Join the Fight against Medicare Fraud

Medicare fraud affects everyone. You can team up with Medicare to help.

Our Senior Medicare Patrol volunteers are teaching people like you how to spot, report, and stop fraud, and protect themselves from identity theft.

Here are some things you can do:

• Guard your Medicare and Social Security numbers. Treat them like you would treat your credit cards.

• Hang up the phone if someone calls and asks for your Medicare number, Social Security number, or bank or credit card information. We will NEVER call and ask for this information, and we will NEVER call you or come to your home uninvited to sell Medicare products.

• Be suspicious of anyone who offers you free medical equipment or services and then requests your Medicare number. It’s illegal, and it’s not worth it!

• Do not let anyone borrow or pay you to use your Medicare ID card or your identity.

• Check your Medicare claims for errors. Look at your Medicare Summary Notice (MSN) or statements from your Medicare plan. You can also check www.MyMedicare.gov or call 1-800-MEDICARE (1-800-633-4227) as soon as your claims have been processed. The sooner you see and report errors, the sooner we can stop fraud.

• Call 1-800-MEDICARE to report any suspected fraud. TTY users should call
1-877-486-2048.

Medicare is cracking down on fraud, and so can you.

Learn more about spotting and reporting fraud, and get tips on protecting yourself from identity theft.
• Find out about Senior Medicare Patrol activities in your area.

The “Extra Help” Program. Something to talk about.

Do you know about the “Beneficio Adicional” or “Extra Help” program? My mother always told me if you wanted to know anything, you went to “la plaza del pueblo” (town square).  You went to socialize with neighbors, exchange important news, pass “chisme” (gossip) and take part in the community. The plaza was all about conversation and learning from one another what’s really happening in the world. We may have left the plaza behind, but the tradition of sharing information is as vital as ever. Blogs, IM, chat and social media are now our plaza. So here is some important information you might want to pass on.

Many people with limited income and resources may qualify for Medicare’s “Extra Help” program, but they must apply to find out. You could be one of them.

You can get help with Part D prescription drug coverage premiums, deductibles and co-payments. This means you don’t have to go without medications because you can’t afford them.

It’s easy and free to apply for “Extra Help.” 

  • Visit Social Security’s Web site (in Spanish or English) to apply online or for more information.
  • Call Social Security at 1-800-772-1213 to apply over the phone or request an application (TTY users should call 1-800-325-0778).
  • Apply at your local Social Security office.

Save money, live well, and share the information, because this program is too important to keep to yourself.

Find High-Quality Health Care Options

The health care providers and facilities you choose can affect your health – finding the right expertise and specialists may speed your recovery and improve how well your treatment works. We’ve just updated Nursing Home Compare and the Department of Veterans Affairs’ (VA) Hospital Compare with more information to help you compare health care facilities. And our new Quality Care Finder is updated regularly to provide you with an easy way to search for health care professionals, services, and facilities.

Use these resources to make informed decisions about which facilities you choose:

Nursing Homes
Medicare’s Nursing Home Compare now has information about:

-          Nursing home health inspections and what happens after a facility is inspected

-          Complaints filed about a nursing home in the last 3 years

-          Incidents that a nursing home self-reported in the last 3 years

-          Enforcements, which are monetary penalties and denials of payments, that a nursing home received in the last 3 years

This information, along with the existing measures including quality of care and staffing, can help you compare the care you’ll get at different nursing homes and the specialties they offer. You can now read complaints filed at each nursing home, and find out how they affected residents’ care. Use the Nursing Home Checklist to track information about different nursing homes you visit.

VA Hospitals
The Department of Veterans Affairs’ (VA) Hospital Compare helps Veterans compare the quality of care at VA hospitals based on:

-          Reducing preventable surgical complications (part of the Surgical Care Improvement Project) including:

  • Infections
  • Blood clots
  • Heart (cardiac) problems
  • Breathing (respiratory) problems

-          Measures about death (mortality) rates, readmissions to the hospital, and best treatments for these medical conditions:

  • Congestive Heart Failure
  • Heart Attack
  • Pneumonia

Better Health and Lower Costs for Medicare Beneficiaries

By Don Berwick, Administrator, Centers for Medicare & Medicaid Services. Cross-post from Healthcare.gov

It’s been a big summer for the millions of Americans who are benefitting from improved Medicare coverage thanks to the Affordable Care Act. The benefits are clear: More people are getting preventive services to keep them healthy and people with high prescription drug costs are seeing the donut hole coverage gap starting to close – lowering the cost of drugs so that people don’t have to worry about being able to afford the care they need. Take a look at the past few months:

  • June:
    • Through the end of June, 899,000 Americans with Medicare have benefited from the discount on brand name drugs in the Medicare Part D “donut hole” coverage gap — an increase of over 420,000 individuals in the month of June alone.
    • These discounts have saved seniors and people with disabilities a total of $461 million, including $200 million in June alone!
  • July:
    • Through the end of July, 17.3 million people with traditional Medicare, or 51.5 percent, have received one of more free preventive services. 
    • During the same time period, over 1 million Americans with traditional Medicare have taken advantage of Medicare’s new free Annual Wellness Visit, up from 780,000 in mid-June;

To learn more about these new benefits, check out the Medicare campaign, “Share the News, Share the Health”, to learn about the importance of prevention for people with Medicare.

But the good news doesn’t stop here. Over the coming years, provisions of the Affordable Care Act will help close the donut hole coverage gap completely. Here is a sense of what Medicare beneficiaries can look forward to:

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

The chart below shows Medicare prescription drug savings over time:

  You Will Pay This Percentage for Brand-name Drugs in the Coverage Gap YouWill Pay This Percentage for Generic Drugs in the Coverage Gap
2011 50% 93%
2012 50% 86%
2013 47.5% 79%
2014 47.5% 72%
2015 45% 65%
2016 45% 58%
2017 40% 51%
2018 35% 44%
2019 30% 37%
2020 25% 25%

Source: Centers for Medicare and Medicaid Services

This all amounts to even more examples of how the Affordable Care Act is providing better health care for people covered by Medicare and making a difference in the lives of millions of Americans.

Protect Your Health with Covered Shots

Keeping your immune system strong is a lifelong, life-protecting job, but we’ve got you covered. Your Medicare preventive benefits include three shots:

  • Flu Shots—Covered once a flu season in the fall or winter.
  • Hepatitis B ShotsCovered for people at high or medium risk for Hepatitis B (usually a series of three shots).
  • Pneumococcal ShotCovered to help prevent pneumococcal infections (like certain types of pneumonia). Most people only need this shot once in their lifetime.

Getting your shots has never been easier. As we approach the fall season, you will see these shots offered in many places, such as your local pharmacy, so make sure you take advantage of them. As long as the supplier or doctor accepts assignment for giving the shot, you pay nothing.