Questions?
Call us at 1-866-547-3060 (TTY: 1-800-958-2692)
8:00 a.m. to 8:00 p.m. in your local time zone, every day
Compare Your Plan Options
Medicare Fraud
Insurance fraud affects everyone by making insurance premiums more expensive. Generations Healthcare HMO is helping the fight against health care fraud by increasing awareness among our members and employees.
We fully support the prosecution of health care providers, agents, policy owners, employees, and other groups or individuals who defraud the Medicare system and insurance companies. We aggressively investigate reports of fraud and cooperate with law enforcement officials in their prosecution efforts.
Examples of Medicare Plan Fraud
- Billing for prescriptions that were not dispensed
- Dispensing a generic drug, but billing for a brand name drug
- Prescription drug shorting (i.e., billing for 60 tablets, but dispensing 30)
- Bait and switch pricing
- Routine waivers of coinsurance premiums
- Charging a beneficiary a price over the copay amount
- Adding unauthorized refills to prescriptions
- Drug diversion
- Prescription forging or altering
- Patient has falsely assumed someone’s identity in an attempt to utilize their Medicare benefits
Site Glossary
CLOSEGeneric Drug
A prescription medicine made of the same active ingredients as a brand-name medicine, but usually less expensive because it is produced and distributed without patent protection.
Site Glossary
CLOSECoinsurance
A percentage of the cost you pay when your plan does not cover 100% of the cost. For example, a plan may cover 80% of the cost of your medicine or your hospital visit; the other 20% is your coinsurance.
Site Glossary
CLOSECopay
This is a fixed dollar amount that you pay when your plan does not cover 100% of the cost of your medicines. For example, if you pay a certain amount for a medicine, or for a visit to the doctor, that amount is your copay.
Please view Universal American’s Medicare Advantage Part D Fraud, Waste and Abuse Training for Downstream Providers.
Help Fight Fraud
When someone commits fraud against Medicare, it affects everyone. If you suspect someone of committing insurance fraud against Generations Healthcare or think you may be a victim, please report the suspicious activity.
Call the Fraud, Waste and Abuse Hotline at 1-800-853-0186 or e-mail fraud@uafc.com. All calls and e-mails are confidential and may be anonymous. For more information about insurance fraud, visit www.insurancefraud.org.
