Extended health benefit plans are wonderful and helpful with medical expenses (yes massage does count as a medical expense) but it’s easy to feel compelled to maximize their use at any cost. You’d be surprised how often this topic actually comes up in my office and most people would never think that what they’re asking is actually considered FRAUD. I’ve had this post written for months but have avoided posting as I didn’t want any one client to think I was speaking about them but over the past 5 years I have a collective memory of discussing fraud on an almost weekly basis. Here are some of the requests:
All of these requests can be answered the same simple sentence: NO – that is fraud.
By definition, insurance fraud is any action that seeks an outcome you are not entitled to receive. All of the situations listed above are seen as “creative solutions” to maximize an extended health benefit plan but are in fact fraud. As such, the decision to involve oneself in any of these situations can result in the loss of benefits, job loss and/or the possibility of criminal charges and fines. I think now, knowing of the possible outcomes, everyone will agree that these are no longer “solutions” you’d want to pursue.