Q & A
What is the government doing about (Medicare Fraud)?
Answer: The Centers for Medicare and Medicaid Services, the agency that administers the federal health-insurance program for the elderly and disabled, has been working to crack down on the problem of fraud. Enrollment moratoriums were instituted for “high risk” providers in…
How hard is it to recover payments made on bogus Medicare claims?
Answer: It is difficult. The government clawed back just $2.86 billion in the 2013 fiscal year. Most times the money is simply gone. As one law-enforcement official said, “As soon as it hits an account, it disappears.” Source: The Short Answer, WSJ –…
How big a problem is Medicare fraud?
Answer: There is no official number for the amount of fraud in the Medicare system. Some law-enforcement officials estimate that fraud could account for as much as 10% of the program’s yearly spending. That would amount to about $58 billion last…
How is income divided in the calculation of subsidies on the insurance exchanges?
Full Question: My wife will be exploring insurance options on the federal exchange in November. In regard to subsidies, we file jointly and most of our income comes from dividends derived from jointly owned assets. I am assuming that her share…
Will Medicare pay for infusion therapy?
Full Question: My husband was recently in the hospital for a pacemaker implant. He was set to come home but developed a staph infection and a blood clot. He now has to receive an antibiotic infusion for six to eight weeks.Medicare…
Must a divorced dad cover adult kids?
Full Question: My ex-husband has been responsible for providing health insurance for our kids until the age of majority. My sons are now 21 and almost 18. My ex has family coverage for himself and his new wife, but he wants me…
My application for Supplemental Security Income (SSI) based on my disability was recently denied. Can I appeal the decision?
Answer: Yes, if you disagree with a disability decision made on your claim, you can appeal it. The steps you can take are explained in our online publication, Your Right To Question A Decision Made On Your Supplemental Security Income (SSI)…
What information do I need to apply for Supplemental Security Income (SSI)?
Answer: Here are some of the things we will ask for when you apply for SSI. Even if you do not have all of the things listed below, apply anyway. But keep in mind that the more information you can provide,…
What can I do if I think someone has stolen my identity?
Answer: You should: File a report with the local police, and keep a copy of the police report as proof of the crime; Notify the Federal Trade Commission (1-877-ID-THEFT); File a complaint with the Internet Crime Complaint Center at www.ic3.gov; and Contact the fraud…
My grandmother receives Supplemental Security Income (SSI) benefits. She may have to enter a nursing home to get the long-term care she needs. How does this affect her SSI benefits?
Answer: Moving to a nursing home could affect your grandmother’s SSI benefits, depending on the type of facility. In many cases, we have to reduce or stop SSI payments to nursing home residents, including when Medicaid covers the cost of the…