What does health and dental benefits fraud look like?

People you may not expect, like health and dental service providers, friends, family members, and colleagues, could all lead you to commit benefits fraud. It is possible to become involved in it because it was suggested by someone you trust. It’s important to learn what it looks like so you can help prevent it.

Learn how to recognize the signs of benefits fraud. Take this quiz to boost your knowledge. Select ‘Yes’ if you believe the scenario counts as benefits fraud, or ‘No’ if you do not believe it is benefits fraud.

Frequently Asked Questions

What is health and dental benefits fraud?
Benefits fraud occurs when you intentionally submit false or misleading information to your insurance provider for the purpose of financial gain.
Who commits health and dental benefits fraud?
Benefits fraud can be committed by health or dental service providers, plan members or both.
What are the consequences of health and dental benefits fraud?
The consequences of benefits fraud can include loss or reduction of your benefits, loss of employment, a criminal record, fines and jail time.
How can you protect yourself from the consequences of health and dental benefits fraud?

Learning how to recognize benefits fraud is the first step toward preventing it. If you suspect your health or dental service provider or coworkers are encouraging you to submit a fraudulent claim, or something just doesn’t feel right, report it to your employer or insurance provider immediately. You can also report benefits fraud anonymously here: report benefits fraud.