Category: Medicare Supplement

Do I Need To Do Anything To Enroll in Medicare?

Do I Need To Do Anything To Enroll in Medicare?

This is a question I get quite frequently at my offices in Sidney and Vandalia, Ohio. When it comes to Medicare, soon-to-be retirees know that they’ve been paying for it since they started working through Social Security. However, they often don’t know how they collect the benefit they’ve worked so hard to earn.

 

Does it just happen automatically? Or do soon-to-be retirees like you need to do something?

 

Well, that depends on one thing…

 

Are You Already Receiving Your Social Security Benefit?

If you decided to claim your Social Security benefit before 65, then you don’t have to sign up. Your Medicare card will arrive in the mail around your 65th birthday and you will be automatically signed up for Medicare Parts A and B.

 

If Not, Make Sure You Sign Up!

But if you are not receiving your Social Security benefit, you need to sign up during your open enrollment period, the seven-month period surrounding your 65th birthday. You will be doing yourself a big favor by signing up on time because there are many late enrollment fees. For example, the Part B penalty is 10% for every year you are late. Unfortunately, this penalty will continue for the rest of your life.

 

So take the time amidst retirement planning and birthday celebrations to sign up. You can sign up online at ssa.gov or you can call or stop by your local Social Security office. If you live near Sidney, that office is in Piqua, 227 Looney Rd.  If you live somewhere else in Ohio, find your closest location here:  Ohio Social Security office locations.

 

Everyone’s Got a Lot More to Consider!

But whether or not you have to sign up for Medicare, you are far from done. It is a big misconception (see our blog on this here) to think that original Medicare alone is enough to cover all your health care expenses. There are two things you should do. Firstly, it is almost always a good idea to pick up a stand-alone prescription drug plan through Part D of Medicare. Otherwise, you will have no coverage for your medications. In addition, I also recommend finding some way to supplement Medicare with additional insurance. You can get a Medicare Supplement plan, or—for those who are more cost-conscious—a low to no cost Advantage plan.

 

As you can see, even though you may not have to do anything to sign up for Medicare, signing up is just the first step before you have your health insurance in order. I recommend seeing an advisor to help guide you through this complex process.

 

Need help navigating Medicare? Want personal help to find a plan that is right for your needs and pocketbook? Call Seniormark at 937-492-8800 for a free consultation!

 

You Can Save Hundreds on Your Supplement Without Changing Your Benefits!

You Can Save Hundreds on Your Supplement Without Changing Your Benefits!

And when I say, “without changing your benefit,” I really mean it. This isn’t about covering decreased benefits or numerous hassles under a cloak of a lower premium. You can get on an identical plan to the one you have now and still save hundreds.

 

How is this possible? Allow me to explain.

 

Standardization: Easier Comparison = Easier Savings

Before standardization, shopping Medicare Supplements was a lot more difficult. It was hard to see which one of any two plans was the better value because insurance companies provided diverse benefits at diverse premiums.

 

Then, in 1992, Medicare standardized 11 lettered plans (A-N). Now, although there are diverse benefits from plan to plan (each lettered plan is unique), the plans remain the same from company to company. In other words, a Plan F is a Plan F no matter who you shop with, no matter which company you purchase from. Similar to the apples and oranges saying, you are comparing all the fruits to their respective fruits.

 

But here’s where you can save money: even though the plans are standardized from company to company, the premiums are not. A Plan F at one company, although identical in coverage, can be over a hundred dollars more at another. To demonstrate this, I compared all the available plans for each of the three most popular Medicare Supplement plans at our agency. The difference between the most expensive company plan and the least expensive is

  • $196.43 for a Plan F
  • $212.71 for a Plan G
  • $141.65 for a Plan N

Note: These numbers are based off a woman living in Sidney, OH who does not use tobacco.

 

Imagine if you could shop like this for other items. It would be like walking onto a car dealership’s lot and, instead of being confronted with an onslaught of varying features; you just had a line up of identical cars, some of them thousands more than others. No discrepancies in gas mileage. No debating the value of seat warmers versus a little extra trunk space. Just easy comparison, making it easy to get the best deal.

 

What If I’ve Never Heard of Them? What About the Company Ratings?

This is a common fear when it comes to shopping Medicare Supplements. The Plan may be the same, but the company is different. How do you know when the company you plan to work with is qualified, trustworthy, and stable?

 

Firstly, I would say not to let the fact that you don’t recognize a company deter you. There are many qualified, trustworthy, and stable companies that are not as well known. It’s good to ask a professional or do a little research yourself, but this should not be a reason to write a company off. In our practice, we screen the companies we represent before we recommend their plans to our clients. This way we know for certain all of our clients will have a good experience in claims processing and general customer service.

 

On the other hand, when it comes to the company ratings, you should pay a little more attention. This evaluation is based on the company’s financial stability, so it is easy to see the importance. You want your insurance company to have the money to pay your claims when they are needed. However, I wouldn’t let this carry too much weight. Obviously going with a D or F rated company isn’t a good idea, but I’ve found that you can count on any company above a B+ rating. They are well established enough to deliver the promised benefits.

 

I thought I could only change during Annual Enrollment?

While this is a very common misconception, it is not true.  You can change your supplement any day of the year!  (The only items that can only be changed during Annual Enrollment are Prescription Drug Plans and Medicare Advantage plans.)  And, as an added bonus, any deductible you have already paid in a calendar year, travels with you to the next supplement if you switch.  It’s the gift that keeps on giving!

 

Concluding Thoughts

Overall, I’ve found that switching plans about every 4-5 years is beneficial. On a regular basis at Seniormark, we see people save $30-50 per month just by switching.  If you take the few minutes it takes to compare Supplement rates, you may be surprise by how much you can save!

 

Interested in Finding Out How Much You Can Save?

Use our Quoting Tool to compare Medicare Supplement rates in your area. It’s absolutely free, and we don’t ask for any personal information, so you can be sure you won’t get any annoying junk emails.   If you find a price you like, or would like us to run more quotes for you, give us a call at 937-492-8800. We would love to save you money!

Half-Truths And Medicare Advantage Commercials

Half-Truths And Medicare Advantage Commercials

Weekly, we receive phone calls from people asking about something they saw on their tv and wondering if their insurance covers whatever they are seeing advertised.  This is more prevalant in the fall of each year, when Medicare Advantage companies ramp up their advertising during annual enrollment.  As an office, we offer both Medicare Supplements and Medicare Advantage plans to our clients.  We try to help people figure out what is best for their situation, budget, and lifestyle.  Our end goal is to help people avoid costly Medicare mistakes.  Sometimes, what is portrayed on tv is only half of the story, as you will see below.  This is an article recently published online at Forbes magazine, but echoes our thoughts so we wanted to share.  Source:  https://www.forbes.com/sites/dianeomdahl/2020/02/11/half-truths-and-medicare-advantage-commercials/#3d223f8c42ff

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If you watched any television in the last several months, you probably saw a slew of commercials for Medicare Advantage plans. One that pops up frequently features a former professional football player who once did a commercial wearing pantyhose. His commercials must be working so well that another former NFL star has also started promoting Advantage plans.

All the commercials, no matter the narrator, talk about the Medicare benefits you deserve, that you should be getting. They list those benefits in a very big and bold font, and encourage you to call the free number and sign up today.

According to Federal law, whatever we see or hear in an advertisement must be truthful and not misleading. I spent some time the last few days closely watching several different commercials. Everything that was said about the cost and benefits was true, to the extent that it was said. But there was much left unsaid and that’s the important information you need to make a smart decision.

First, the benefits

Get the benefits you deserve, including rides to medical appointments, private home aides, nurse and doctor visits by telephone.

Medicare describes these as benefits for daily maintenance and doesn’t cover them. However, because of policy changes, Medicare Advantage plans can now provide them. The plan, not Medicare, must cover the costs. This is a new program and not that many plans offer these benefits.

Based on my preliminary plan research, here are some important points not mentioned in the commercials:

  • These benefits appear to be more common in health maintenance organization (HMO) plans. Except for an emergency, the benefits are only available through a network of selected providers, which can limit the individual’s choice.
  • The plan likely will require prior approval or authorization. Before receiving care, the plan must review and approve the physician’s order.
  • There are limits on these benefits. For example, two meals a day for five days after hospitalization with a limit of four hospitalizations, and a private home aide four hours a day for no more than 31 days in a year.
  • And, most important, the plans we researched require members to select only one benefit per calendar year.

In some of the commercials, there were two more benefits that require clarification.

Free preventive screenings

Medicare covers a long list of preventive and screening services. You don’t need to enroll in one of these plans to get preventive services.

A 75% discount on prescription medications in the Coverage Gap

You see this and think, “Wow! A big discount on drugs! Where do I sign?” However, as with preventive services, this benefit is not unique to Medicare Advantage plans.

The Coverage Gap is more commonly known as the donut hole. In 2020, the donut hole closed. Beneficiaries are responsible for 25% of the cost of medications in this payment stage. Or, in other words, they get a 75% discount. Anyone with Part D prescription drug coverage will qualify automatically for this discount when their total drug costs hit $4,080. This benefit comes with the plans in the commercials, some other Advantage plan with drug coverage, or a stand-alone Part D drug plan.

Second, the costs

All these benefits may be available at no additional cost to you.

The commercials focus on zero-premium plans and benefits available for no added cost. However, at the moment the narrator says this, a line of small type appears on the bottom of the screen. It’s there for only four seconds, while the list of benefits continues. The small type reads, “Plan premiums, copayments, and coinsurance can apply.”

Not all Medicare Advantage plans are zero-premium. And for those that are, it’s important to know that zero-premium does not mean zero costs. There are out-of-pocket costs for most services. Plan members will pay their share of costs until they reach the plan’s out-of-pocket maximum limit. That’s how much a person could write in checks when something happens, like a cancer diagnosis or a major car crash. In 2019, the average limit was $5,059.

Third, the call

The narrators talk about the help you will get when you call the toll-free number. But, once again, the small print is revealing.

Dial the number and you’ll be transferred to a licensed insurance agent. One commercial noted that the agent may or may not offer Medicare Advantage plans. Another said the person you talk with may not offer plans in your area.

A question

The facts, as presented, are true but then the question becomes, “Are these commercials misleading?” According to the Macmillan dictionary, misleading means something that is intended or likely to make someone believe something that is incorrect or not true.

In fall 2019, the American Medical Association (AMA) passed a resolution.

“Whereas, Medicare Advantage plans are heavily marketed to seniors by insurance companies, with less than ideal transparency in advertising; … and

“Whereas, Presentations by insurance company officials to seniors can overemphasize the value of different options and can create confusion; therefore be it

“RESOLVED, That our American Medical Association encourage AARP, insurance companies and other vested parties to develop simplified tools and guidelines for comparing and contrasting Medicare Advantage plans.”

The AMA identified the need for tools to help individuals go beyond the TV commercials and get the information they need to make a smart decision.

The Centers for Medicare and Medicaid Services redid its tool for comparing plans. The Medicare Plan Finder shows the premium in a large font. Then, you can check out the plan’s out-of-pocket costs for medical benefits on the details page. Beyond that, as pointed out in a past post, most of the essential information has disappeared. The Plan Finder no longer has links to networks, a list of preferred pharmacies, and most important, complete information about coverage rules like prior authorization.

The best way to get all the facts is to check the plan’s Evidence of Coverage. This document describes in detail the plan’s benefits, how much you will pay, and how the plan works, including authorization rules, limits, networks, and more. To find it, go to the plan’s website, look for the Evidence of Coverage link. This may take some searching but you’ll get the information you need on available benefits, limits, approval, and more.

Keep in mind that these Medicare Advantage plans are offered by for-profit entities, corporations not unlike your cable provider, department store, or neighborhood used car lot. The purpose of the TV commercials is to get you to act, to call the number on your screen, to make a purchase. First, do your research. Be an informed shopper. Go beyond the commercials to the whole truth. Your Medicare coverage is too important.

If you would like help muddling through all of this confusing information, please give our office a call.  We are happy to help you sort through the complicated Medicare alphabet and choices!  Call our office at 937-492-8800 and schedule a free, no obligation consultation.

Source:  Diane Omdahl for Forbes Magazine

Know Your Rights! (Your Medicare Supplement Guaranteed Issue Rights)

Know Your Rights! (Your Medicare Supplement Guaranteed Issue Rights)

Everyone knows that they have the right to remain silent and the right to an attorney, but few retirees know their rights to a Medicare Supplement policy. For this reason, many people believe that if they missed their Open Enrollment Period and have health problems, they will be unable to get insurance.

 

This is not so. Thanks to guarantee issue periods, retirees like you have rights. During guaranteed issue periods, insurance companies are obligated to offer you a policy at the normal rate and cover your pre-existing conditions. All of this with no pesky medical questioning whatsoever!

 

The following circumstances spur a guaranteed issue period. In other words, you have the right to a Medicare Supplement policy if:

  • Your Medicare Advantage Plan is going out of service or you are moving out of the service area.
  • Your employer health insurance is ending.
  • You’ve been enrolled in an Advantage Plan for less than one year and want to switch back to a Medicare Supplement plan.
  • You lose your coverage without fault (i.e. your insurance company goes bankrupt).
  • Your insurance company misled you or doesn’t follow the rules.

(For a more comprehensive chart of potential situations, click here to visit Medicare.gov).

 

From the day any one of these events happen to you, you have 63 days of guaranteed issue to get into a new Medicare Supplement Plan.

 

Do not take this newfound information lightly, and keep any proofs of the previously mentioned events at your disposal such as:

  • Claim denials
  • Letters from employers
  • Official notifications

 

Insurance companies will ask for these items to prove your right to a policy. Then they will have no choice but to insure you. This is why it is so important to educate yourself on your rights. It allows you to take advantage of what has been made available to you.

 

If you want to find out more about guaranteed issue rights or need help shopping a Medicare Supplement Plan for your needs, Call Seniormark at 937-492-8800 for a free consultation from licensed experts.

You Can Save Hundreds on Your Supplement Without Changing Your Benefits!

You Can Save Hundreds on Your Supplement Without Changing Your Benefits!

And when I say, “without changing your benefit,” I really mean it. This isn’t about covering decreased benefits or numerous hassles under a cloak of a lower premium. You can get on an identical plan to the one you have now and still save hundreds.

 

How is this possible? Allow me to explain.

 

Standardization: Easier Comparison= Easier Savings

Before standardization, shopping Medicare Supplements was a lot more difficult. It was hard to see which one of any two plans was the better value because insurance companies provided diverse benefits at diverse premiums.

 

Then, in 1992, Medicare standardized 11 lettered plans (A-N). Now, although there are diverse benefits from plan to plan (each lettered plan is unique), the plans remain the same from company to company. In other words, a Plan F is a Plan F no matter who you shop with, no matter which company you purchase from. Similar to the apples and oranges saying, you are comparing all the fruits to their respective fruits.

 

But here’s where you can save money: even though the plans are standardized from company to company, the premiums are not. A Plan F at one company, although identical in coverage, can be over a hundred dollars more at another. To demonstrate this, I compared all the available plans for each of the three most popular Medicare Supplement plans at our agency. The monthly difference between the most expensive company plan and the least expensive is

  • $196.43 for a Plan F
  • $212.71 for a Plan G
  • $141.65 for a Plan N

Note: These numbers are based off a woman living in Sidney, OH who does not use tobacco.

 

Imagine if you could shop like this for other items. It would be like walking onto a car dealership’s lot and, instead of being confronted with an onslaught of varying features; you just had a line up of identical cars, some of them thousands more than others. No discrepancies in gas mileage. No debating the value of seat warmers versus a little extra trunk space. Just easy comparison, making it easy to get the best deal.

 

What If I’ve Never Heard of Them? What About the Company Ratings?

This is a common fear when it comes to shopping Medicare Supplements. The Plan may be the same, but the company is different. How do you know when the company you plan to work with is qualified, trustworthy, and stable?

 

Firstly, I would say not to let the fact that you don’t recognize a company deter you. There are many qualified, trustworthy, and stable companies that are not as well known. It’s good to ask a professional or do a little research yourself, but this should not be a reason to write a company off. In our practice, we screen the companies we represent before we recommend their plans to our clients. This way we know for certain all of our clients will have a good experience in claims processing and general customer service.

 

On the other hand, when it comes to the company ratings, you should pay a little more attention. This evaluation is based on the company’s financial stability, so it is easy to see the importance. You want your insurance company to have the money to pay your claims when they are needed. However, I wouldn’t let this carry too much weight. Obviously going with a D or F rated company isn’t a good idea, but I’ve found that you can count on any company above a B+ rating. They are well established enough to deliver the promised benefits.

 

Concluding Thoughts

Overall, I’ve found that switching plans about every 4-5 years is beneficial. On a regular basis at Seniormark, we see people save $30-50 per month just by switching.  If you take the few minutes it takes to compare Supplement rates, you may be surprise by how much you can save!

 

Interested in Finding Out How Much You Can Save?

Use our Quoting Tool to compare Medicare Supplement rates in your area. It’s absolutely free, and we don’t ask for any personal information, so you can be sure you won’t get any annoying junk emails. If you have any questions, give us a call at 937-492-8800. We love to hear from you!

 

Will Poor Health Prevent Me From Switching to a New Medicare Supplement?

Will Poor Health Prevent Me From Switching to a New Medicare Supplement?

There are lots of reasons you might be dissatisfied with your current health insurance plan. Perhaps you’ve had a Medicare Supplement for a few years and the premiums have been creeping up into the stratosphere. Or—if you are in an Advantage Plan—maybe you are sick and tired of an ever-changing benefits package or pesky out-of-pocket expenses like copays or coinsurance.

 

Regardless of the reason, you realize it’s time to switch.

 

If you’re in good health, it’s simple. You make like a Nike commercial and just do it.

 

But what if you battle blood pressure or cholesterol? What if you have diabetes? What if you have a personal history of cancer or heart trouble on your records? Or even an open heart surgery?

 

Well, in this case, I’d like to be the bearer of good news. It may not be as easy for you, but there’s still a really good chance you can switch.

 

As a quick side note, if you are in a Medicare Supplement Open Enrollment Period or a Guaranteed Issue Period, you are completely in the clear. No insurance company can deny you coverage.

 

But if you aren’t in one of those periods and you just want a better premium or benefits package, you can also switch.

 

Why? You’ll be happy to know…

 

Medicare Supplement Underwriting is Not as Selective as You Might Think.

Prior to Obamacare, health insurance for people under the age of 65 was much stricter. People with more serious health issues were often immediately turned away. The approach to questioning might be something like this:

  • Have you had cancer in the last 10 years?
  • Do you have a history of heart problems?
  • Do you have diabetes and take insulin?

 

But the Medicare Supplement underwriting process is significantly less harsh. Since Medicare is footing part of the bill for them, they aren’t taking on near as much risk. And because they aren’t taking on as much risk, they can be a bit more lax. A Supplement company’s approach to those same questions might look something like this:

  • Have you had cancer in the last 10 years? Well, as long as it’s not in the past two, we can make this work.
  • Do you have a history of heart problems? Well, have you been stable over the past two years?
  • Do you have diabetes and take insulin? Let’s take a closer look.

 

I’m not saying there aren’t some companies who will still deny you.  You’re always going to have that. But I would like to widen your perspective a little bit. Just because Anthem denies you coverage doesn’t mean another one will.

 

There Are Many, Many Medicare Supplement Companies Out There!

In fact, according to page 27 of the Ohio Department of Insurance’s Medicare Supplement guide, there are 43+ Medicare Supplement companies just in Ohio. You have to think, these companies have diverse ways of evaluating the health of their potential policyholders. Chances are you will find one that will take a chance on you!

 

At our practices in Sidney and Vandalia, Ohio, we’ve had a lot of luck with the smaller companies who are trying to be more competitive. They are often more likely to take a look at your individual situation and seek clarification rather than put your application through the shredder at the first mention of a chronic disease. Then, after a close analysis of your situation, they make their final decision.

 

So don’t stay in a plan you hate.

So if you premium is too high, if the copays are frustrating, or if you just plain don’t like it, shop around! Just don’t cancel your current policy until you have another one in place.

 

If you want to shop supplement rates in your area without inputting any personal information, you can compare Medicare Supplement rates here.

 

Do You Want A Licensed Medicare Expert to Help You Shop A Supplement?

Seniormark is always here to help. We represent dozens of diverse, competitive companies in the area. Call us at 937-492-8800 and we will help you shop a plan for your unique needs and budget!

 

What Is My Full Retirement Age? (And Why Does It Matter to My Social Security Check)

What Is My Full Retirement Age?

(And Why Does It Matter to My Social Security Check?)

 

Laws, guidelines, tax codes, regulation, health care—pretty much everything involved with the government—is constantly evolving. And the full retirement age is no different.

 

Life expectancy has been rising. So that means that retirees are drawing on their Social Security for much longer than they used to. Couple this with shockingly high spending for other programs, and you’ve got yourself a little budget problem on your hands. Social Security has to remain solvent somehow!

 

This is why the full retirement age is creeping up. Ever since Ronald Reagan signed the 1983 Social Security Act amendments, the government has been inching its way to a full retirement age of 67, like peeling off a Band-Aid nice and slow.

 

But What’s My Full Retirement Age?

Your full retirement age depends on when you were born. The younger you are, the closer your full retirement age will be to 67. But if you’re retiring soon, your full retirement age is likely 66. Check out this chart from SSA.gov to find out for sure:

 

Why Does it Matter to My Social Security Check?

Your full retirement age is when you qualify for full Social Security benefits (not to be confused with your Medicare eligibility)[LINK TO WARNING: CONFUSING MEDICARE AND SOCIAL SECURITY ELIGIBILITY]. You can apply as early as age 62, but you will receive reduced benefits, only 75% of what you would’ve received had you waited until your full retirement age.

 

But there’s another side to this coin. You can also delay your benefits, leading to bigger benefits. For every year you delay beyond your full retirement age, you get an extra 8% tacked onto your Social Security check every month.

 

These options leave a lot up to you, and I wouldn’t take them lightly. Deciding when to start your Social Security takes a lot more than just understanding your full retirement age; it calls for a carefully planned strategy, another step along the way to a successful retirement.

 

Looking for some strategies to help you get the most out of Social Security? Click here.

3 Reasons to Start Medicare Planning NOW!

3 Reasons to Start Medicare Planning NOW!

Every last one of us is pretty much the same in this respect: we don’t take now for an answer. When the task is daunting, overwhelming, or complex, we always manage to escape doing it now by putting it off for tomorrow. We’re like a gaggle of Houdinis. Just when you think time constraints have us trapped, we magically free ourselves into an enchanted tomorrow land of channel flipping, Internet surfing, and power naps.

 

But some things are just too important to put off. Even for one more day, one more catnap, one more rerun of I Love Lucy. Medicare planning is one of these things. Not convinced? Here are three reasons why you should start the Medicare planning process now:

 

Reason #1 Mistakes Happen

Glitches. Mistakes. Goofs. If there is a way something can go wrong, Lord knows it probably will. Just like a customer service call can turn into several hours of God-awful hold music, a small slip-up in the Medicare process can turn a five minute solution into a month long ordeal.

 

This is because you are just one of the 10,000 people turning 65 everyday. Medicare has a lot to handle; little things can slip through the cracks. Even if you are fortunate enough to not make any mistakes, you still have to plan in advance for theirs.

 

Reason #2 You’ve Got a Ton of Decisions to Make

Do you need a med sup? Or should you go the Medicare Advantage route? Should you sign up now? Or wait until you are done working? When are the deadlines? What are the penalties? What is a donut hole and how do I navigate it?

 

Take these questions along with deciding between 24 drug plans, 11 supplement plans and a legion of Medicare Advantage options, and you’ve got yourself a to-do list you can’t leave until the last minute.

 

Reason #3 Your Hairdresser Is Not a Retirement Advisor

Getting advice from your family or friends over coffee at church or in-between hands of euchre won’t cut it.  And no, your all-knowing hairdresser won’t do either.   Although your loved ones and acquaintances may have your best interests at heart, they simply do not know the ins and outs of Medicare. What was right for them may not be right for you. And what they overheard at the grocery store is (gasp) probably not watertight advice.

 

This is why seeing an expert is a great (dare I say the only) way to make sure you are on the right track, ensuring you a smooth, penalty-free transition to retirement. But you may find it difficult to schedule an appointment if you wait last minute. We will still help you out, of course, but it will save you a lot of stress to plan an appointment weeks or months ahead.

 

So—when should you start the Medicare Planning process? If you are within 6 months of turning 65, the answer is…you guessed it…Now!

 

Well……

Maybe not now, right?

 

Not sure what to do next? Give us a call at 937-492-8800 for a free consultation!

4 Lightweight Tips to Prevent Medicare Fraud

4 Lightweight Tips to Prevent Medicare Fraud

 

An ounce of prevention is worth a pound of cure. Very few people use this saying anymore, but the truth of it is still relevant—almost shockingly so. Especially when it comes to Medicare fraud.

 

No one wants to be a victim. No one wants to deal with some con down in Florida, racking up charges using their Medicare number. And no one wants to feel taken advantage of.

 

That’s why it’s much better to take the simple steps now. So let’s get started.

 

  1. Protect your Medicare Number!

First things go first. It’s the oldest tip in the book, but it works. This number is unique to you.  So protecting those 9 digits is doubly important: It’s your identity.

 

One way to protect your number is to avoid carrying the actual card unless you have to. And—this almost goes without saying—don’t share it with anyone except your doctor, health care provider, and your insurance agent, who will need it to write a policy.

 

  1. Take a Lesson From Sherlock Holmes.

This sounds like a pound-sized piece of advice, but it’s really not too heavy once you get into the habit. Be like Mr. Holmes and notice the small stuff. Check your Medicare Summary Notice for anything suspicious (i.e. billing to Medicare for care or services you didn’t receive). Check your pills before you leave the pharmacy to make sure everything is correct. Did you get your full prescription?

 

It pays off to notice things that no one else does. It’s elementary, my dear…umm…Medicare beneficiary?

 

  1. Strive to Understand for Yourself.

This is another tip that sounds heavier than it really is. So allow to me translate. For all intents and purposes, this means to ask questions. And I mean a lot of questions.

 

When you don’t understand your bill or your plan or your Medicare options, just ask. Ask your doctor’s office, or ask at your insurance agent’s office.  Shift the weight on the expert to help you understand. If he gives you a boulder-sized answer, give him another boulder-sized question. And don’t let down until you get a manageable answer. This might sound stubborn, but you have a right to know what you want about your health care. It’s the expert’s job to give you an understandable (yet accurate) answer.

 

Because knowing how Medicare works, your plan works, and why you were taken care of the way you were are excellent starting points for noticing and preventing fraud.

 

  1. Don’t go to the mousetrap for the free cheese.

Only a mousetrap has free cheese. This is the truth with all the sales and advertising junk pared away.

 

It’s not that I don’t understand the allure. Someone comes to your door or calls you to offers you something for free. Do you believe it? FREE! All you have to do is give them your Medicare number and then POOF…all your money saving dreams can come true.

 

But don’t fall for it. Don’t go for the cheese. This is a surefire way to get snapped into the metal jaws of Medicare fraud.

 

Stopping Medicare Fraud Ounce by Ounce

In closing, Medicare fraud is a crushing problem. The Medicare Fraud Strike Force is constantly hunting down the bad guys, trying to recover as many funds as they can. But it hardly puts a dent in the 60 billion dollar a year problem, according to AARP. This is why the government needs you to take the necessary measures of prevention. It’s a big problem, but I am confident that if enough people decide to get smart and do these small  “ounce-sized” things now, we can prevent another round of crushing Medicare fraud later.

 

Think you’ve been a victim of fraud? Want to make up to $1000? Then check out this post! 

 

Still have questions?  Call our office at 937-492-8800.  We can help!

CONSUMER ALERT: Seniors Should Beware of DNA Testing Scam

COLUMBUS – Ahead of World Elder Abuse Awareness Day this Saturday, June 15, the Ohio Department of Insurance and the Ohio Department of Aging are warning Ohioans of a new scam targeting seniors. Ohio consumers should be cautious of genetic testing firms visiting senior communities or making unsolicited phone calls and mailings related to DNA screenings.

“Scam artists are always looking for new ways to steal money or personal information,” said Governor Mike DeWine. “We want people to be careful and to know the signs of a possible scam.”

 

In the scheme, which has been reported in Ohio and other states, firms reportedly collect consumers’ personal information under the pretense of DNA testing to screen them for cancer, Alzheimer’s, or other life-threatening diseases. Victims are told that Medicare will cover the cost of their testing. However, Medicare provides limited coverage for DNA testing (which is why consumers should consult their health care providers). As part of the scam, consumers often are asked for their Medicare card number and Social Security number.

 

“We want Ohioans to be aware and cautious as they consider DNA screening services,” said Ohio Department of Insurance Director Jillian Froment. “Consumers should never share their personal information, including Social Security number or Medicare card number, with anyone who reaches out unexpectedly. If you think you may be a victim of fraud or if you suspect potentially fraudulent activity, please contact us.”

 

“Scammers and shady businesses target older adults to steal money, get personal information, or in this case, improperly access individuals’ insurance benefits,” added Ohio Department of Aging Director Ursel McElroy. “As older adults get wiser to common scams, scammers are doing more to try to win their trust. Guard your Medicare or other insurance card like you would a credit card. To a scammer, it is just as valuable.”

 

To protect yourself, be alert if anyone conducting DNA cheek swabs requests that you agree to be billed for services in the event Medicare does not pay. These types of “testers” may be committing Medicare fraud because they are attempting to bill Medicare for a procedure that has not been ordered by a health care provider.

What Should Medicare Recipients Know About Genetic Testing?
  • In order for the testing to be covered by Medicare, it must be medically necessary.
  • Consumers should always confirm that their test has been ordered by their doctor, that it’s covered by their plan, and that it’s medically necessary.
  • If you are interested in DNA screening, talk to your doctor and determine if it is right for you.

How Can I Protect Myself from This Type of Scam?

  • If you or a loved one is approached by someone claiming to offer genetic testing, do not give your personal information (like your Medicare or Social Security information) to them.
  • Theft of Medicare card numbers may be used to commit identity theft or fraud.
  • Instead of receiving a DNA screening unsolicited from a firm not affiliated with your health care provider, talk to your doctor first and determine if the test is necessary.
  • Some consumers have reported receiving DNA testing kits in the mail without requesting them. Consumers should not use these kits but should instead talk to their doctor first.

If you suspect wrongdoing or if you believe you have been victimized, call the Ohio Department of Insurance’s Fraud and Enforcement Hotline at 800-686-1527 or the Ohio Senior Health Insurance Information Program at 800-686-1578.

Older Ohioans and their loved ones can learn more about scams and other forms of elder abuse and exploitation, along with ways to prevent and report them, on the Ohio Department of Aging’s website (www.aging.ohio.gov/elderabuse).

 

Source:  Ohio Department of Insurance