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Medicare News

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September 4, 2015

By Shantanu Agrawal, M.D., Deputy Administrator and Director, Center for Program Integrity

Fight health care fraud: guard your Medicare number!

The next Medicare Open Enrollment season (October 15 to December 7) is almost here, which means fraudsters and identity thieves will increase their efforts to get and abuse Medicare numbers from people like you.

Fortunately, there are many measures you can take to fight health care fraud:

  • Guard your Medicare number. Protect it the same way you do for your credit card numbers. Medicare will never contact you for your Medicare number or other personal information. Don’t share your Medicare number or other personal information with anyone who contacts you by phone, email or by approaching you in person, unless you’ve given them permission in advance.
  • Don’t ever let anyone borrow or pay to use your Medicare number.
  • If you’re looking to enroll in a Medicare plan, be suspicious of anyone who pressures you to act now for the best deal. There are no “early bird discounts” or “limited time offers”. Any offer that sounds too good to be true probably is.
  • Be skeptical of free gifts and free medical services. A common ploy of identity thieves is to say they can send you your free gift right away—they just need your Medicare number to confirm. Decline politely but firmly. Remember, it’s not rude to be shrewd!
  • Do your part to protect your friends and neighbors: remind them to guard their Medicare numbers, too.
  • Check your Medicare Summary Notice (MSN) to make sure you and Medicare are only being charged for services you actually had. Instead of waiting for the MSN, which comes in the mail every 3 months, you can access your Original Medicare claims at MyMedicare.gov. You’ll usually be able to see a claim within 24 hours after Medicare processes it.

You can report suspected fraud by calling 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048. To learn more about how to protect yourself from health care fraud, visit Medicare.gov or contact your local Senior Medicare Patrol (SMP). To find the SMP in your state, go to the SMP Locator at Smpresource.org.

Filed under: Open enrollment, Strengthening Medicare, Uncategorized

R Fisher

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November 5, 2013

Have you ever pumped gas into your car from a station just around the corner from home even though it’s a bit more expensive than the one in town? Most of us have made decisions to do or not do something based on convenience.

The same is true when it comes to choosing a health plan: convenience matters. So in addition to cost, coverage, and benefits, here are some other things you may want to consider as you compare Medicare options this year:

Doctor and hospital choice

You want to be comfortable with the people you’re working with, especially when it comes to something as private as your health. Do the doctors you know accept your coverage? Where are the doctors’ offices? What are their hours? Do they often keep you waiting?

Pharmacy access

Is the pharmacy you use included in your drug plan’s network?  Do they use e-prescribing? Can you get refills by mail? Remember that plan networks can change from year to year. If it’s important to you to stay with the same pharmacy, it’s worth checking to make sure they’ll still be in your plan’s network.

Travel

Maybe you travel a lot, or spend part of the year in a different state. If you do, make sure you know whether your coverage will travel with you.

Quality

Ask yourself whether you’re truly satisfied with your medical care. Not all health care is created equal, and the doctors, hospitals and facilities you choose can impact your health. Look for plans with a 5‑star performance rating — the right expertise and care may help speed your recovery and improve your outcomes.

Your time is valuable — and so is your health. Only you know what mix of coverage and convenience is most important to you and your family.

We’re working hard to make sure you have choices in the way you get the Medicare benefits you’ve earned – and we want you to be comfortable. Use the Medicare Plan Finder to look at all of the health and drug plan options in your area.

Filed under: Affordable Care Act

R Fisher

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March 25, 2013

By Kathleen Sebelius, Secretary of Health and Human Services

Posted March 21, 2013, Crossposted from healthcare.gov

In the three years since the Affordable Care Act became law, the slower growth of health care costs is saving money in Medicare and the private insurance market, helping to curb previously skyrocketing premiums and making Medicare stronger.

The nonpartisan Congressional Budget Office recently estimated that Medicare and Medicaid spending would be 15 percent less — or about $200 billion— in 2020 than was previously projected, thanks to this slower growth. Medicare spending per beneficiary rose by just 0.4% in 2012, while Medicaid spending per beneficiary actually dropped by 1.9% last year. We are making Medicare stronger, too, by spending smarter, promoting coordinated care, and fighting fraud. Not only does this ensure that taxpayer dollars are spent wisely.  It means that those who count on Medicare — our grandparents, parents, our friends, and neighbors – will have it for years to come.

Today, we are announcing that thanks to the Affordable Care Act, more than 6.3 million seniors and people with disabilities on Medicare have saved more than $6.1 billion on prescription drugs since the health care law was enacted three years ago. This is the result of the law’s closing of the prescription coverage gap known as “the donut hole.”

Nearly 3.5 million people with Medicare saved an average of more than $706 each on their prescriptions in 2012.

In the case of Helen Rayon of Pennsylvania, the savings on her medications is enough to help her contribute to the education of her grandson. She says: “I take seven different medications. Getting the donut hole closed … gives me a little more money in my pocket.” Watch a video to learn more about Helen.

David Lutz, a community pharmacist from Hummelstown, PA, described his elderly customers, “splitting pills, taking doses every other day, missing doses, stretching their medications.”  But he says this has begun to change with the savings resulting from the Affordable Care Act, and that’s good for their health as well as their budgets.

After the law was passed, the Affordable Care Act provided a one-time $250 check for people with Medicare who reached the Part D prescription drug coverage gap in 2010. Since then, individuals in the donut hole have continued to receive savings on prescription drugs. In 2013 individuals in the donut hole are saving over 50% off of the cost of branded drugs. The savings on both brand name and generic drugs will continue to increase until the coverage gap is closed in 2020.

Along with savings on their medications, American seniors have also benefited from access to vital preventive services — such as mammograms, cholesterol checks, cancer screenings, and annual wellness visits — with no Part B coinsurance or deductibles. In 2012, more than 34 million seniors and people with disabilities with Medicare received at least one free preventive service. Having easier access to preventive services without worrying about the cost helps seniors stay healthier and identify health conditions before they become more serious and costly.

Helen works as a health-and-wellness coordinator at a senior center, arranging for health and fitness activities for seniors older than herself.  She knows they struggle with the costs of staying healthy. “If it weren’t for the health care reform, many of our seniors would not get to a doctor,” to get a check up, Helen says. “It is expensive for us to keep good health.”

Affordable Care Act initiatives are also ensuring that if Medicare beneficiaries do end up in the hospital that their care is coordinated and they stay out of the hospital once they’re discharged. This also gives Medicare beneficiaries – and other taxpayers – more value for their health care dollars. In fact, hospital readmissions in Medicare have fallen for the first time on record, resulting in 70,000 fewer readmissions in the last half of 2012.

The Affordable Care Act is helping us keep our moral commitment to ensure that our grandparents and other seniors get the high-quality, affordable health care and security they need and deserve.

To learn more about how the Affordable Care Act is saving seniors on prescription drug costs by closing the donut hole coverage gap, visit www.hhs.gov/news/press/2013pres/03/20130321a.html

Follow Secretary Sebelius on Twitter at @Sebelius.

Filed under: Affordable Care Act

R Fisher

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October 1, 2012

It’s that time of year again.  With the beginning of fall comes the beginning of flu season. 

Get your flu shot early and stay healthy!  It’s free for people with Medicare, once per flu season in the fall or winter, when given by doctors or other health care providers (such as senior centers and pharmacies) that take Medicare.

Schedule your flu shot today!

Filed under: Affordable Care Act, Share the Health

R Fisher

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September 8, 2011

By Don Berwick, Administrator, Centers for Medicare & Medicaid Services

Millions of Americans are enjoying improved Medicare coverage thanks to the Affordable Care Act. More people are getting preventive services to keep them healthy, and people with high prescription drug costs are seeing the coverage gap “donut hole” starting to close. Here are the latest numbers from the past few months:

  • July:
    • Through the end of July, 1.28 million Americans with Medicare have received discounts on brand name drugs in the Medicare Part D coverage gap — up from 899,000 through the end of June and 478,000 through the end of May.
    • These discounts have saved seniors and people with disabilities a total of$660 million, including $199 million in July alone!

For state-by-state information on the number of people who are benefiting from this discount in 2011, visit this page.

  • August:
    • Through the end of August, over 18.9 million people with Original Medicare, or 55.6 percent, have received one or more free preventive services.
    • During the same time period, over 1.2 million Americans with Original Medicare have taken advantage of Medicare’s new free Annual Wellness Visit, up from 1.06 million in July.

For state-by-state information on the numbers of people who are utilizing preventive services in 2011, visit this page.

Over the coming years, provisions of the Affordable Care Act will help close the coverage gap completely. Here is a sense of what people with Medicare can look forward to:

  • 2013: Paying less and less for your brand-name Part D prescription drugs in the coverage gap.
  • 2020: The coverage gap will be closed, meaning there will be no more “donut hole,” and people with Medicare will pay only 25% of the costs of their drugs until they reach the yearly out-of-pocket spending limit.

The chart below shows what people with Medicare prescription coverage will pay over time:

Medicare Prescription Drug Coverage Over Time

chart showing Medicare Prescription Drug Coverage Over Time

Filed under: Affordable Care Act, Strengthening Medicare

R Fisher

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National Senior Services is not connected with or endorsed by the US government or the federal Medicare program; Medicare has neither reviewed nor endorsed this information. We are a licensed and approved Medicare Service Provider.

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