Medicare Blog

how to reach medicare beneficiaries

by Dr. Dorcas Ondricka Published 2 years ago Updated 1 year ago
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Calling or using third parties to contact your current members (i.e., calling members aging-in to Medicare from commercial products offered by same sponsoring organization, calling an organization’s Medicaid

Medicaid

Medicaid in the United States is a federal and state program that helps with medical costs for some people with limited income and resources. Medicaid also offers benefits not normally covered by Medicare, including nursing home care and personal care services. The Health Insurance As…

plan members to talk about its Medicare products) Calling individuals who have given permission for a plan or agent to contact them, (i.e., filling out a business reply card (BRC), or asking a Customer Service Representative (CSR) to have an agent call them) Returning phone calls or messages

HCFA staffs a Medicare Hotline (1-800-638-6833, TDD 1800-820-1202) that is widely publicized to Medicare beneficiaries through most of their print materials. The Hotline is available from 8 a.m. to 8 p.m. EST Monday through Friday.

Full Answer

What happens if a Medicare beneficiary has other health insurance?

When a Medicare beneficiary has other insurance (like employer group health coverage), rules dictate which payer is responsible for paying first. Please review the Reporting Other Health Insurance page for information on how and when to report other health plan coverage to CMS.

What is beneficiaries Services Medicare?

Beneficiary Services Medicare is a health insurance program designed to assist the nation's elderly to meet hospital, medical, and other health costs. Medicare is available to most individuals 65 years of age and older.

Who is eligible for Medicare?

Medicare is available to most individuals 65 years of age and older. Medicare has also been extended to persons under age 65 who are receiving disability benefits from Social Security or the Railroad Retirement Board, and those having End Stage Renal Disease (ESRD).

When to inform Medicare of other insurance coverage available?

The Medicare beneficiary or his/her attorney should inform Medicare as soon as they become aware other insurance is available or if they feel another party was responsible for causing the beneficiary’s injuries or illness. Additional information on this topic can be found on the Liability, No-Fault and Workers’ Compensation Reporting page.

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What is the phone number to contact Medicare?

(800) 633-4227Centers for Medicare & Medicaid Services / Customer service

Are most Medicare beneficiaries automatically enrolled?

Original Medicare enrollment Most Medicare beneficiaries are automatically enrolled in Original Medicare, Part A and Part B. You're generally enrolled automatically the month you turn 65 if you're receiving Social Security Administration (SSA) or Railroad Retirement Board (RRB) benefits.

How do I find my Medicare beneficiary identifier?

There are 3 ways you and your office staff can get MBIs:Ask your Medicare patients. Ask your Medicare patients for their Medicare cards when they come for care. ... Use your MAC's secure MBI look-up tool. You can look up MBIs for your Medicare patients when they don't or can't give them. ... Check the remittance advice.

How do I reach Medicare?

Call 1-800-MEDICARE For questions about your claims or other personal Medicare information, log into (or create) your secure Medicare account, or call us at 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.

How long does Medicare take to activate?

When your coverage startsIf you sign up:Coverage starts:Before the month you turn 65The month you turn 65The month you turn 65The next month1 month after you turn 652 months after you sign up2 or 3 months after you turn 653 months after you sign up

Does Medicare cover beneficiaries?

The Qualified Medicare Beneficiary (QMB) program provides Medicare coverage of Part A and Part B premiums and cost sharing to low-income Medicare beneficiaries. In 2017, 7.7 million people (more than one out of eight people with Medicare) were in the QMB program.

Can I look up someone's Medicare number?

The Medicare Beneficiary Identifier (MBI) Lookup tool allows providers to use our secure eServices online portal to obtain the new MBI number when patients do not present their Medicare card. If you do not already have access, sign up now for access to eServices to use the tool.

Is your Medicare number the same as your Social Security Number?

Your card has a Medicare Number that's unique to you — it's not your Social Security Number. This helps protect your identity. The card shows: You have Medicare Part A (listed as HOSPITAL), Part B (listed as MEDICAL), or both.

Is the BNC number the same as the Medicare number?

The BNC is an encrypted 13-character alphanumeric code that is used to identify documents from the Social Security Administration. The BNC is used instead of Social Security numbers or Medicare numbers as a security measure to prevent identity theft.

Who is the best person to talk to about Medicare?

Do you have questions about your Medicare coverage? 1-800-MEDICARE (1-800-633-4227) can help. TTY users should call 1-877-486-2048.

Can I contact Medicare via email?

Call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048. Email us at [email protected].

When should I call Medicare?

You should contact your insurer directly about claims or billing issues if you have Medicare Advantage or Part D coverage, or if you need to check on claims that are being processed by your Medigap supplement. (You can also call 1-800-MEDICARE to file a complaint about your health insurance plan.)

Phone

For specific billing questions and questions about your claims, medical records, or expenses, log into your secure Medicare account, or call us at 1-800-MEDICARE.

1-800-MEDICARE (1-800-633-4227)

For specific billing questions and questions about your claims, medical records, or expenses, log into your secure Medicare account, or call us at 1-800-MEDICARE.

How to contact Medicare Advantage?

Your plan is the best resource to resolve plan related issues. Call 1-800-MEDICARE. Call 1-800-633-4227, TTY users should call 1-877-486-2048.

What is the number to call for Medicare?

Call 1-800-633-4227, TTY users should call 1-877-486-2048. If your concern is related to Original Medicare, or if your plan was unable to resolve your inquiry, contact 1-800-MEDICARE for help. Contact the SHIP.

What are the rights and protections of Medicare?

No matter how you get your Medicare, you have certain rights and protections designed to: Protect you when you get health care. Make sure you get the health care services that the law says you can get. Protect you against unethical practices. Protect your privacy. Rights & Protections for everyone with Medicare.

What is the MBO in Medicare?

In 2003, Congress established the MBO position to assist Medicare beneficiaries with their inquiries, complaints, grievances, appeals, and requests for information. The MBO is charged with supporting CMS’ customer service and administration efforts by receiving and responding to beneficiary and other stakeholder inquiries and complaints, working with partners to provide outreach and education to beneficiaries, and providing recommendations for improving the administration of Medicare. The MBO also provides an annual report to Congress. See the Downloads section of this page for links to the published reports.

Can you leave information at a beneficiary's residence?

Leaving information at a beneficiary’s residence if a pre-scheduled appointment at a beneficiary’s residence becomes a “no show” Using mail and other print media to contact beneficiaries (i. e., advertisements, direct mail) Discussing plan specifics at an informal event after the beneficiary approaches your table or kiosk

Can beneficiaries call a beneficiary who attended a sales event?

Calling beneficiaries who attended a sales event, unless beneficiary gave permission at the event for a follow-up call ( documentation of permission to be contacted must be obtained and saved, i.e., Permission-to-Contact form) Permission given to be contacted applies only to the entity from which the individual requested contact, for the duration of that transaction, for the scope of product (i.e., MAPD or PDP) as previously discussed or indicated on a reply card Calling beneficiaries to confirm receipt of mailed information, except as permitted Calling former members who disenrolled, or current members who are voluntarily disenrolling, to market plans or products, except as permitted

What is a POR in Medicare?

A Proof of Representation (POR) authorizes an individual or entity (including an attorney) to act on your behalf. Note: In some special circumstances, the potential third-party payer can submit Proof of Representation giving the third-party payer permission to enter into discussions with Medicare’s entities.

Why is Medicare conditional?

Medicare makes this conditional payment so you will not have to use your own money to pay the bill. The payment is "conditional" because it must be repaid to Medicare when a settlement, judgment, award, or other payment is made.

What is a CPN in BCRC?

If a settlement, judgment, award, or other payment has already occurred when you first report the case, a CPN will be issued. A CPN will also be issued when the BCRC is notified of settlement, judgement, award or other payment through an insurer/workers’ compensation entity’s MMSEA Section 111 report. The CPN provides conditional payment information and advises you on what actions must be taken. You have 30 calendar days to respond. The following items must be forwarded to the BCRC if they have not previously been sent:

What information is sent to the BCRC?

The information sent to the BCRC must clearly identify: 1) the date of settlement, 2) the settlement amount, and 3) the amount of any attorney's fees and other procurement costs borne by the beneficiary (Medicare may only take beneficiary-borne costs into account).

How long does interest accrue on a recovery letter?

Interest accrues from the date of the demand letter and, if the debt is not repaid or otherwise resolved within the time period specified in the recovery demand letter, is assessed for each 30 day period the debt remains unresolved. Payment is applied to interest first and principal second. Interest continues to accrue on the outstanding principal portion of the debt. If you request an appeal or a waiver, interest will continue to accrue. You may choose to pay the demand amount in order to avoid the accrual and assessment of interest. If the waiver/appeal is granted, you will receive a refund.

Can you get Medicare demand amount prior to settlement?

Also, if you are settling a liability case, you may be eligible to obtain Medicare’s demand amount prior to settlement or you may be eligible to pay Medicare a flat percentage of the total settlement. Please see the Demand Calculation Options page to determine if your case meets the required guidelines. 7.

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