Your Guide To
Medicare
Inside... How to sign up for Medicare the first time . . . . . . . . . . . . . . 2 How Medicare works . . . . . . . . 3 When should you apply for Medicare? . . . . . . . . . . . . . 9 A SPECIAL SECTION OF THE DENISON BULLETIN AND DENISON REVIEW | Friday, January 31, 2014
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Your Guide to Medicare
January 31, 2014
How to sign up for Medicare the first time After you successfully register and get your password letter in the mail or by email, you can sign into MyMedicare.gov. First, make sure you have the password letter containing your password. After you registered online, CMS mailed or emailed this letter to you. This letter was emailed to you if you provided your email address at the time of registration. 1. In your internet browser, type www. MyMedicare.gov. 2. If you were automatically registered by Medicare or enrolled by a Medicare customer service representative, type in your Medicare Number (without the dashes) as it appears on your red, white and blue Medicare card in the ‘Username’ field. This number is sometimes called your Medicare Health Insurance Claim Number. It contains letters and numbers. 3. Be sure to type your one-time password in exactly as it appears in your welcome letter. To protect your security, you won’t be able to change your password until you have successfully signed in. 4. Click on the Sign In button. 5. You will be prompted to create a new username of your own choosing to use when signing in to MyMedicare.gov instead of using your Medicare Number. This helps to protect your Medicare information and allows you to pick your own easy-to-remember ID. It should be between 8-30 characters long, and a mix
Information needed before completing an Initial Enrollment Questionnaire Before completing an Initial Enrollment Questionnaire (IEQ), you should have the following information available:
of letters, numbers, and symbols ( - _ ! @ $). Do not use your current Medicare Number or Social Security Number as your new username. 6. When the above steps have been executed successfully, you should have access to MyMedicare.gov. If you continue to have problems signing in, call 1-877-607-9663. Customer service representatives may be able to
OPTOMETRISTS
help you sign in. However, for your security, customer service representatives do not have access to your password and cannot give you or anyone else this information. Deceased Beneficiary Accounts: access to accounts where the beneficiary is deceased is not permitted from MyMedicare. gov. Call 1-800-MEDICARE (1-800-6334227) if you need additional assistance. From questions.medicare.gov
w Your insurance card, for insurance company and prescription drug information w Your employer’s name and address (if you receive group health plan coverage through your employer) w Your spouse’s Social Security number, employer’s name and address, and the group health plan information (if you receive group health plan coverage through your spouse’s employer) w Your family member’s Social Security number, employer’s name and address, and the group health plan information (if you receive group health plan coverage through your family member’s employer) w Extra insurance information The associated insurance carrier information, employer name and attorney information, if you are receiving benefits or treatment for one of the following conditions: - Black Lung benefits - Workers’ Compensation benefits - Injury or illness for which another person could be held responsible - Injury or illness covered under no fault, automobile or liability insurance
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107 years. Many changes have occurred in our world in the past 107 years and so it is true with funeral service. Today, many families are taking advantage of preplanning their funeral service. Whether you just want to record information, select a funeral service and merchandise or discuss options of prepaying in advance, Dan Pfannebecker invites you to stop in or call for an appointment to discuss your needs and desires. Many couples state the main reason they preplan is to be able to do this together, rather than leaving one alone to make all the decisions at a difficult time. For any questions or concerns you might have regarding prearrangements, please give Dan a call at Pfannebecker Funeral Home.
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January 31, 2014
Your Guide to Medicare
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Medicare urges seniors to join the fight against fraud In mailboxes across the country, people with Medicare have seen a redesigned statement of their claims for services and benefits that will help them better spot potential fraud, waste and abuse. “The new Medicare Summary Notice gives seniors and people with disabilities accurate information on the services they receive in a simpler, clearer way,” said CMS Administrator Marilyn Tavenner. “It’s an important tool for staying informed on benefits, and for spotting potential Medicare fraud by making the claims history easier to review. The redesigned notice makes it easier for people with Medicare to understand their benefits, file an appeal if a claim is denied, and spot claims for services they never received. The Centers for Medicare & Medicaid Services (CMS) send the notices to Medicare beneficiaries on a quarterly basis.” “A beneficiary’s best defense against fraud is to check their Medicare Summary Notices for accuracy and to diligently protect their health information for privacy,” said Peter Budetti, CMS deputy administrator for program integrity. “Most Medicare providers are honest and work hard to provide services to beneficiaries. Unfortunately, there are some people trying to exploit the Medicare system.” Medicare beneficiaries and caregivers are critical partners in the fight against
fraud. In April of 2013, CMS announced a proposed rule that would increase rewards - up to $9.9 million - paid to Medicare beneficiaries and others whose tips about suspected fraud lead to the successful recovery of funds. The Affordable Care Act enabled CMS to expand efforts to prevent and fight fraud, waste and abuse. Over the last four years, the Obama administration recovered more than $14.9 billion in healthcare fraud judgments, settlements, and administrative impositions, including record recoveries in 2011 and 2012. Since the Affordable Care Act, CMS has revoked 14,663 providers and suppliers’ ability to bill in the Medicare program since March 2011. These providers were removed from the program because they had felony convictions, were not operational at the address CMS had on file, or were not in compliance with CMS rules. In 18 states, the number of revocations quadrupled since CMS put the Affordable Care Act screening and review requirements in place, as well as the implementation of proactive data analysis to identify potential license discrepancies of enrolled individuals and entities. The efforts are ensuring that only qualified and legitimate providers and suppliers can provide health care products and services to Medicare beneficiaries.
Medicare Part D helps cover the cost of prescription drugs.
How Medicare works Medicare is health insurance for people 65 or older, people under 65 with certain disabilities, and people of any age with End-Stage Renal Disease (ESRD) (permanent kidney failure requiring dialysis or a kidney transplant). The different parts of Medicare are: Medicare Part A (Hospital Insurance), which helps cover inpatient care in hospitals, skilled nursing facility care, hospice care and home health care Medicare Part B (Medical Insurance), which helps cover services from doctors and other health care providers, outpatient care, home health care, durable medical equipment and some preventive services
Medicare Part C (Medicare Advantage). It includes all benefits and services covered under Part A and Part B. It is run by Medicare-approved private insurance companies, usually includes Medicare prescription drug coverage (Part D) as part of the plan and may include extra benefits and services for an extra cost. Medicare Part D (Medicare prescription drug coverage). It helps cover the cost of prescription drugs, is run by Medicare-approved private insurance companies and may help lower your prescription drug costs and help protect against higher costs in the future From Medicare & You, 2014 (www. medicare.gov/pubs/pdf/10050.pdf)
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Your Guide to Medicare
January 31, 2014
Apply What you need before for Social applying for Social Security Before individuals apply for retirement benefits, they should know certain Social Security “basics.” Full retirement age: Depending on your date of birth, that may be between age 66 and 67. This could affect the amount of your benefits and when you want the benefits to start. You may start receiving benefits as early as age 62 or as late as age 70. Monthly benefits will be reduced if you start them any time before “full retirement age.” If you elect to receive benefits before you reach full retirement age, you should understand how continuing to work can affect your benefits. Delayed retirement credits may be added to your benefits if they start after your full retirement age. If you live to the average life expectancy for someone your age, you will receive about the same amount in lifetime benefits whether you choose to start receiving benefits at age 62, full retirement age, age 70 or any age in between. The Social Security Administration encourages individuals to use its Retirement Estimator (http://www.socialsecurity.gov/estimator/) to get a personal estimate of how much their benefits will
Security online
be at different ages and “stop work” dates before they begin the application. Individuals are also encouraged to read “Other Things to Consider” for more information about other things they should think about when making a decision about when to begin benefits. Some of the things individuals should consider include how long they believe
they will receive benefits, their health and whether anyone else in their family can get benefits on tier record. Individuals can find out what documents and information they need to apply by reading the “Checklist for Online Medicare, Retirement, and Spouse Applications” at http://www.socialsecurity.gov/hlp/isba/10/isba-checklist.pdf.
Social Security offers an online retirement application that individuals can complete in as little as 15 minutes from the comfort of the home or office at a time most convenient for you. There’s no need to drive to a local Social Security office or wait for an appointment with a Social Security representative. In most cases, once your application is submitted electronically, you’re done. No forms need to be signed and usually no documentation is required. Social Security will process the application and contact you if any further information is needed. Individuals can apply online for retirement benefits or benefits as a spouse if you: • are at least 61 years and 9 months old; • are not currently receiving benefits on your own Social Security record; • have not already applied for retirement benefits; and • want your benefits to start no more than 4 months in the future. (Social Security cannot process your application if you apply for benefits more than 4 months in advance.)
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Your Guide to Medicare
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Your Guide to Medicare
January 31, 2014
We Really Listen As medical providers dedicated to helping patients feel their very best, we know that taking the time to carefully listen to your symptoms, your history, your concerns and your feedback is essential to delivering the very best care. • Two Denison locations • Convenient evening hours • Schedule appointments online Go to www.ccmhia.com and click on the Family Medicine Associates link.
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January 31, 2014
Your Guide to Medicare
Page 7
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Your Guide to Medicare
January 31, 2014
COMFORT & CARE FOR SENIORS
Enjoy all the comforts of home, along with the security of knowing professional care is there when you need it.
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• Nursing • Health Aide • Physical Therapy • Occupational Therapy • Speech Therapy • Social Work (Hospice only)
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January 31, 2014
Your Guide to Medicare
Page 9
When should you apply for Medicare? If you are already getting Social Security retirement or disability benefits or railroad retirement checks, you will be contacted a few months before you become eligible for Medicare and given the information you need. If you live in one of the 50 states, Washington, D.C., the Northern Mariana Islands, Guam, American Samoa or the Virgin Islands, you will be enrolled in Medicare Parts A and B automatically. However, because you must pay a premium for Part B coverage, you have the option of turning it down. If you are not already getting retirement benefits, you should contact the Social Security Administration about three months before your 65th birthday to sign up for Medicare. You can sign up for Medicare even if you do not plan to retire at age 65. Once you are enrolled in Medicare, you will receive a red, white and blue Medicare card showing whether you have Part A, Part B or both. Keep your card in a safe place so you will have it when you need it. If your card is ever lost or stolen, you can apply for a replacement card on the Internet at www. socialsecurity.gov or call Social Security’s toll-free number. You also will receive a Medicare & You handbook (Publication No. CMS-10050) that describes your Medicare benefits and plan choices. Special enrollment situations You also should contact Social Security about applying for Medicare if: • You are a disabled widow or widower between age 50 and age 65, but have not applied for disability benefits because you are already getting another kind of Social Security benefit; • You are a government employee and became disabled before age 65; • You, your spouse or your dependent child has permanent kidney failure; • You had Medicare medical insurance in the past but dropped the coverage; • You turned down Medicare medical insurance when you became entitled to hospital insurance (Part A); or • You or your spouse worked for the railroad industry. Initial enrollment period for Part B When you first become eligible for hospital insurance (Part A), you have a seven-month period (your initial enrollment period) in which to sign up for medical insurance (Part B). A delay on your part will cause a delay in coverage and result in higher premiums. If you are eligible at age 65, your initial enrollment period begins three months before your 65th birthday, includes the month you turn age 65 and ends
three months after that birthday. If you are eligible for Medicare based on disability or permanent kidney failure, your initial enrollment period depends on the date your disability or treatment began. When does my enrollment in Part B become effective? If you accept the automatic enrollment in Medicare Part B, or if you enroll in Medicare Part B during the first three months of your initial enrollment period, your medical insurance protection will start with the month you are first eligible. If you enroll during the last four months, your protection will start from one to three months after you enroll.12 The following list shows when your Medicare Part B becomes effective: • If you enroll one to three months before your reach 65, your Part B Medicare coverage starts the month you reach age 65 • If you enroll the month you reach age 65, your Part B coverage starts one month after the month you reach age 65 • If you enroll one month after you reach age 65, your Part B coverage starts two months after the month of enrollment • If you enroll two or three months after you reach age 65, your Part B coverage starts three months after the month of enrollment General enrollment period for Part B If you do not enroll in Medicare Part B during your initial enrollment period, you have another chance each year to sign up during a “general enrollment period” from January 1 through March 31. Your coverage begins on July 1 of the year you enroll. However, your monthly premium increases 10 percent for each 12-month period you were eligible for, but did not enroll in, Medicare Part B. Special enrollment period for people leaving Part C If you have a Medicare Advantage plan (Part C), you can leave your plan and switch to original Medicare from January 1 through February 14. If you use this option, you also have until February 14 to join a Medicare prescription drug plan. Your coverage begins the first day of the month after the plan gets your enrollment form. Special enrollment period for people covered under an employer group health plan If you are 65 or older and are covered under a group health plan, either from your own or your spouse’s current employment, you have a “special enrollment period” in which to sign up for Medicare Part B. This means that you may delay enrolling in Medicare Part B without having to wait for
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a general enrollment period and paying the 10 percent premium surcharge for late enrollment. The rules allow you to: • Enroll in Medicare Part B any time while you are covered under the group health plan based on current employment; or • Enroll in Medicare Part B during the eight-month period that begins following the last month your group health coverage ends, or following the month employment ends—whichever comes first. Special enrollment period rules do not apply if employment or employer-provided group health plan coverage ends during your initial enrollment period. When you enroll in Medicare Part B while you are still in the group health plan or during the first full month when you are no longer in the plan, your coverage begins either on the first day of the month you enroll or at your option, on the first day of any of the following three months. If you enroll during any of the remaining seven months of the “special enrollment period,” your Medicare Part B coverage begins on the first day of the following month. If you do not enroll by the end of the eightmonth period, you will have to wait until the next general enrollment period, which begins January 1 of the next year. You also may have to pay a higher premium, as described previously. People who receive Social Security disability benefits and are covered under a group health plan from either their own or a family member’s current employment also have a special enrollment period and premium rights that are similar to those for workers age 65 or older. Options for receiving health services Medicare beneficiaries may have choices for receiving health care services. You can get more information about your health care options from the following publications: Medicare & You (Publication No. CMS10050), a general guide mailed to people after they enroll in Medicare and an updated version is mailed each year after that. Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare (Publication No. CMS-02110), a guide that describes how other health insurance plans supplement Medicare and offers some shopping hints for people looking at those plans. If you have other health insurance Medicare hospital insurance is free for almost everyone, but you do pay a monthly premium for medical insurance. If you already have other health insurance when you become eligible for Medicare, is it worth the monthly premium cost to sign up for
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Medicare medical insurance? The answer varies with each person and the kind of other health insurance you may have. Although the Social Security Administration cannot give you “yes” or “no” answers, it can offer information that may be helpful when you make your decision. If you have a private insurance plan, get in touch with your insurance agent to see how your private plan fits with Medicare medical insurance. This is especially important if you have family members who are covered under the same policy. And remember, just as Medicare does not cover all health services, most private plans do not either. In planning your health insurance coverage, keep in mind that most nursing home care is not covered by Medicare or private health insurance policies. One important word of caution: for your own protection, do not cancel any health insurance you now have until your Medicare coverage actually begins. If you have insurance from an employer-provided group health plan Group health plans of employers with 20 or more employees are required by law to offer workers and their spouses who are age 65 (or older) the same health benefits that are provided to younger employees. If you are currently covered under an employer-provided group health plan, you should talk to your personnel office before you sign up for Medicare medical insurance. If you have health care protection from other plans If you have coverage under a program from the Department of Defense, your health benefits may change or end when you become eligible for Medicare. You should contact the Department of Defense or a military health benefits advisor for information before you decide whether to enroll in Medicare medical insurance. If you have health care protection from the Indian Health Service, Department of Veterans Affairs or a state medical assistance program, contact the people in those offices to help you decide whether it is to your advantage to have Medicare medical insurance. For more information on how other health insurance plans work with Medicare, call the Medicare toll-free number, 1-800-MEDICARE (1-800-633-4227), and ask for Medicare and Other Health Benefits: Your Guide to Who Pays First (Publication No. CMS-02179) or visit www.medicare. gov/publications. If you are deaf or hard of hearing, you may call TTY 1-877-4862048.
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Your Guide to Medicare
HHS strengthens community living options for older Americans and people with disabilities The Centers for Medicare & Medicaid Services (CMS) issued a final rule on January 10 to ensure that Medicaid’s home and community-based services programs provide full access to the benefits of community living and offer services in the most integrated settings. The rule, as part of the Affordable Care Act, supports the Department of Health and Human Services’ Community Living Initiative. The initiative was launched in 2009 to develop and implement innovative strategies to increase opportunities for Americans with disabilities and older adults to enjoy meaningful community living. Under the final rule, Medicaid programs will support home and community-based settings that serve as an alternative to institutional care and that take into account the quality of individuals’ experiences. The final rule includes a transitional period for states to ensure that their programs meet the home and community-based services settings requirements. Technical assistance will also be available for states. “People with disabilities and older adults have a right to live, work, and participate in the greater community. HHS, through its Community Living Initiative, has been expanding and improving the community services necessary to make this a reality,” said HHS Secretary Kathleen Sebelius. “The announcement will help ensure that all people participating in Medicaid home and com-
munity-based services programs have full access to the benefits of community living.” In addition to defining home and community-based settings, the final rule implements the Section 1915(i) home and community-based services State Plan option. This includes new flexibility provided by the Affordable Care Act that gives states additional options for expanding home and community-based services and to target services to specific populations. It also amends the 1915(c) home and communitybased services waiver program to add new person-centered planning requirements, allow states to combine multiple target populations in one waiver, and streamlines waiver administration. For more information about the final rule, please visit: http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-Sheets/2014-Fact-sheetsitems/2014-01-10-2.html For more information regarding the Home and Community-Based Services available under Medicaid, please visit: http://www.medicaid.gov/HCBS For more information regarding the Community Living Initiative, please visit: http://www.hhs.gov/od/community/index.html The final rule can be found here: http://ofr.gov/OFRUpload/OFRData/2014-00487_PI.pdf
January 31, 2014
More than 25 million Original Medicare beneficiaries received free preventive services through November 2013 According to new data released by the Centers for Medicare & Medicaid Services (CMS), more than 25.4 million people covered by Original Medicare received at least one preventive service at no cost to them during the first 11 months of 2013, because of the Affordable Care Act. Last month CMS announced that the health care law also saved seniors $8.9 billion on their prescription drugs since the law’s enactment. “Thanks to the Affordable Care Act, millions of seniors have been able to receive important preventive services and screenings such as an annual wellness visit, screening mammograms and colonoscopies, and smoking cessation at no cost to them,” said CMS Administrator Marilyn Tavenner. “Prevention and early detection are so vital to ensure that Americans are healthy and Medicare is healthy. The Affordable Care Act makes Medicare stronger and improves the wellbeing of millions of beneficiaries who have taken advantage of preventive services and wellness visits.” The announcement exceeds the comparable figure from last November, when an estimated 24.7 million people with Original Medicare received one or more preventive benefits at no out of pocket costs by this point in time during 2012. When factoring in Medicare Advantage utilization rates and a full year of experience, an estimated 34.1 million people with Medicare took advantage of at least one preventive service in 2012. Moreover, in the first 11 months of 2013, more than 3.5 million beneficiaries with Original Medicare took advantage of the Annual Wellness Visit established by the health care law – a significant increase from the 2.8 million who used this service by this point in the year in 2012. Before the Affordable Care Act, Medicare recipients had to pay part of the cost for many preventive health services. These out-of-pocket costs made it difficult for people to get the important preventive care they needed.
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January 31, 2014
Your Guide to Medicare
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More partnerships strengthen care for Medicare beneficiaries Doctors, hospitals and other health care providers have formed 123 new Accountable Care Organizations (ACOs) in Medicare, providing approximately 1.5 million more Medicare beneficiaries with access to high-quality coordinated care across the United States, Health and Human Services Secretary Kathleen Sebelius announced in late December. Doctors, hospitals and health care providers establish ACOs in order to work together to provide higher-quality coordinated care to their patients, while helping to slow health care cost growth. Since passage of the Affordable Care Act, more than 360 ACOs have been established, serving more than 5.3 million Americans with Medicare. Beneficiaries seeing health care providers in ACOs always have the freedom to choose doctors inside or outside of the ACO. ACOs share with Medicare any savings generated from lowering the growth in health care costs when they meet standards for high quality care. “Accountable Care Organizations are delivering higher-quality care to Medicare beneficiaries and are using Medicare dollars more efficiently,” Secretary Sebelius said. “This is a great example of the Affordable Care Act rewarding hospitals and doctors that work together to help our beneficiaries get the best possible care.” The ACOs must meet quality standards to ensure that savings are achieved through improving care coordination and providing care that is appropriate, safe, and timely. The Centers for Medicare & Medicaid Services (CMS) evaluates ACO quality performance using 33 quality measures on patient and caregiver experience of care, care coordination and patient safety, appropriate use of preventive health services, and improved care for at-risk populations. The new ACOs include a diverse cross-section of health care providers across the country, including providers delivering care in underserved areas. More than half of ACOs are physicianled organizations that serve fewer than 10,000 beneficiaries. Approximately one in five ACOs include community health centers, rural health clinics, and critical access hospitals that serve low-income and rural communities. Affordable Care Act pro-
visions have a substantial effect on reducing the growth rate of Medicare spending. Growth in Medicare spending per beneficiary hit historic lows during the 2010 to 2012 period, and this trend continued into 2013. Projections by both the Office of the Actuary at CMS and the Congressional Budget Office estimate that Medicare spending per beneficiary will grow at approximately the rate of growth of the economy for the next decade, break-
ing a decades-old pattern of spending growth outstripping economic growth. The next application period for organizations interested in participating in the Shared Savings Program beginning January 2015 will be in summer 2014. More information about the Shared Savings Program, including previously announced ACOs, is available at: http://www.cms. gov/Medicare/MedicareFee-for-Service-Payment/ sharedsavingsprogram/ News.html.
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Your Guide to Medicare
January 31, 2014
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