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Robin Cruson
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Fight health care fraud: guard your Medicare number!

The next Medicare Open Enrollment season (October 15 to December 7) is almost here, which means fraudsters and identity thieves will increase their efforts to get and abuse Medicare numbers from people like you.

Fortunately, there are many measures you can take to fight health care fraud:

  • Guard your Medicare number. Protect it the same way you do for your credit card numbers. Medicare will never contact you for your Medicare number or other personal information. Don’t share your Medicare number or other personal information with anyone who contacts you by phone, email or by approaching you in person, unless you’ve given them permission in advance.
  • Don’t ever let anyone borrow or pay to use your Medicare number.
  • If you’re looking to enroll in a Medicare plan, be suspicious of anyone who pressures you to act now for the best deal. There are no “early bird discounts” or “limited time offers”. Any offer that sounds too good to be true probably is.
  • Be skeptical of free gifts and free medical services. A common ploy of identity thieves is to say they can send you your free gift right away—they just need your Medicare number to confirm. Decline politely but firmly. Remember, it’s not rude to be shrewd!
  • Do your part to protect your friends and neighbors: remind them to guard their Medicare numbers, too.
  • Check your Medicare Summary Notice (MSN) to make sure you and Medicare are only being charged for services you actually had. Instead of waiting for the MSN, which comes in the mail every 3 months, you can access your Original Medicare claims at MyMedicare.gov. You’ll usually be able to see a claim within 24 hours after Medicare processes it.

You can report suspected fraud by calling 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048. To learn more about how to protect yourself from health care fraud, visit Medicare.gov or contact your local Senior Medicare Patrol (SMP). To find the SMP in your state, go to the SMP Locator at Smpresource.org.

 

 

(972) 896-3851

robin@crusoninsurance.com

www.crusoninsurance.com

 

Independent Broker with your best interests in mind.  I work for you and not one specific insurance carrier.  I will find a plan that best suits your needs both medically and financially so you can make an informed decision.  Contact me TODAY!  I CAN help!

Robin Cruson
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MJ, 79, has a bad fall, breaks her leg and spends three days in the hospital for her injury.  Although she received the same care as an inpatient, she wasn't classified as one.  The hospital coded her as "Under Observation" based on guidelines set by Medicare, which means she is not eligible for rehabilitation coverage.

The term and practice "Under Observation" has been around a long time, and prior to Medicare changing the guidelines a patient would be covered and should not incur any out-of-pocket expenses.  Now, that is not the case, it could literally cost them thousands of dollars, depending on their medical situation.  If your doctor says something to the effect of "We're going to keep you here 'x' amount of time for observation...," simply tell them that Medicare will not cover those charges and they either need to admit you into the hospital, or you need to go to another medical facility that will.

Little did MJ know, Medicare would not cover the $28,350 claim from the nursing home for her rehabilitation after the fall. 

 

What Can Be Done To Help Cover the Costs
Invest in a Short Term Recovery Care plan that can help pay for costly expenses due to injury or illness
  • Covered Benefits include: Nursing Facility Care, Assisted Living Facility Care, Home Health Care, Adult Day Care or Hospice Care.
  • Daily Benefit Options between $100-$300
  • Elimination Periods of 0, 15 or 30 days
  • Lifetime Maximum Benefit Period of 120, 240 or 360 days.
Applying What We Know
If a Medicare beneficiary undergoes rehab for 3 months and has enrolled in a $200 Daily Benefit for 120 days with a 0 Day Elimination Period, the Short Term Recovery Care plan would cover their claim up to $18,000. This benefit would be paid even if they are Medicare eligible for rehab coverage.

 

For more information about Short Term Recovery Care plans, or Medicare health plans, Final Expense plans, please contact Cruson Insurance Agency here, or call (972) 896-3851.  We CAN and WILL help you!

 

Real-Life Story of MJ:

 

 

 

(972) 896-3851

robin@crusoninsurance.com

www.crusoninsurance.com

 

Independent Broker with your best interests in mind.  I work for you and not one specific insurance carrier.  I will find a plan that best suits your needs both medically and financially so you can make an informed decision.  Contact me TODAY!  I CAN help!

Robin Cruson
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Posted by Medicare Made Clear

 

A 16% increase set the base Medicare Part B premium at $121.80 a month for 2016. That’s much less than the 52% hike that many feared. But most Medicare beneficiaries will pay the same amount in 2016 as they did in 2015–$104.90 a month. How can this be?

Hold Harmless Rule Holds 2016 Part B Premium Down for Most

The hold harmless rule states that the Part B premium increase in a given year can’t be more than the Social Security cost of living adjustment (COLA) adds to your check.

There is no Social Security COLA for 2016. This means that the Part B premium amount cannot go up at all for beneficiaries who are “held harmless.” Their monthly 2016 Part B premium will stay flat at $104.90. This applies to most Medicare beneficiaries who have their Part B premium deducted from their monthly Social Security checks.

2016 Part B Premium Increases for Some

By law, the premiums paid by Medicare beneficiaries must cover 25% of expected Part B costs for the year. Medicare costs are projected to go up in 2016. The hold harmless rule effectively shifts the cost increase to beneficiaries who are not protected by it. This includes you if:

  • You are not collecting Social Security benefits.
  • You enroll in Part B for the first time in 2016.
  • You pay an income-related monthly adjustment amount.
  • You are dual eligible and get both Medicare and Medicaid benefits. (Your state Medicaid program will bear the cost increase.)

The 2016 Part B premium is $121.80 a month for most people in the not-held-harmless group. It could be as high as $389.80 for those who pay an income-related monthly adjustment amount.

Federal Funds Help Bridge Gap

A federal budget agreement succeeded in keeping the 2016 Part B premium increase down to 16%. This is a relief for many who were facing the possibility of a much larger premium hike. But the budget agreement does not erase the fact that Medicare costs are expected to rise.

A transfer of federal funds will bridge the gap between the 16% premium increase and the actual amount needed to cover beneficiaries’ share of the projected Medicare Part B costs.

The funds will be repaid over time, starting with a $3.00 surcharge included in the 2016 premium increase for those not held harmless. The surcharge is expected to be added to the Part B premium for all beneficiaries starting in 2017.

Related Content

Medicare Part B Enrollment Forms and Resources at Your Fingertips

Part B Late Penalties Could Cost You Big Time

For more information, explore MedicareMadeClear.com or contact the Medicare helpline 24 hours a day, seven days a week at 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048.  Please contact Cruson Insurance Agency here, or call (972) 896-3851, to speak with a Licensed Insurance Broker to help you get the answers you need about Medicare.  Thank you!

 

 

(972) 896-3851

robin@crusoninsurance.com

www.crusoninsurance.com

 

Independent Broker with your best interests in mind.  I work for you and not one specific insurance carrier.  I will find a plan that best suits your needs both medically and financially so you can make an informed decision.  Contact me TODAY!  I CAN help!

Robin Cruson
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We hope that all of your health care experiences are positive. But if they’re not, we want filing a complaint to be as easy as possible. That’s why we offer you a variety of tools to express your concerns. One of those tools is the ability to file a complaint (sometimes called a “grievance”).

Is your concern a complaint or an appeal?

A complaint is different than an appeal. A complaint is about the way your Medicare health plan, Medicare drug plan, or health provider is giving care. Examples of complaints are problems with:

Things to know before you file a complaint

If you have a complaint with your plan, each plan has specific rules you’ll need to know and follow when filing a complaint. If, after filing a complaint, your plan doesn’t address the issue, call 1-800-MEDICARE for help. For any Medicare-related complaint, you can call your State Health Insurance Assistance Program (SHIP) for free personalized help.

If you’ve contacted 1-800-MEDICARE about a Medicare-related inquiry or complaint but still need help, ask the 1-800-MEDICARE representative to send your inquiry or complaint to the Medicare Ombudsman’s Office. The Medicare Ombudsman’s Office helps make sure that your inquiry or complaint is resolved.

In addition to basic information like your name and address, have your Medicare card and health plan card (if you have one) readily available when you’re ready to file your complaint. And, in the future, you can also use Medicare’s Blue Button to help. It provides you an easy way to download your personal health information to a file on your own personal computer. Check out the Blue Button through your account on MyMedicare.gov.

 

 

(972) 896-3851

robin@crusoninsurance.com

www.crusoninsurance.com

 

Independent Broker with your best interests in mind.  I work for you and not one specific insurance carrier.  I will find a plan that best suits your needs both medically and financially so you can make an informed decision.  Contact me TODAY!  I CAN help!

Robin Cruson
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It’s that time of year again—flu season! But if you get sick, think twice before going to your doctor for antibiotics. If you get a cold or flu, antibiotics won’t help. That’s because these are viral infections, and antibiotics only cure bacterial infections. Taking antibiotics when you don’t need them can be harmful. Every time you take antibiotics, they kill sensitive bacteria, but resistant germs may survive to grow and multiply. These resistant germs can lead to severe infections, hospitalizations, and death—especially among people over 65.

The CDC has marked this week as Get Smart About Antibiotics Week. Here are 3 things you can do to make sure you’re using antibiotics the right way:

  1. Take antibiotics only to treat true bacterial infections. It should be for only as long as your doctor prescribed to treat the infection, to reduce your risk of getting the infection again, or to reduce the risk to those around you.
  2. Always talk to your doctor before taking an antibiotic to be sure it will treat the infection you have.
  3. Never take antibiotics for a viral infection, like a cold, cough, or flu. Antibiotics won’t cure your virus, they won’t keep those around you from getting sick, and they won’t help you feel better. In fact, taking antibiotics when you have a virus may do you more harm than good, because you increase your risk of getting an antibiotic-resistant infection later.

Antibiotics won’t help you recover from the flu, but you can keep yourself from catching the major flu viruses in the first place by getting your flu shot! It’s free for people with Medicare, once per flu season when given by doctors or other health care providers (like senior centers and pharmacies) that take Medicare.

 

 

(972) 896-3851

robin@crusoninsurance.com

www.crusoninsurance.com

 

Independent Broker with your best interests in mind.  I work for you and not one specific insurance carrier.  I will find a plan that best suits your needs both medically and financially so you can make an informed decision.  Contact me TODAY!  I CAN help!

Robin Cruson
Pin on Pinterest

 

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

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

Here are some things you can do:

  • Guard your Medicare and Social Security numbers. Treat them like you would treat your credit cards.
  • Hang up the phone if someone calls and asks for your Medicare number, Social Security number, or bank or credit card information. We will NEVER call and ask for this information, and we will NEVER call you or come to your home uninvited to sell Medicare products.
  • Be suspicious of anyone who offers you free medical equipment or services and then requests your Medicare number. It’s illegal, and it’s not worth it!
  • Do not let anyone borrow or pay you to use your Medicare ID card or your identity.
  • Check your Medicare claims for errors. Look at your Medicare Summary Notice (MSN) or statements from your Medicare plan. You can also check www.MyMedicare.gov or call 1-800-MEDICARE (1-800-633-4227) as soon as your claims have been processed. The sooner you see and report errors, the sooner we can stop fraud. TTY users should call 1-877-486-2048.
  • Call 1-800-MEDICARE to report any suspected fraud.

Learn more about spotting and reporting fraud, and get tips on protecting yourself from identity theft.

Find out about Senior Medicare Patrol activities in your area.

 

 

(972) 896-3851

robin@crusoninsurance.com

www.crusoninsurance.com

 

Independent Broker with your best interests in mind.  I work for you and not one specific insurance carrier.  I will find a plan that best suits your needs both medically and financially so you can make an informed decision.  Contact me TODAY!  I CAN help!

Robin Cruson
Pin on Pinterest

 

Diabetes affects 22 million people in the U.S.—are you one of them? Tuesday, March 22 is American Diabetes Association Alert Day, and it’s a great time to take the Diabetes Risk Test to find out if you’re at risk for developing type 2 diabetes, a disease where blood glucose levels are higher than normal. Type 2 diabetes develops most often in middle-aged and older adults.

Many people with diabetes don’t know that they have it, but Medicare covers screening tests so you can find out if you do.

If you have diabetes, Medicare covers many of your supplies, including insulintest stripsmonitors,lancets and control solutions. In some cases, Medicare also covers therapeutic shoes if you have diabetic foot problems. You pay 20% of the Medicare-approved amount for these supplies.

Medicare also covers diabetes self-management training to help you learn how to better manage your diabetes. You can learn how to monitor your blood sugar, control your diet, exercise, and manage your prescriptions. Talk to your doctor about how this training can help you stay healthy and avoid serious complications.

Take control of your health—talk to your doctor today about screening tests and what supplies and training may help you stay healthy.

 

 

(972) 896-3851

robin@crusoninsurance.com

www.crusoninsurance.com

 

Independent Broker with your best interests in mind.  I work for you and not one specific insurance carrier.  I will find a plan that best suits your needs both medically and financially so you can make an informed decision.  Contact me TODAY!  I CAN help!

Robin Cruson
Pin on Pinterest

 

Brittle bones could shatter your life. Every year, more Americans are diagnosed with osteoporosis—a disease that causes bones to weaken and become more likely to break. You may not know that you have this “silent” disease until your bones are so weak that a sudden strain, bump, or fall causes your wrist to break or your hip to fracture.

Medicare can help you prevent or detect osteoporosis at an early stage, when treatment works best. Talk to your doctor about getting a bone mass measurement—if you’re at risk, Medicare covers this test once every 24 months (more often if medically necessary) when your doctor or other qualified provider orders it.

May is National Osteoporosis Awareness and Prevention Month. Learn more about what puts you at risk for osteoporosis and how to prevent and treat it at the National Osteoporosis Foundation. Watch our short video to learn more about how Medicare can help you protect your bones.

 

 

(972) 896-3851

robin@crusoninsurance.com

www.crusoninsurance.com

 

Independent Broker with your best interests in mind.  I work for you and not one specific insurance carrier.  I will find a plan that best suits your needs both medically and financially so you can make an informed decision.  Contact me TODAY!  I CAN help!

Robin Cruson

 

Have you ever had an injury from a fall or another kind of an accident? Each year, accidents like falls result in at least 6 million medically-treated injuries and more than 30,000 deaths. Many of these unintentional injuries happen to older Americans.

Every May, we recognize older Americans for their contributions and demonstrate our nation’s commitment to helping them stay healthy and active.  This year, our theme is “Safe Today. Healthy Tomorrow.”  We want to help you learn about safety and injury prevention so that you can protect yourself and remain active and independent for as long as possible.

Here are 5 things you can do to be safe today:

  1. Talk to your doctor about activities that are appropriate for you.
  2. Manage your medications.
  3. Prevent falls.
  4. Prevent fires and burns.
  5. Drive wisely.

Learn more about these 5 safety tips so that you’ll be healthy tomorrow. You can also visit www.eldercare.gov to get information about services for older Americans in your area.

 

 

(972) 896-3851

robin@crusoninsurance.com

www.crusoninsurance.com

 

Independent Broker with your best interests in mind.  I work for you and not one specific insurance carrier.  I will find a plan that best suits your needs both medically and financially so you can make an informed decision.  Contact me TODAY!  I CAN help!

Robin Cruson

 

Did you know that by the year 2029, more than 20% of people in the U.S. will be at retirement age? Older adults are a vital part of our society. Since 1963, communities across the country have shown their gratitude by celebrating Older Americans Month each May. This year, to celebrate the Older Americans Act, we’re raising awareness about important issues facing older adults and highlighting how older Americans are advocating for themselves, their peers, and their communities.

Medicare helps older adults “Blaze a Trail” by helping them stay healthy and offering vital preventive services like mammograms, diabetes screenings, and colorectal cancer screenings. If you’ve had Part B for longer than 12 months, you can get an annual wellness visit to develop or update a personalized prevention help plan to prevent disease and disability based on your current health and risk factors.

No matter what your age is, you can stay healthy, get involved, and be a trailblazer for older Americans.

 

 

(972) 896-3851

robin@crusoninsurance.com

www.crusoninsurance.com

 

Independent Broker with your best interests in mind.  I work for you and not one specific insurance carrier.  I will find a plan that best suits your needs both medically and financially so you can make an informed decision.  Contact me TODAY!  I CAN help!