Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:01):
Welcome to Medicare three sixty, where the world of Medicare
is simplified and you are empowered to make informed healthcare choices.
With over two decades of experience and insurance and financial
solutions with host licensed insurance agents Jennifer Lee, you are
guided through the ins and outs of Medicare, whether you
(00:22):
are nearing retirement, navigating your options, or just curious about
what's available. Everything you need to know is covered. Tune
in for knowledgeable insights, tips and answers to your Medicare
questions so you can take charge of your health and
your future. And Now Medicare three sixty.
Speaker 2 (00:44):
Welcome to today's Medicare three sixty show. I'm your host, Jennifer Lee,
and we are diving into Medicare and new handbook. I
think we're almost there, guys, I think we might actually
finish it on today's show. So find general Medicare information online.
Speaker 3 (01:04):
We are at.
Speaker 2 (01:05):
Page one eights and so let's dive in. Visit Medicare
dot gov. Get information at medicare dot gov slash plan
dash compare about the Medicare health and drug plans in
your area, including what they cost and what services they provide.
(01:28):
Find mediccare participating doctors, or other healthcare providers and suppliers.
At medicare dot gov, slash care dash compare. You can
also learn about the quality of care provided by plans
nursing homes, hospitals, doctors, home health agencies, dialysis facilities, hospice
(01:49):
centers and patient rehabilitation facilities and long term care hospitals.
Find out what Medicare covers, including preventive services like screening
shots or vac scenes and yearly wellness visits. Get Medicare
appeals and information.
Speaker 3 (02:07):
And forms.
Speaker 2 (02:08):
Okay, so what I'd like to say about this is, yes,
you could definitely go on medicare gov and compare plans.
But the biggest thing is that it's just all on paper,
right the ins and out. It's not going to tell
you the ins and outs of the plans, meaning the
(02:30):
vendors that these plans use.
Speaker 4 (02:33):
What vendor do they use for the gym or for
your the over the counter or just your dental visioning hearing.
That's really important. So let's take an example dental. There's
some Medicare advantage plans that are dental HMOL, there's some
(02:55):
that are PPO, and there are some that are indemnity,
meaning that you could get a reimbursement for whatever care
with sipulations maybe right, or there's ones that have Visa
cards or MasterCards. So the thing is things like that.
Speaker 2 (03:16):
While you could get the general gist and of course
familiarize yourself with plans, sometimes it might not be in
your best interests or there's things that you might be missing.
Other things as well as is if it's an HMO
plan and you have a doctor and you have tons
(03:38):
of specialists, it doesn't show if your doctors are specialists.
Are they in the same network, meaning are they in
the same medical group, So that might cause issues. So
things like that. The drugs might be also confusing. What
I find is that sometimes clients do their homework and
(04:01):
of course do your homework, be educated. They come to
me thinking, you know, this is the best plan, and
of course you know.
Speaker 3 (04:10):
We will go with what they want.
Speaker 2 (04:12):
But as a trusted insurance agent, I'm going to go
over like the pros and cons of each plan, the
different vendors, just what's out in the market today, what's
you know, like, what are plans that have better service
than others? And this is just all from experience from
(04:32):
my clients and even our experience calling these back offices
for you, so things like that and not it might
not be cut or dry to just go on medicare
dot gov and pick a plan.
Speaker 3 (04:47):
That's all I'm saying. I think.
Speaker 2 (04:50):
People are on group plans for so long and they
have to pick their own without any guidance. So when
you do get on Medicare, it is a whole new world. Yes,
you could do it yourself, your DIY, you could go
look on yourself.
Speaker 4 (05:08):
But what's another person's.
Speaker 2 (05:11):
Eyes that's been in the industry for a long time
that could tell you about plans, tell you about foreseeable
changes in the future that they've heard around the grapevine,
or just kind of give you a landscape on what's
going on Medicare today. Right. I don't think it's like
(05:32):
headlines on what's going on with Medicare, and most probably
don't care once ones they're happy with their plan. It's
just like out of sight, out of mind. I've been
having my annuals where clients where I want to go
over changes, and.
Speaker 3 (05:50):
You know, they're.
Speaker 2 (05:51):
Fine because they want to just go on with their life.
Speaker 3 (05:54):
Right, unless you.
Speaker 2 (05:56):
Really need that coverage or that help Okay, so that
is my soapbox for that. So you can get your
personal Medicare information online, create your own Medicare account. Visit
Medicare dot gov to log into or create your secure
(06:17):
Medicare account. You could also add your prescriptions in pharmacies
to help you better compare Medicare health and drug plans
in your area. Sign up to get this Medicare New
Handbook and your official original Medicare claim statements called Medicare
Summary Notices. Electronically review your original Medicare claims as soon
(06:39):
as their processed. Print a copy of your official Medicare card.
Find a list of preventive services you're eligible to get
with original Medicare. Learn about Medicare premiums and pay them
online if you get a bill from Medicare.
Speaker 3 (06:55):
Okay, that was a handful.
Speaker 2 (06:58):
So what I'd like to say about that is you
can definitely get your Medicare New Handbook on PDF. We
could help you with that. Then you get the one
that gets mailed to your house. And with that one
in the back, there are some of the plans on there,
(07:20):
so definitely look into that as well. But of course,
contact a license agent like me to go over that
body in more detail. Okay Medicare's Connected app directory. Connected
apps are Medicare proved applications or websites. They third party,
(07:41):
not Medicare creates. When you connect to an app and
log in when your Medicare dot Gov account information, you
could use an app service without manually entering your health information.
These thirty party app third parties can only access your
Medicare data if you choose to share.
Speaker 3 (07:59):
It with them.
Speaker 2 (08:00):
It's always your choice if you want to connect or
stay connected to a third party app. With these apps,
you can share your information with doctors, caregivers, and others.
View all of the health records in one place like hospitalization,
lab results, and medication. Submit your health information to participate
in clinical research studies. Note if you are enrolled in
(08:26):
a Medicare advantage, only Part D information is available through
Medicare connected apps.
Speaker 3 (08:31):
For Part A and Part B data check with your plan.
Speaker 2 (08:34):
Treat your personal and health information the same way you
treat other confidential information, so learn more about to how
to use Medicare connected apps to save your Medicare claims information.
Visit Medicare dot gov slash, manage your health, share your
dash Medicare claims Medicare dot gov slash Manager Health Medicare
(08:56):
slash blue slash button, slash blue dash button twenty slash
blue dash button dash apps. So it's nice to get
on your Medicare dot gov online. I believe you don't
need an email address, but create the user ID and
(09:16):
password and it's nice to know what plan you have.
Probably will deep dive on that one time too.
Speaker 3 (09:25):
Okay.
Speaker 2 (09:26):
So another thing is there is actually a Medicare you
like app that you could download on your phone, and
this is great for people that actually I want to
know what's covered right. Sometimes it's just something off off
the bat that you're like, oh, like I don't want
to call my agent, but what's what's cover?
Speaker 5 (09:48):
Right?
Speaker 2 (09:48):
So it's an application and then like you just type
in whatever service it is, like chiropractor or acupuncture, and
then it will say what original Medicare does cover. So
in a way that's nice. So if you do have
a slip the mental plan, you'll know what it is
exactly covered. And then when you have a Medicare advantage plan,
(10:12):
you know it is covered.
Speaker 3 (10:13):
But then you probably.
Speaker 2 (10:14):
Want to just look at your summary of benefits or
a contact agent to also just make sure understand how
it works.
Speaker 5 (10:24):
Okay, So I think also this has to do like
I have my own like portal website where my clients
could go in and add their drugs and their.
Speaker 3 (10:40):
Doctors and so forth.
Speaker 2 (10:41):
So this is something that's a little bit different, but
that's something you could definitely use as well.
Speaker 5 (10:48):
Okay.
Speaker 2 (10:49):
So Medicare is working to better coordinate your care. Medicare
continues to look for better ways to coordinate your care
and to make sure that you get the best healthcare possible.
Here are examples of how your healthcare providers can better
coordinate your care. Accountable care organizations. In an accountable care
(11:12):
organization ACO is a group of doctors, hospitals, and other
healthcare providers accept the original Medicare and work together and
coordinate your healthcare. Working as part of an ACO helps
your doctor and other healthcare providers understand your health history
and talk to one another about your care and your
(11:34):
healthcare needs. This may save you time, money, and frustration
by avoiding repeated tests and appointments. More coordination also helps
medical errors and unexpected drug interactions that may happen if
one provider isn't aware of what another provider has prescribed,
(11:58):
So that's kind of.
Speaker 3 (11:58):
The only thing.
Speaker 2 (12:00):
When you're working with a group of doctors that are
not managed together, they might not know you know the
prescription drugs. But I would say most doctors do ask
you what prescription drugs you take, so they don't prescribe
you a prescription drug that does not fit well with
(12:21):
that other drug. Okay, important. An ACO won't limit your
choice of healthcare providers. If your doctor or other provider
is part of an ACO, you still have the right
to visit any doctor, hospital, other provider that takes Medicare
at any time. In addition, if your primary care doctor
(12:43):
participates in an ACO, you may be able to get
more benefits. For example, in some acos, your provider may
offer more telehealth services. This means you may be able
to get some services from home using technology like your
phone or computer to communicate in real time with your
(13:06):
healthcare provider. In addition, a other a provider who is
part of an ACO may be able to send their
parents for skilled nursing, facility care, or rehabilitation services even
if they haven't stayed in a hospital for three days first,
which is usually a requirement in Medicare for you to
(13:28):
qualify for this benefit, your doctor other provider has to
decide that you need skilled nursing facility care and meet
certain other eligible requirements. So keep in mind this was
implemented a few years back, and where like, if you
had original Medicare, you couldn't go straight to a skilled
(13:49):
nursing facility care or rehab. You'd have to go to
the hospital first stay three days. And I've had it
where clients they wouldn't. They're just like, oh, you have
now and one or two days, right, So please fight
for your care and advocate for that because knowing that
you really can't go to.
Speaker 4 (14:10):
A skilled nursing facility or rehab.
Speaker 2 (14:12):
If you haven't stayed that three days. So just keep
that in mind because you want to you want to
fight that sooner than later if that's the case and
you know you just can't go home, So keep that
in mind. Okay, So, if your primary care doctor participates
in an ACO and you have original Medicare, you'll get
(14:36):
a writ to notice and or find a poster in
their office about their ACO participation. There are now hundreds
of acos across the country. Visit Medicare dot gov, slash care,
dosh compared to find a primary doctor that's part of
an ACO, so accountable care organization. Okay, we are onto
(14:59):
a page one of the sharing your health care information
with acos. One of the most important benefits of an
ACO is that your doctor and other providers can communicate
and coordinate your care. To help with that, Medicare allows
your healthcare providers ACO to ask for certain information about
(15:21):
your care. Having Medicare share your data in this way
helps make sure all the people involved in your care
have access to your health information when they need it
to help you. If you don't want Medicare to share
your health information with your doctors for care coordination, call
one one hundred Medicare eight hundred and sixty thirty three
(15:41):
four two twenty seven and let the representative know. Medicare
may still share general or information to measure provider quality.
To learn about acos, visit Medicare dot gov, slash managed ash,
your Health h Coordination DASH, your dash care Flash. Accountable
(16:02):
care organizations are called one hundred Medicare.
Speaker 3 (16:06):
Electronic health records.
Speaker 2 (16:10):
Electronic health records are a history of your Medicare conditions, healthcare,
and treatment with that your doctor, other healthcare provider medical
office staff, or hospital keeps on a computer. They could
help lower the chances of medical errors, eliminate duplicate tests,
and may improve your overall quality of care your doctors.
(16:31):
Electronic health records may be able to link a hospital, lab, pharmacy,
or doctors or immanization information systems registries so that people
who care for you could have a more complete picture
of your health. Electronic prescribing. This isn't an electronic way
(16:52):
for your prescriber, your doctor or other healthcare provider who's
legally allowed to write prescriptions to send your prescriptions directly
to your pharmacy. Electronic pers crime can save you money
and time and help you safe, help you keep safe okay.
Other ways to get more information Medicare emails. Visit medicare
(17:12):
dot gov to create your secure Medicare accounts include your
email adders To get impurportant reminders and information about Medicare publications,
visit medicare dot gov slash publications to review, print, or
(17:34):
download copies of publications on different Medicare topics. You could
also call one eight hundred Medicare. Go to page one
twenty four for information about getting publications in accessible formats
like large print ebooks or brail at no costs. The
Medicare in You Handbook is available in other languages like Spanish, Chinese, Korean,
(17:56):
and Vietnamese. Social media say up to day and connect
with other people with Medicare by following us on Facebook,
Facebook dot com slash medicare I need to follow that okay,
and x formally known as Twitter videos. Find videos about
Medicare and other healthcare topics at YouTube dot com, slash
(18:20):
c m s, hhs gov. Other helpful con text social
security visit SSA dot gov for sign to apply for
sign up for original Medicare and find out if you
qualify for extra help with Medicare costs. Also, when you
(18:40):
open a personal social security account, you could review your
Social Security statement, verify your earnings, change your deposit information.
It costs a replacement Medicare card, update your address, and more.
Visit SSA dot CoV slash my account to in your
personal account so okay. As time goes by, buy there
(19:08):
are updates to say dot gov. So first, if you've
never signed on, there's two ways to sign up, which
is going to be the login dot gov or the
ID dot meet.
Speaker 3 (19:23):
So they made it awfully.
Speaker 2 (19:25):
Difficult for people to just sign up, so you do
need an email address, a password. You'll also need sometimes
if they can't verify you, you'll need your driver's license
front and back. And they also do like facial recognition
(19:47):
for you as well. I've done this several times for
clients and they only give you five tries and it's
like lo and behold the fifth.
Speaker 3 (19:57):
Time it does work.
Speaker 2 (20:00):
But I did have an instant where I had two
clients recently. One was like, let you have to go
to the post office to verify who you are? Okay,
what a hassle, right, And then I had one was
just like, we finally got in, but even when we
got in, sorry, your records don't match.
Speaker 3 (20:22):
Call us right.
Speaker 2 (20:23):
So in that case, it is very very frustrating for you.
But we are here to help you walk you through
it because I literally do it every single day for clients.
So let us know if you need help with that.
It is really cumbersome, okay. So Benefit Coordination and Recovery Center.
(20:51):
Contact the Benefits Coordination or Recovery Center at eight by
five seven ninety eight two six two seven to report
changes in your insurance information or let medicare know you
have other insurance, so.
Speaker 3 (21:03):
This is big.
Speaker 2 (21:05):
Sometimes, like supplemental clients, they do get bills and they
are not getting paid or denied. Sometimes it's just that coordination,
right because if you left your group plan, but for
some reason the system still has it, it might not
(21:26):
want to pay that bill. So just an easy call
with them just to show them that hey, you are
off that group plan, you have a different Medicare policy
and so forth definitely helps. So contact us for that
too because we do help out with that as well. Okay,
(21:48):
So Beneficiary and Family Centered Care Quality Improvement Organization and
State Survey Agency. Contact your Beneficiary and Family Centered Care
Quality Improvement Organization be fcc QI zero. If you think
Medicare coverage for your services ending soon, like if your
hospital stays that you may be just discharged and you disagree.
(22:12):
You may have the right to a fast appeal. If
you have concerns about the quality of care you or
your love when received in a state or fairly certified
healthcare facility for your status aren't satisfied with your provider's
response your concern, we file a cormal formal complaint directly
with your state Survey Agency or the BFCC DASH QI
(22:32):
zero called one hundred metigare to get the phone number
of your BFCC QI zero or your state Service Survey
agency eight seven seven four eighty six two zero four eight.
For more information, visit Medicare dot govs slash Claims Appeals,
dash file dash A Dash Complaint Dash Grievance slash filing
(22:53):
dash A Dash complaint, dash about dash your dash.
Speaker 3 (22:57):
Quality of care.
Speaker 2 (22:59):
Think you guys a can miss this Department of Defense,
So get information about Try Care for Life TfL and
the Tricare Pharmacy program. That's eight hundred and seven seven
threes zero four zer a four. There's Tricare dot m
l slash TfL, Trycare for You dot com, the Tricare
(23:20):
Pharmacy Program, Tricare dot mill slash pharmacy or x dot
express dash scripts dot com. Department of Veterans Affair contact
the VA if you're a veteran, have served in the
US military and have questions. So yeah, like I would say,
(23:41):
for our veterans, some of it is really straightforward that
you definitely should get a Medicare plan.
Speaker 3 (23:50):
Some aren't.
Speaker 2 (23:52):
Trycare for instances a little bit harder to maneuver and
to understand that.
Speaker 3 (23:59):
But just know that we are here for you if
you do have questions on that.
Speaker 2 (24:06):
Office of Personal Management. Get information about federal employee health
benefits programs for current and retired federal employees SO Federal
Retirees so eight seven seven seven sixty seven six seven
three eight at OPM dot gov slash Healthcare dash Insurance
slasky dash me slash Retirees lash Survivors, so active Federal
(24:27):
Employees OPM dot gov slash Heare Healthcare dash Insurance slash
guy dash me slash retirees nashby servevibers.
Speaker 1 (24:39):
So.
Speaker 2 (24:40):
I thought we were going to finish the Medicarean New
Handbook today, but we are not. We are out of time.
So I am going to finish that up next week.
I look forward to talking to you guys. Then we
are at page one thirteen and I think we are
almost to the finished ninth.
Speaker 3 (25:02):
Thank you. You have a wonderful day and we will
talk soon. Goodbye.
Speaker 1 (25:08):
Thank you for joining the program Medicare at three sixty.
Hope you found today's episode insightful and empowering. Remember understanding
your Medicare options is key to making the right choices
for your health and financial well being. If you have
questions or topics you would like covered in future episodes
of Medicare three sixty, don't hesitate to reach out and
(25:30):
speak with our licensed insurance agent. Until next time, Stay
informed and take charge of your healthcare journey. This has
been Medicare three sixty, your trusted source for all things Medicare.
Take care,
Welcome to Medicare three sixty, where the world of Medicare
is simplified and you are empowered to make informed healthcare choices.
With over two decades of experience and insurance and financial
solutions with host licensed insurance agents Jennifer Lee, you are
guided through the ins and outs of Medicare, whether you
(00:22):
are nearing retirement, navigating your options, or just curious about
what's available. Everything you need to know is covered. Tune
in for knowledgeable insights, tips and answers to your Medicare
questions so you can take charge of your health and
your future. And Now Medicare three sixty.
Speaker 2 (00:44):
Welcome to today's Medicare three sixty show. I'm your host, Jennifer Lee,
and we are diving into Medicare and new handbook. I
think we're almost there, guys, I think we might actually
finish it on today's show. So find general Medicare information online.
Speaker 3 (01:04):
We are at.
Speaker 2 (01:05):
Page one eights and so let's dive in. Visit Medicare
dot gov. Get information at medicare dot gov slash plan
dash compare about the Medicare health and drug plans in
your area, including what they cost and what services they provide.
(01:28):
Find mediccare participating doctors, or other healthcare providers and suppliers.
At medicare dot gov, slash care dash compare. You can
also learn about the quality of care provided by plans
nursing homes, hospitals, doctors, home health agencies, dialysis facilities, hospice
(01:49):
centers and patient rehabilitation facilities and long term care hospitals.
Find out what Medicare covers, including preventive services like screening
shots or vac scenes and yearly wellness visits. Get Medicare
appeals and information.
Speaker 3 (02:07):
And forms.
Speaker 2 (02:08):
Okay, so what I'd like to say about this is, yes,
you could definitely go on medicare gov and compare plans.
But the biggest thing is that it's just all on paper,
right the ins and out. It's not going to tell
you the ins and outs of the plans, meaning the
(02:30):
vendors that these plans use.
Speaker 4 (02:33):
What vendor do they use for the gym or for
your the over the counter or just your dental visioning hearing.
That's really important. So let's take an example dental. There's
some Medicare advantage plans that are dental HMOL, there's some
(02:55):
that are PPO, and there are some that are indemnity,
meaning that you could get a reimbursement for whatever care
with sipulations maybe right, or there's ones that have Visa
cards or MasterCards. So the thing is things like that.
Speaker 2 (03:16):
While you could get the general gist and of course
familiarize yourself with plans, sometimes it might not be in
your best interests or there's things that you might be missing.
Other things as well as is if it's an HMO
plan and you have a doctor and you have tons
(03:38):
of specialists, it doesn't show if your doctors are specialists.
Are they in the same network, meaning are they in
the same medical group, So that might cause issues. So
things like that. The drugs might be also confusing. What
I find is that sometimes clients do their homework and
(04:01):
of course do your homework, be educated. They come to
me thinking, you know, this is the best plan, and
of course you know.
Speaker 3 (04:10):
We will go with what they want.
Speaker 2 (04:12):
But as a trusted insurance agent, I'm going to go
over like the pros and cons of each plan, the
different vendors, just what's out in the market today, what's
you know, like, what are plans that have better service
than others? And this is just all from experience from
(04:32):
my clients and even our experience calling these back offices
for you, so things like that and not it might
not be cut or dry to just go on medicare
dot gov and pick a plan.
Speaker 3 (04:47):
That's all I'm saying. I think.
Speaker 2 (04:50):
People are on group plans for so long and they
have to pick their own without any guidance. So when
you do get on Medicare, it is a whole new world. Yes,
you could do it yourself, your DIY, you could go
look on yourself.
Speaker 4 (05:08):
But what's another person's.
Speaker 2 (05:11):
Eyes that's been in the industry for a long time
that could tell you about plans, tell you about foreseeable
changes in the future that they've heard around the grapevine,
or just kind of give you a landscape on what's
going on Medicare today. Right. I don't think it's like
(05:32):
headlines on what's going on with Medicare, and most probably
don't care once ones they're happy with their plan. It's
just like out of sight, out of mind. I've been
having my annuals where clients where I want to go
over changes, and.
Speaker 3 (05:50):
You know, they're.
Speaker 2 (05:51):
Fine because they want to just go on with their life.
Speaker 3 (05:54):
Right, unless you.
Speaker 2 (05:56):
Really need that coverage or that help Okay, so that
is my soapbox for that. So you can get your
personal Medicare information online, create your own Medicare account. Visit
Medicare dot gov to log into or create your secure
(06:17):
Medicare account. You could also add your prescriptions in pharmacies
to help you better compare Medicare health and drug plans
in your area. Sign up to get this Medicare New
Handbook and your official original Medicare claim statements called Medicare
Summary Notices. Electronically review your original Medicare claims as soon
(06:39):
as their processed. Print a copy of your official Medicare card.
Find a list of preventive services you're eligible to get
with original Medicare. Learn about Medicare premiums and pay them
online if you get a bill from Medicare.
Speaker 3 (06:55):
Okay, that was a handful.
Speaker 2 (06:58):
So what I'd like to say about that is you
can definitely get your Medicare New Handbook on PDF. We
could help you with that. Then you get the one
that gets mailed to your house. And with that one
in the back, there are some of the plans on there,
(07:20):
so definitely look into that as well. But of course,
contact a license agent like me to go over that
body in more detail. Okay Medicare's Connected app directory. Connected
apps are Medicare proved applications or websites. They third party,
(07:41):
not Medicare creates. When you connect to an app and
log in when your Medicare dot Gov account information, you
could use an app service without manually entering your health information.
These thirty party app third parties can only access your
Medicare data if you choose to share.
Speaker 3 (07:59):
It with them.
Speaker 2 (08:00):
It's always your choice if you want to connect or
stay connected to a third party app. With these apps,
you can share your information with doctors, caregivers, and others.
View all of the health records in one place like hospitalization,
lab results, and medication. Submit your health information to participate
in clinical research studies. Note if you are enrolled in
(08:26):
a Medicare advantage, only Part D information is available through
Medicare connected apps.
Speaker 3 (08:31):
For Part A and Part B data check with your plan.
Speaker 2 (08:34):
Treat your personal and health information the same way you
treat other confidential information, so learn more about to how
to use Medicare connected apps to save your Medicare claims information.
Visit Medicare dot gov slash, manage your health, share your
dash Medicare claims Medicare dot gov slash Manager Health Medicare
(08:56):
slash blue slash button, slash blue dash button twenty slash
blue dash button dash apps. So it's nice to get
on your Medicare dot gov online. I believe you don't
need an email address, but create the user ID and
(09:16):
password and it's nice to know what plan you have.
Probably will deep dive on that one time too.
Speaker 3 (09:25):
Okay.
Speaker 2 (09:26):
So another thing is there is actually a Medicare you
like app that you could download on your phone, and
this is great for people that actually I want to
know what's covered right. Sometimes it's just something off off
the bat that you're like, oh, like I don't want
to call my agent, but what's what's cover?
Speaker 5 (09:48):
Right?
Speaker 2 (09:48):
So it's an application and then like you just type
in whatever service it is, like chiropractor or acupuncture, and
then it will say what original Medicare does cover. So
in a way that's nice. So if you do have
a slip the mental plan, you'll know what it is
exactly covered. And then when you have a Medicare advantage plan,
(10:12):
you know it is covered.
Speaker 3 (10:13):
But then you probably.
Speaker 2 (10:14):
Want to just look at your summary of benefits or
a contact agent to also just make sure understand how
it works.
Speaker 5 (10:24):
Okay, So I think also this has to do like
I have my own like portal website where my clients
could go in and add their drugs and their.
Speaker 3 (10:40):
Doctors and so forth.
Speaker 2 (10:41):
So this is something that's a little bit different, but
that's something you could definitely use as well.
Speaker 5 (10:48):
Okay.
Speaker 2 (10:49):
So Medicare is working to better coordinate your care. Medicare
continues to look for better ways to coordinate your care
and to make sure that you get the best healthcare possible.
Here are examples of how your healthcare providers can better
coordinate your care. Accountable care organizations. In an accountable care
(11:12):
organization ACO is a group of doctors, hospitals, and other
healthcare providers accept the original Medicare and work together and
coordinate your healthcare. Working as part of an ACO helps
your doctor and other healthcare providers understand your health history
and talk to one another about your care and your
(11:34):
healthcare needs. This may save you time, money, and frustration
by avoiding repeated tests and appointments. More coordination also helps
medical errors and unexpected drug interactions that may happen if
one provider isn't aware of what another provider has prescribed,
(11:58):
So that's kind of.
Speaker 3 (11:58):
The only thing.
Speaker 2 (12:00):
When you're working with a group of doctors that are
not managed together, they might not know you know the
prescription drugs. But I would say most doctors do ask
you what prescription drugs you take, so they don't prescribe
you a prescription drug that does not fit well with
(12:21):
that other drug. Okay, important. An ACO won't limit your
choice of healthcare providers. If your doctor or other provider
is part of an ACO, you still have the right
to visit any doctor, hospital, other provider that takes Medicare
at any time. In addition, if your primary care doctor
(12:43):
participates in an ACO, you may be able to get
more benefits. For example, in some acos, your provider may
offer more telehealth services. This means you may be able
to get some services from home using technology like your
phone or computer to communicate in real time with your
(13:06):
healthcare provider. In addition, a other a provider who is
part of an ACO may be able to send their
parents for skilled nursing, facility care, or rehabilitation services even
if they haven't stayed in a hospital for three days first,
which is usually a requirement in Medicare for you to
(13:28):
qualify for this benefit, your doctor other provider has to
decide that you need skilled nursing facility care and meet
certain other eligible requirements. So keep in mind this was
implemented a few years back, and where like, if you
had original Medicare, you couldn't go straight to a skilled
(13:49):
nursing facility care or rehab. You'd have to go to
the hospital first stay three days. And I've had it
where clients they wouldn't. They're just like, oh, you have
now and one or two days, right, So please fight
for your care and advocate for that because knowing that
you really can't go to.
Speaker 4 (14:10):
A skilled nursing facility or rehab.
Speaker 2 (14:12):
If you haven't stayed that three days. So just keep
that in mind because you want to you want to
fight that sooner than later if that's the case and
you know you just can't go home, So keep that
in mind. Okay, So, if your primary care doctor participates
in an ACO and you have original Medicare, you'll get
(14:36):
a writ to notice and or find a poster in
their office about their ACO participation. There are now hundreds
of acos across the country. Visit Medicare dot gov, slash care,
dosh compared to find a primary doctor that's part of
an ACO, so accountable care organization. Okay, we are onto
(14:59):
a page one of the sharing your health care information
with acos. One of the most important benefits of an
ACO is that your doctor and other providers can communicate
and coordinate your care. To help with that, Medicare allows
your healthcare providers ACO to ask for certain information about
(15:21):
your care. Having Medicare share your data in this way
helps make sure all the people involved in your care
have access to your health information when they need it
to help you. If you don't want Medicare to share
your health information with your doctors for care coordination, call
one one hundred Medicare eight hundred and sixty thirty three
(15:41):
four two twenty seven and let the representative know. Medicare
may still share general or information to measure provider quality.
To learn about acos, visit Medicare dot gov, slash managed ash,
your Health h Coordination DASH, your dash care Flash. Accountable
(16:02):
care organizations are called one hundred Medicare.
Speaker 3 (16:06):
Electronic health records.
Speaker 2 (16:10):
Electronic health records are a history of your Medicare conditions, healthcare,
and treatment with that your doctor, other healthcare provider medical
office staff, or hospital keeps on a computer. They could
help lower the chances of medical errors, eliminate duplicate tests,
and may improve your overall quality of care your doctors.
(16:31):
Electronic health records may be able to link a hospital, lab, pharmacy,
or doctors or immanization information systems registries so that people
who care for you could have a more complete picture
of your health. Electronic prescribing. This isn't an electronic way
(16:52):
for your prescriber, your doctor or other healthcare provider who's
legally allowed to write prescriptions to send your prescriptions directly
to your pharmacy. Electronic pers crime can save you money
and time and help you safe, help you keep safe okay.
Other ways to get more information Medicare emails. Visit medicare
(17:12):
dot gov to create your secure Medicare accounts include your
email adders To get impurportant reminders and information about Medicare publications,
visit medicare dot gov slash publications to review, print, or
(17:34):
download copies of publications on different Medicare topics. You could
also call one eight hundred Medicare. Go to page one
twenty four for information about getting publications in accessible formats
like large print ebooks or brail at no costs. The
Medicare in You Handbook is available in other languages like Spanish, Chinese, Korean,
(17:56):
and Vietnamese. Social media say up to day and connect
with other people with Medicare by following us on Facebook,
Facebook dot com slash medicare I need to follow that okay,
and x formally known as Twitter videos. Find videos about
Medicare and other healthcare topics at YouTube dot com, slash
(18:20):
c m s, hhs gov. Other helpful con text social
security visit SSA dot gov for sign to apply for
sign up for original Medicare and find out if you
qualify for extra help with Medicare costs. Also, when you
(18:40):
open a personal social security account, you could review your
Social Security statement, verify your earnings, change your deposit information.
It costs a replacement Medicare card, update your address, and more.
Visit SSA dot CoV slash my account to in your
personal account so okay. As time goes by, buy there
(19:08):
are updates to say dot gov. So first, if you've
never signed on, there's two ways to sign up, which
is going to be the login dot gov or the
ID dot meet.
Speaker 3 (19:23):
So they made it awfully.
Speaker 2 (19:25):
Difficult for people to just sign up, so you do
need an email address, a password. You'll also need sometimes
if they can't verify you, you'll need your driver's license
front and back. And they also do like facial recognition
(19:47):
for you as well. I've done this several times for
clients and they only give you five tries and it's
like lo and behold the fifth.
Speaker 3 (19:57):
Time it does work.
Speaker 2 (20:00):
But I did have an instant where I had two
clients recently. One was like, let you have to go
to the post office to verify who you are? Okay,
what a hassle, right, And then I had one was
just like, we finally got in, but even when we
got in, sorry, your records don't match.
Speaker 3 (20:22):
Call us right.
Speaker 2 (20:23):
So in that case, it is very very frustrating for you.
But we are here to help you walk you through
it because I literally do it every single day for clients.
So let us know if you need help with that.
It is really cumbersome, okay. So Benefit Coordination and Recovery Center.
(20:51):
Contact the Benefits Coordination or Recovery Center at eight by
five seven ninety eight two six two seven to report
changes in your insurance information or let medicare know you
have other insurance, so.
Speaker 3 (21:03):
This is big.
Speaker 2 (21:05):
Sometimes, like supplemental clients, they do get bills and they
are not getting paid or denied. Sometimes it's just that coordination,
right because if you left your group plan, but for
some reason the system still has it, it might not
(21:26):
want to pay that bill. So just an easy call
with them just to show them that hey, you are
off that group plan, you have a different Medicare policy
and so forth definitely helps. So contact us for that
too because we do help out with that as well. Okay,
(21:48):
So Beneficiary and Family Centered Care Quality Improvement Organization and
State Survey Agency. Contact your Beneficiary and Family Centered Care
Quality Improvement Organization be fcc QI zero. If you think
Medicare coverage for your services ending soon, like if your
hospital stays that you may be just discharged and you disagree.
(22:12):
You may have the right to a fast appeal. If
you have concerns about the quality of care you or
your love when received in a state or fairly certified
healthcare facility for your status aren't satisfied with your provider's
response your concern, we file a cormal formal complaint directly
with your state Survey Agency or the BFCC DASH QI
(22:32):
zero called one hundred metigare to get the phone number
of your BFCC QI zero or your state Service Survey
agency eight seven seven four eighty six two zero four eight.
For more information, visit Medicare dot govs slash Claims Appeals,
dash file dash A Dash Complaint Dash Grievance slash filing
(22:53):
dash A Dash complaint, dash about dash your dash.
Speaker 3 (22:57):
Quality of care.
Speaker 2 (22:59):
Think you guys a can miss this Department of Defense,
So get information about Try Care for Life TfL and
the Tricare Pharmacy program. That's eight hundred and seven seven
threes zero four zer a four. There's Tricare dot m
l slash TfL, Trycare for You dot com, the Tricare
(23:20):
Pharmacy Program, Tricare dot mill slash pharmacy or x dot
express dash scripts dot com. Department of Veterans Affair contact
the VA if you're a veteran, have served in the
US military and have questions. So yeah, like I would say,
(23:41):
for our veterans, some of it is really straightforward that
you definitely should get a Medicare plan.
Speaker 3 (23:50):
Some aren't.
Speaker 2 (23:52):
Trycare for instances a little bit harder to maneuver and
to understand that.
Speaker 3 (23:59):
But just know that we are here for you if
you do have questions on that.
Speaker 2 (24:06):
Office of Personal Management. Get information about federal employee health
benefits programs for current and retired federal employees SO Federal
Retirees so eight seven seven seven sixty seven six seven
three eight at OPM dot gov slash Healthcare dash Insurance
slasky dash me slash Retirees lash Survivors, so active Federal
(24:27):
Employees OPM dot gov slash Heare Healthcare dash Insurance slash
guy dash me slash retirees nashby servevibers.
Speaker 1 (24:39):
So.
Speaker 2 (24:40):
I thought we were going to finish the Medicarean New
Handbook today, but we are not. We are out of time.
So I am going to finish that up next week.
I look forward to talking to you guys. Then we
are at page one thirteen and I think we are
almost to the finished ninth.
Speaker 3 (25:02):
Thank you. You have a wonderful day and we will
talk soon. Goodbye.
Speaker 1 (25:08):
Thank you for joining the program Medicare at three sixty.
Hope you found today's episode insightful and empowering. Remember understanding
your Medicare options is key to making the right choices
for your health and financial well being. If you have
questions or topics you would like covered in future episodes
of Medicare three sixty, don't hesitate to reach out and
(25:30):
speak with our licensed insurance agent. Until next time, Stay
informed and take charge of your healthcare journey. This has
been Medicare three sixty, your trusted source for all things Medicare.
Take care,
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