Tag Archives: Government Health Care Programs

Oct 10 2020

Resources to help you avoid scams during the COVID-19 Pandemic

Scammers are taking advantage of the coronavirus pandemic to con people into giving up their money. During this time of uncertainty, knowing about possible scams is a good first step toward preventing them.

Beware of these corona-related scams:

Vaccine, cure, air filters, and testing scams

The FTC warned  about an increasing number of scams related to vaccines, test kits, cures or treatments, and air filter systems designed to remove COVID-19 from the air in your home. There is no vaccine for this virus, and there is no cure. If you receive a phone call, email, text message, or letter with claims to sell you any of these items–it’s a scam.

What to do instead: Testing is available  through your local and state governments, but these tests are not delivered to your house.

Fake coronavirus-related charity scams

A charity scam is when a thief poses as a real charity or makes up the name of a charity that sounds real to get money from you. Be careful about any charity calling you and asking for donations. Also be wary if you get a call following up on a donation pledge that you don’t remember making–it could be a scam.

What to do instead: If you are able to help financially, visit the website of the organization of your choice to make sure your money is going to the right place.

“Person in need” scams

Scammers could use the circumstances of the coronavirus to pose as a grandchild, relative or friend who claims to be ill, stranded in another state or foreign country, or otherwise in trouble, and ask you to send money. They may ask you to send cash by mail or buy gift cards. These scammers often beg you to keep it a secret and act fast before you ask questions.

What to do instead: Don’t panic! Take a deep breath and get the facts. Hang up and call your grandchild or friend’s phone number to see if the story checks out. You could also call a different friend or relative. Don’t send money unless you’re sure it’s the real person who contacted you.

Scams targeting Social Security benefits

While local Social Security Administration (SSA) offices are closed to the public due to COVID-19 concerns, SSA will not suspend or decrease  Social Security benefit payments or Supplemental Security Income payments due to the current COVID-19 pandemic. Scammers may mislead people into believing they need to provide personal information or pay by gift card, wire transfer, internet currency, or by mailing cash to maintain regular benefit payments during this period. Any communication that says SSA will suspend or decrease your benefits due to COVID-19 is a scam, whether you receive it by letter, text, email, or phone call.

What to do instead: Report Social Security scams to the SSA Inspector General online at oig.ssa.gov .

For more information, go to: click here.

Teaching Suggestions

  • Ask students if they or their families have received calls from scammers. If so, what was their response?
  • Ask students to prepare a list of actions to take if they receive calls from scammers. Share the list with others.

Discussion Questions

  1. Why is it important to do your homework when you donate to a charity? should you donate in cash, by gift card, or by wiring money?  Why or why not?
  2. What should you do if you receive a call, an email, text message, or a letter claiming that an air filter system will remove COVID-19 from the air in your home?
  3. How would you handle any communication which claims that Social Security will suspend or decrease your benefits due to COVID-19 pandemic?
May 9 2020

Health Insurance Coverage in the United States

In September 2019, the U.S. Census Bureau published a report on health insurance coverage in the United States.  The report is based on information collected in The Current Population Survey Annual Social and Economic Supplement and the American Community Survey.

Here are some of the highlights from the report:

  • In 2018, 8.5 percent of Americans, or 27.5 million people, did not have health insurance at any point during the year.
  • The percentage of people with health insurance coverage for all or part of 2018 was 91.5 percent, lower than the rate in 2017 (92.1 percent).
  • In 2018, private health insurance coverage continued to be more prevalent than public coverage, covering 67.3 percent of the population and 34.4 percent of the population, respectively.
  • Between 2017 and 2018, the percentage of people covered by Medicaid decreased by 0.7 percentage points to 17.9 percent.
  • The percentage of uninsured children under the age of 19 increased by 0.6 percentage points between 2017 and 2018, to 5.5 percent.

For more information, click here.

Teaching Suggestions

  • Ask students if they have health insurance of their own or through their parents. What are the premiums for their coverage?
  • Ask students to make a list of available sources for private and public health insurance coverage in their states.

Discussion Questions

  1. What might be some reasons why 8.5% of people, or 27.5 million, did not have health insurance in 2018?
  2. While most people have a single type of health insurance, some people may have more than one type of coverage during a calendar year. Why?
Mar 16 2019

Deceptive Stem Cell Therapy

People spend billions of dollars each year on health-related products and treatments that don’t deliver. People who buy them are cheated out of their money, their time, and even their health.

The Federal Trade Commission (FTC) reports  that California-based Regenerative Medical Group, Telehealth Medical Group, and Dr. Bryn Jarald Henderson, the founder of both companies, sold false hope at high prices.

These companies and Dr. Henderson used social media and websites to promote stem cell therapy for all kinds of health issues affecting older adults and children. Supposedly, it could treat and cure diseases and health conditions such as Parkinson’s disease, autism, dementia, depression, multiple sclerosis, cerebral palsy, traumatic brain injury, heart disease, macular degeneration, chronic kidney disease, osteoarthritis, and stroke. Dr. Gunderson  charged up to $15,000 for their initial stem cell therapy and up to $8,000 for follow-up treatments.

But, according to the FTC, these claims were not backed up by any scientific studies and, in fact, no studies have established that stem cells cure, treat, or reduce the severity of diseases or health conditions in humans. With the exception of a few FDA-approved treatments, stem cell therapy is still largely experimental.

Are you — or someone you know — thinking about stem cell therapy?  If so,

  • Be skeptical about amazing health claims.
  • Don’t trust a website just because it looks professional, uses medical terms, or has success stories from “real people.”
  • Talk to your health care professional before you consider any medical treatment.

For more information, click here.

Teaching Suggestions

  •  Help students understand that health information, whether online or in print, should come from a trusted source.
  • Let students make a list of the richest and most reliable sources of health information and share it with the class.

Discussion Questions

  1. Why is it important to seek a second or even third opinion from a qualified health care provider before trying experimental medical procedures?
  2. What can the FTC and other federal/state governmental agencies do to prevent such businesses to make deceptive treatments.
Feb 16 2019

Fake healthcare plans

If you’re looking online for health insurance, there are lots of results that seem to offer good choices. But dishonest companies are literally counting on you being confused by all those choices. So, before you sign up and pay, take steps to know you’re getting exactly what the plan advertised. Otherwise, fake “coverage” can leave you exposed to substandard benefits and costly payments.

For example, according to the Federal Trade Commission, a Florida-based company, Simple Health Plans, LLC, allegedly tricked consumers into believing its plans offer comprehensive coverage and are compliant with Affordable Care Act (ACA) standards. The company allegedly lured people in through lead-generation sites, using logos of well-known health insurance providers to make itself look credible. Simple Health asked for personal information on the site, followed up with phone calls, and pitched what it said were affordable, comprehensive, ACA-qualified plans with low or no co-pays or deductibles.

But once consumers signed up — often at premiums as high as hundreds of dollars per month — the FTC says they did not get anywhere near the full coverage Simple Health promised, and the benefits were not ACA-qualified.

For more information, click here.

Teaching Suggestions

  • Ask students if they or any of their friends and relatives have received sham health insurance plans calls. If so, how did they handle such calls?
  • Help students understand that two best-known and legitimate sources of the government health insurance are Medicare and Medicaid.

Discussion Questions

  1. What are some ways to protect yourself against false health care plans?
  2. Why is it important to learn the difference between health insurance and medical insurance discount plans?
Aug 5 2017

New Medicare cards are on the way

Changes are coming to your Medicare card.  By April 2019, your card will be replaced with one that no longer shows your Social Security number.  Instead, your card will have a new Medicare Beneficiary Identifier (MBI) that will be used for billing and for checking your eligibility and claim status.

Having your Social Security number removed from your Medicare card helps fight medical identity theft and protects your medical and financial information.

Here are some common Medicare scams relating to the new cards:

  • Someone calling, claiming to be from Medicare, and asking for your Social Security number or bank information.
  • Someone asking you to pay for your new card.
  • Someone threatening to cancel your benefits if you don’t provide information or money?

For more on the new changes to your Medicare card, visit Centers for Medicare & Medicaid Services.  And report scams to the FTC.

For more information, click here.

Teaching Suggestions

  1. How do you think this change will affect patients? You?
  2. Replacing Social Security number with Health Insurance Claim Number will cost millions of taxpayers dollars. Do you think it is worth the expense?

Discussion Questions

  • What is the biggest reason the Social Security is taking the Social Security Number off of Medicare cards?
  • How will the new system affect people with Medicare?
  • Who will be the affected stakeholders?
Jul 25 2015

The Supreme Court, Health Care, and You

On June 26, 2015, the Supreme Court made an important decision about the Health Insurance Marketplace keeping           quality, affordable coverage for millions of Americans.  The Supreme Court’s decision confirmed that if you qualify, you can receive financial assistance, including premium tax benefit to make coverage more affordable no matter where you live.

On average, consumers enrolled in the Marketplace are receiving $3,260 per year in tax credit, or $272 each month.

About 8 in 10 consumers could find coverage for $100 or less with tax credit through the Marketplace.

If you don’t have health insurance, see if you can get health coverage for 2015.  You may qualify for a Special Enrollment Period due to life change, such as marriage, having a baby, or losing other coverage.  Open enrollment for 2016 starts on November 1, 2015.

For more information, click here.

Teaching Suggestions

  • Ask students if anyone in their family is affected by the Supreme Court ruling, and if so, how?
  • Ask students to prepare a summary of the major provisions of the Affordable Care Act.

Discussion Questions

  1. Why is it important to inform the Marketplace about any changes to your household, income, and insurance status?
  2. If you have health insurance through your employer or purchased it on the individual market, does the Supreme Court ruling impact you?
Jul 11 2015

CMS Proposes Rule to Strengthen Managed Care for Medicaid and CHIP enrollees

On May 26, 2015, the Centers for Medicare and Medicaid Services (CMS) proposed to modernize Medicaid and Children’s Health Insurance Program (CHIP) managed care regulations to update the programs’ rules and strengthen the delivery of quality care for beneficiaries.  This proposed rule is the major update to Medicaid and CHIP managed care regulations in more than a decade.  It would improve beneficiary communications and access, provide new program integrity tools, support state efforts to deliver higher quality care in a cost-effective way, and better align Medicaid and CHIP managed care rules and practices with other sources of health insurance coverage.  Overall, this proposed rule supports the agency’s mission of better care, smarter spending, and healthier people.

For more information, click here.

Teaching Suggestions

  • Ask students to visit the CMS.gov website to learn how the healthcare delivery landscape has changed and grown substantially since 2002.
  • Ask students how CMS might strengthen the quality of care provided to beneficiaries.

Discussion Questions

  1. Why is the CMS proposing new rules to strengthen managed care for Medicaid and CHIP enrollees?
  2. How does the CMS plan to modernize Medicaid and CHIP regulations?
Jul 8 2015

5 Ways To Become An Informed Medicare Consumer

Each day, you make important choices about your finances, health, privacy, and more.  Medicare has 5 things you can do to help you become an informed Medicare consumer.

  1. Know your rights. As a person with Medicare, you have certain rights and protections designed to help protect you and make sure you get the health care services the law provides.
  2. Protect your identity. Identity theft happens when someone uses your personal information without your consent to commit fraud or other crimes.  Keep the following information safe:
    • Your name
    • Your Social Security Number (SSN)
    • Your Medicare Number (or your membership card if you’re in a Medicare Advantage or other Medicare health plan)
    • Your credit card and bank account numbers
  1. Help fight Medicare fraud. Medicare fraud takes money from the Medicare program each year, which means higher health care costs for you.  Learn how to report fraud.
  2. Get involved with other seniors with the Senior Medicare Patrol (SMP). The SMP educates and empowers people with Medicare to take an active role in detecting and preventing health care fraud and abuse.
  3. Make informed Medicare choices. Each year during the Fall Open Enrollment Period (October 25-December 7), review your plan to make sure it will meet your needs for the following year.  If you are not satisfied with your current plan, you can switch during the Open Enrollment Period.

For more information, click here.

Teaching Suggestions

  • Ask students to prepare a list of medical expenses that Medicare does not cover.
  • Ask students to check out the Centers for Medicare and Medicaid Services (CMS) videos for tips on preventing Medicare fraud and see how seniors are learning to stop, spot, and report fraud.

Discussion Questions

  1. Why is it vital to fight against Medicare fraud?
  2. Why is it important to review your health care plan during the Fall Enrollment Period?
Feb 28 2015

Your 2015 Tax Return and the Health Care Law

Certain provisions of the Affordable Care Act will probably affect your federal income tax return when you file this year.  The law requires that you and each member of your family have qualifying health insurance coverage for each month of the year, qualify for an exemption from the coverage requirement, or make an individual shared responsibility payment when filing your federal income tax return.

Most taxpayers will simply check a box on the tax return to indicate that each member of their family had qualifying health coverage for the whole year.  Qualifying health insurance includes coverage for most, but not all, types of health care coverage plans.  If you bought coverage through the Health Insurance Marketplace, you should receive Form 1095A, Health Insurance Marketplace Statement from your Marketplace by early February.

For more information, Click Here.

Teaching Suggestions

  • Ask students to search the Internet to gather more information about the new IRS requirements and the Affordable Care Act.
  • What are provisions that might affect an individual and their families?

Discussion Questions

  1. What are the reporting requirements when you file your federal income tax return this year?
  2. How can you determine if you are eligible for an exemption?
  3. What should you do if you are expecting to receive 1095A and you don’t receive it by early February.
Dec 31 2014

Health Insurance Marketplace Application Check List

When you apply for or renew your coverage in the Health Insurance Marketplace, you’ll need to provide information about you and your household, including income, and insurance coverage you currently have, and some additional information.

Use the checklist below to help you gather what you need to apply for coverage.  Open enrollment ends February 15, 2015.

  • Home and/or mailing addresses for everyone applying for coverage.
  • Social Security Numbers.
  • Document information for
  • Employer and income information for every member of your household (for example, from pay stubs or W-2 forms—Wage and Tax Statements)
  • Your best estimate of what your household income will be in 2015.
  • Policy numbers for any current health insurance plans covering members of your household.
  • A completed “Employer Coverage Tool” for every job-based plan you or someone in your household is eligible for. (You’ll need to fill out this form even for coverage you’re eligible for but don’t enroll in.)
  • Notices from current plan that include your plan ID, if you have or had bad health coverage in 2014.

For more information, go to:

https://marketplace.cms.gov/outreach-and-education/marketplace-application-checklist.pdf

Teaching Suggestions

  • Many states are expanding Medicaid to cover more people. Ask students to find out what Medicaid expansion might mean for them.
  • Why do some people qualify for an exemption from the fee based on income or other situation?

Discussion Questions

  1. Do most people who apply for health insurance through marketplace qualify for premium tax credit?
  2. What penalties are imposed on people who don’t have a coverage in 2015?
  3. Can you buy a plan outside the marketplace and still meet the health care law’s coverage requirement?