Who do I call if I Have Questions 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. What should I have ready when I call 1-800-MEDICARE?
Do you ask your doctor questions about your health?
When you go to the doctor it's typically for a specific problem, such as a cold, stomach pain or other issue that you want to get better. But often in their haste to be cured, patients fail to ask doctors questions about their health.
Is it safe to give out your Medicare number?
Never give out your Medicare — or Social Security — number to anyone who calls you on the phone, sends email or makes a personal contact. Your personal information, including your Medicare number, should be shared only with health care providers, your insurers or trusted counseling services, such as the State Health Insurance Assistance Program.
What happens if I don’t schedule a welcome to Medicare visit?
Remember, even if you don’t schedule a Welcome to Medicare visit, you are still eligible and encouraged to schedule an Annual Wellness Visit. Both visits are conversations between the patient and clinician to discuss health history and any health concerns, and to review medications and immunizations.
What are the questions that are ask on Medicare wellness exam?
Top 10 questions you should be asking your doctor during your annual wellness examDo I still need my medications? ... Does my family's health put me at risk? ... Are my bowel movements normal? ... Am I getting enough sleep? ... How is my blood pressure? ... Is this normal? ... Would you recommend any additional annual screenings?More items...•
What does a Medicare wellness check up consist of?
Your visit may include: A review of your medical and family history. A review of your current providers and prescriptions. Height, weight, blood pressure, and other routine measurements.
Why do doctors not like to take Medicare?
Can Doctors Refuse Medicare? The short answer is "yes." Thanks to the federal program's low reimbursement rates, stringent rules, and grueling paperwork process, many doctors are refusing to accept Medicare's payment for services. Medicare typically pays doctors only 80% of what private health insurance pays.
What is the difference between a Medicare wellness exam and a physical?
There is a difference between an “annual wellness visit” and an “annual physical exam.” One is focused more on preventing disease and disability, while the other is more focused on checking your current overall health.
What do doctors do at a wellness check?
Your doctor will ask questions about your weight, height, blood pressure, body mass index (BMI), and discuss your health choices and current lifestyle. The visit may also include different types of screening depending on your gender, risk, and age.
Can I refuse the Medicare Annual wellness visit?
Medicare covers a “Welcome to Medicare” visit and annual “wellness” visits. While both visit types are available to Medicare recipients, recipients aren't required to participate in either visit type to maintain their Medicare Part B coverage.
Do doctors treat Medicare patients differently?
Many doctors try to help out patients who can't afford to pay the full amount for an office visit or the copay for a pricey medication. Now along comes a study suggesting that physicians in one Texas community treat patients differently, depending on whether they are on Medicare or have private insurance.
Do doctors lose money on Medicare patients?
Summarizing, we do find corroborative evidence (admittedly based on physician self-reports) that both Medicare and Medicaid pay significantly less (e.g., 30-50 percent) than the physician's usual fee for office and inpatient visits as well as for surgical and diagnostic procedures.
What will Medicare not pay for?
Medicare doesn't provide coverage for routine dental visits, teeth cleanings, fillings, dentures or most tooth extractions. Some Medicare Advantage plans cover basic cleanings and X-rays, but they generally have an annual coverage cap of about $1,500.
How often will Medicare pay for routine blood work?
For people watching their cholesterol, routine screening blood tests are important. Medicare Part B generally covers a screening blood test for cholesterol once every five years. You pay nothing for the test if your doctor accepts Medicare assignment and takes Medicare's payment as payment in full.
Is EKG required for Welcome to Medicare visit?
Is an EKG required during a Welcome to Medicare visit? No. Medicare Part B covers one electrocardiogram screening if you receive a referral from your doctor or other health care provider as part of your one-time Welcome to Medicare preventive visit. However, your doctor will not perform an EKG during your visit.
Does Medicare pay for a physical every year?
As a rule, Medicare does not cover an annual physical. The exam and any tests your doctor orders are separate services, and you may have costs related to each depending on your Medicare plan.
How long does it take to get Medicare if you don't have Social Security?
If you are not receiving Social Security and need to sign up for Medicare, you should do it 2-3 months before the month that you turn 65. You can do it online or at a local Social Security office. It can take Social Security up to a month or more to process a new enrollment into Medicare.
When will Medicare show up in mailbox?
It will just show up in your mailbox one day about 3 months before your 65th birthday. If that situation applies to you, there’s nothing else you need to do with Medicare itself – your next step is to pick a Medigap plan and Part D plan (if you are going to get those).
What color is Medicare card?
When you go to the doctor, you present your red, white and blue Medicare card in addition to your Medigap card. The provider files the claims to Medicare, which pays its portion and coordinates the payment from the supplemental (Medigap) company.
How much is Medicare Part B 2021?
For Medicare Part B, the standard premium (for 2021) is $148.50/month. This premium can change over time. Also, people in higher/lower income brackets can pay different amounts. For a resource on people in higher income brackets and how much they pay, read about IRMAA.
How long before you turn 65 can you get Medicare?
If this is your situation, there is nothing else you need to do. Medicare will send you a card in the mail about 3 months in advance of the month in which you turn 65. Your Medicare will start on the 1st day of the month you turn 65 UNLESS your birthday is on the 1st day of the month, in which case it will start on the 1st day of the previous month.
Is Medigap a Medicare Advantage plan?
Medigap plans are NOT Medicare Advantage plans and vice versa. The two could not be any different in how they work. At a fundamental level, the biggest difference is that Medigap plans work WITH Medicare and supplement Medicare’s coverage, while Advantage plans work IN PLACE OF Medicare.
Does Medicare cover prescriptions?
Medicare itself (Parts A and B) and the Medigap plans provide NO coverage for prescription medications. Part D national average premiums are around $34/month currently (2021). But there are plans for as low as $7-15/month in most geographic locations – rates vary by state.
What to do if you suspect Medicare fraud?
If you suspect you’ve been victimized by fraud, alert Medicare that a scammer may have your identifying number so that your account can be flagged and monitored. And, keep a careful eye on the monthly explanation of benefits that Medicare sends, looking out for any suspicious charges.
What are qualifying circumstances for Medicare Advantage?
Qualifying circumstances include everything from marriage or divorce to retirement. In your recent discussion of limitations of Medicare Advantage plans, you did not include information about improper claims denials and the difficulty people have pursuing appeals. That certainly should be part of your coverage.
What is the inflation rate for Medicare?
Enrollees in traditional Medicare can expect inflation of 6 percent if inflation for Medigap premiums is included. Among Medicare Advantage plans (Part C), 49 percent of plans that include drug coverage will charge no additional premium beyond Part B next year, according to the Kaiser Family Foundation. Plans that do have additional premiums ...
What is Medicare alphabet soup?
Medicare features an alphabet soup of plans, coverage choices, premium levels and enrollment rules. The New York Times recently invited readers to submit their questions about Medicare. Today, we’re responding to some of the most frequent ones. What kind of monthly premiums for either original Medicare or Advantage can I realistically plan on ...
What is the Office of Inspector General at the Department of Health and Human Services?
The Office of Inspector General at the Department of Health and Human Services found “widespread and persistent problems related to denials of care and payment in Medicare Advantage” plans.
How much does Medicare cost for a 65 year old?
According to HealthView, a 65-year-old couple using original Medicare this year will spend around $10,300 on premiums for prescription drugs and Medigap, and various out-of-pocket costs. In 20 years, their costs are projected to be around $33,000 annually (future dollars).
What is the AARP fraud line?
AARP’s fraud help line (877-908-3360) has noted a recent increase in phone schemes, usually aimed at persuading people to order equipment or services that are then billed to Medicare. “A big one lately has been DNA genetic testing kits,” Ms. Nofziger said.
Why is it important to plan ahead for Medicare?
Today, the medical community realizes that planning ahead can help manage Medicare patients’ potential concerns, including hearing and vision loss, depression and progression of chronic disease. This can make a key difference in staying healthy longer.
What is a welcome to Medicare visit?
A: When you or a loved one first enrolls in Medicare, the Welcome to Medicare visit is an optional, one-time appointment. It serves as a reference point or baseline for planning personalized medical care going forward.
What is a medical visit?
Both visits are conversations between the patient and clinician to discuss health history and any health concerns, and to review medications and immunizations. These visits are meant to help determine what health issues may become a concern in the future based on family history and risk factors, and help patients work to prevent issues and stay healthy for as long as possible.
What does a doctor do to review health history?
A: The doctor reviews health history and current health by measuring blood pressure, height and weight, testing vision and cognitive function, assessing depression risk, level of safety and evaluating medications.
Can you call for an appointment with Medicare?
If you’re of Medicare age, don’t hesitate to call for your appointment, which can be conducted in-person. Similarly, if you have parents or loved ones on Medicare, it is important to encourage them to schedule their appointment.
How often is a wellness visit covered by Medicare?
Your Annual Wellness Visit is covered under Medicare Part B, under two conditions: You only complete this visit once every 12 months. Your doctor or healthcare provider sticks to the checklist above. As long as both of these things are true, you won’t pay anything and your Medicare Part B deductible doesn’t apply.
What is covered visit?
These covered visits are designed to help you develop or update a personalized prevention plan which can help prevent disease and disability. During your visit, your doctor will assess your current health and risk factors.
Do you have to pay coinsurance for annual wellness visit?
However, you may have to pay coinsurance or the Medicare Part B deductible if your doctor or provider performs services outside of what is covered under the Annual Wellness Visit and those services aren’t a part of preventive and screening services. Here’s what isn’t covered as part of your AWV:
What happens if you blow off your doctor?
If they blow you off – or neglect to give your message to the physician, say, about side effects of a new medication – your health could be at risk. Even if you like your doctor, a bad office staff could signal it's time to look elsewhere. You don't feel comfortable with your doctor.
What is the role of primary care physician?
Your primary care physician should be the quarterback of your health care team, managing each step of the medical process. That means keeping track of specialists' reports and instructions and talking with you about their recommendations. If he or she is slacking, an important piece of your care could slip through the cracks.
How do you know if you should fire your doctor?
Here are 12 signs it's time to fire your doctor. You and your doctor don't mesh. You and your doctor don't need to see eye to eye on everything, but it's helpful if you work well together. If you want a partnership, for example, a doctor who spouts commands is not the best fit; if you value a warm bedside manner, consider ditching a formal, ...
Can you share your doctor's information?
You don't feel comfortable with your doctor. Doctors need to know intimate details you may not even share with friends or family members. If you're unable to disclose such facts, you and your doctor may not be the right match.
Who is the patient advocate for the Alliance of Professional Health Advocates?
Your doctor's unreachable. A good doctor is available for follow-up questions and concerns. Patient advocate Trisha Torrey , founder of the Alliance of Professional Health advocates and author of "You Bet Your Life!
Is it bad to stay with a doctor?
Staying with a doctor you're not happy with is as harmful as staying in a relationship you know is bad because it's easier than making a change. But parting ways may be the healthiest move. Changing doctors can be a challenging process.
What do doctors do?
Doctors are trained in how the body works, the ways in which diseases work, and pharmacology (and ethics and a few other things) so they might not be able to answer questions about appointments, or insurance, or other things like that but if you're concerned ask anyway .
Is the human body a machine?
The human body - yes, even YOUR body - is a machine, and you go to him if you are having a problem with that machine. Would it be appropriate if you brought your car into a mechanic, and he did not even want to know why you were there, he just said, without even checking your car, "I think your piston rings are worn.
Is it offensive to ask personal questions?
Personal questions are less offensive if you know why we're asking. However, unfortunately, sometimes we falsely assume the reason for the question is obvious. Sometimes we simply forget. The problem is that doctors don't find these questions personal, sensitive or embarassing at all.
What happened to a 70 year old woman who fell on her face?
70 yo female tripped and fell 2 days ago. She came it with hip pain but reports after the fall her nose was bleeding - she had landed on her nose. About a year prior her dentist had messes up an infraorbital nerve block and caused some swelling in that region but that all was resolved. This old lady is now convinced her nosebleed after falling on her face is related to an "infection" from the dental issue a year ago. After multiple back-and-forth on the etiology of the nosebleed, she became the first patient I raised my voice and put down an authoritative "no, you are wrong, just stop it".
Why did a man inyected kitchen oil into his own cheeks?
A male patient inyected kitchen oil into his own cheeks because he saw a plastic surgery tv show where a surgeon inyected something similar to a model, then he was amazed that the bumps of the oil didnt go away and were turning red and painful af.