paying for.

When you review the Explanation of Benefits, you also have to double check the following information:

  • The names of the providers and contact details should any problems arise
  • The dates of the services
  • The specific list of types of services that forms part of what you are paying for
  1. Be Cautious About Buying Services Online Or Over The Phone

Veterans can easily fall victim to healthcare fraud and abuse because of the false convenience presented by signing up for online healthcare services.

Avoid this as much as possible. While it may seem convenient to take this route because, for starters, it lessens the time spent waiting in long lines, it is not a guarantee that the healthcare service that you are signing up for is legitimate. Although there’s a significant rise in online transactions nowadays, it still not immune to deceptive practices. Thus, it’s best for veterans to initiate healthcare transactions in person in a reputable office or agency.

  1. Protect Your Insurance And Personal Information

This tip is one of the most common and foolproof ways for you to be safe from scams, fraud, and abuse. You have to protect your insurance and personal information at all times. If you are a techy senior citizen, remember that these vital pieces of information are not to be shared online or with just anyone you know, especially to those whom you have just met. Whatever confidential information you have about yourself and your insurance policies must be kept private. You never know if scammers are trying to gain your trust by taking advantage of your age and vulnerability.

  1. Be Careful Of Companies That Push You Into Signing Up Right Away

Yes, healthcare companies are always on the hunt for potential long-term clients. However, this doesn’t necessarily mean that they have to push you into signing up right then and there. Hence, be skeptical about a healthcare agent who is too aggressive in getting you to sign up without providing ample time to check on your insurance policy.

Do not fall into the trap of too-good-to-be-true discounts that have to be availed right away. Remember that a reliable insurance company will always be there to guide you through your whole decision-making process without rushing you.

  1. Count Your Items After Every Purchase

If you think that frauds and scams in healthcare only involve insurance collection and other documents, you are wrong. Healthcare fraud can exist even in the dispensing of medicines, after every purchase at a pharmacy or after you have claimed your benefits. Always check the medications that are dispensed to you after every purchase to be sure that you have the right brand and quantity as prescribed.

Abuse can happen when the claimant is already very old and doesn’t check what is in their hands. They might not be aware of it, but they could have been given a cheaper variant of the medicine, or a smaller quantity. There have been many cases where elderly veterans thought that they were getting the brand and type that they were paying for. Instead, they were given the same medication but with a generic brand. Generic manufacturers are often cheaper than company-branded medications. This is not to say that all generic medicines are ineffective, but not taking the precise medication prescribed may affect a person’s recovery and bodily reactions. As a veteran, you want to sign up for the best funding services available rather than having to lose all your retirement money on scams.

  1. Do Not Believe Anyone Who Says That Insurance Is “Required By Law”

No legitimate insurance company is going to call you over the phone and use the line “it is required by the law” for you to purchase insurance from them. Under the Patient Protection and Affordable Care Act, uninsured veterans need to obtain insurance coverage. Although the population of veterans having no medical insurance is very small, this is still enough of a number prying scammers can take advantage of. Most veterans are already insured but for those who aren’t, there is a very high likelihood that their family members and even these veterans themselves, through their military veterans organizations, will be notified of this change. As it is for their benefit, this amendment will most likely be tackled during their regular meetings and similar discussions.

However, you must be very skeptical of insurance companies that try to force this on you during the first call. In fact, sales scripts of legitimate insurance companies never include a phrase that reminds their clients that this is something they have to purchase because it is required. They should only end on trying to sell their policy. If it doesn’t work, then it ends there. The law isn’t usually brought up during a phone call. Hence, the moment you are told this line, leave, hang up the phone or delete the email. That is sure to be a scam.

  1. Research On The Healthcare Provider

If there is a healthcare provider trying to reach you and you know very little about their background, it is best that you do thorough research first about the company that the so-called agent is representing. Never put your trust and retirement money, for instance, on a company that you have never even heard of. For example, there are medical state boards in your locality that regulate these healthcare providers to make sure that they are providing you with trustworthy and reliable service. Many fraudsters have successfully abused aging veterans and, after collecting a considerable amount of money from them, had run off with their hard-earned retirement money.

  1. Be Cautious About Offers That Are Way Below The Standard Price

Many insurance companies provide their clients with different offers, but most of these offers have a price ceiling. Even when they fight for the best discounts that they can offer, these discounts are still within a level of what is considered as profitable and proper for insurance companies. None of these discounts are too good to be true.

Thus, take time to compare the prices first among various providers. When you do this, you can get an overall idea of how much you should expect to be paying for your healthcare. When a company approaches you or an agent seems to be offering something that is too good to believe in, walk away immediately. There’s a high chance that you may be entering into a fraudulent transaction. Keep in mind that increasing hospital prices have also meant an increase in the cost of healthcare, and not the opposite.

  1. Always Report Any Suspected Fraud

If you are dealing with a healthcare company that you suspect to be a fraud, don’t hesitate to report it to authorities. When you do so, you are making the authorities aware that they have to investigate on this particular person or company before it is too late, and before they can victimize others.


Due to the rapid advancements in technology, scammers are finding smarter ways to deceive insurance applicants. Thus, remain vigilant and always practice thorough verification of any kind of transaction before signing any contract.


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