The Future of Medicare and How to Avoid Medicare Fraud Future of Medicare and How to Avoid Medicare Fraud

A Look at the Future of Two Programs

The two most important programs that affect the health and well-being of older Americans are Medicare and Social Security. According to a 2021 analysis conducted by KFF, 94% of people 65 and older on medicare report to be very satisfied or just satisfied with the quality of the medical care that they receive. This also included satisfaction with the availability of specialists.

On the other hand, in 2020 AARP utilized a poll to understand the support rate of social security benefits. The poll found that 96% of participants support social security. Regarding the program’s popularity, there are 64 million people that collected social security in the year 2020 when the poll was conducted. 

However, although the poll showed an undeniably high percentage in favor of the protection that social security offers, the financial future of the social security program doesn’t look to healthy. If you weren’t aware, there were changes made to social security in 1983. Those changes have provided enough information for the Social Security Board of Trustees to declare a projection of the program’s future. Let’s take a close look at this.

A Closer Look at Social Security

Social security benefits are now expected to be paid in full and on time to recipients until the year 2037. That provides enough time for Congress to make changes to any scheduled benefits or sources of revenue after that cutoff year. Here’s the thing, Social Security funding looks as though the reserve will be completely exhausted by 2037. However, by that time, the continuance of taxes is expected to be able to pay 76% of any scheduled benefits. 

The board of trustees does have a plan to combat the issue we’ll face in the coming years with social security. The conclusion that was found was this; there could be an immediate increase in the tax rate of payroll to 14.4% from 12.4% where it currently sits. Or there could be a reduction in benefits by at least 13%. 

Aside from the two proposed fixes, the board also decided that a combination of the two could also be a solution. These options are sufficient enough to allow for full payment of any benefits that were scheduled to recipients for at least another 75 years. By then, the economy will have changed and adjustments will be made accordingly. In addition, if you aren’t aware how much in terms of value that will cause such a gap, or overturn of the program it’s around $13.6 trillion.

As for Medicare…

As for Medicare, according to a press release provided by CMS, anyone with medicare will notice significant increases in 2022 social security payments. What’s interesting though, is that at its current pace, Medicare is looking as though it’ll go bankrupt by the year 2026 according to Kiplinger.

In comparison to the social security program, medicare’s reserve may deplete completely, and 11 years faster in comparison. You should also know that by 2035, disability and old-age benefits are seemingly going to be exhausted as well.

The biggest problem that both programs face currently is the long-term issue of financial shortcomings regarding benefits and financing options that are currently available and scheduled. 

What Is Medicare Fraud Exactly?

Since there are plans in place to save both programs, it’s important that you still stay vigilant when it comes to your Medicare enrollment information. Fraud is another factor that can determine what happens with the limited reserve in both programs so this is something all medicare recipients should be concerned about.

Medicare fraud takes away benefits and services that should go to the people that deserve and have earned them. Money that’s lost to fraud will not be used to pay for your benefits, and that’s why it’s important to be proactive in terms of prevention.

Here’s an example of fraud; a healthcare professional sends a claim to Medicare for services that you never received. Additionally, it’s considered fraud if anyone that isn’t you, uses your Medicare account to obtain medical care or equipment in any way. 

How Do You Prevent Medicare Fraud?

Now onto even more important information. Quarterly, you will receive a statement of all Medicare benefits paid to your providers if there are charges to your Medicare account. The Medicare Summary Notice, or “MSN,” is a statement issued by the Centers for Medicare & Medicaid Services, or CMS. Make sure that you do not throw this statement away or misinterpret this quarterly notification as something that’s not important. 

When you receive your record, make sure to check your records against the MSN. Your quarterly MSN is essentially a statement that lists all of the services and materials that were billed to your Medicare account during the previous quarter. It shows how much Medicare paid and how much the supplier may owe you.

So you’re aware, there are three main types of Medicare Fraud:

  • Billing for services that were not delivered
  • Billing for more expensive services than those that were actually received
  • Billing for unneeded services

There are also a few main tactics that you can use to prevent Medicare fraud;

  • Always protect your Medicare number as well as your social security number.
  • Keep track of everything. Record all of your appointments and try to keep a record of any ordered medications, tests, equipment, etc.
  • Do your best to stay up to date on the most recent medicare scams.
  • Ensure that you know what a medicare plan is and isn’t capable of.

Now that you know more about the future of medicare, and social security, and how to prevent Medicare fraud, it might also interest you to know that there are “whistleblower rewards” for anyone that reports known fraud against the government. Some of which could payout 15% to 25% of what the government recovers.