What Services Does The Partnership Provide
- Medicare and Medicaid information and education
- Help with original Medicare eligibility, enrollment, benefits, complaints, rights and appeals
- Explain Medicare Supplemental insurance policy benefits and comparisons
- Explain Medicare Advantage and provide comparisons and help with enrollment and disenrollment
- Explain Medicare Prescription Drug coverage, help compare plans and search for other prescription help
- Information about long-term care insurance
The partnership also helps with the following programs. Benefit Counselors are specially trained to help you understand all the fine print to find and apply to a plan that works for you. They advocate for you with these programs and help you get the services you need.
How Do I Speak To A Person At Medicare
Some people may prefer to speak to a Medicare representative over the phone, and some actions may require you to do so.
The official phone number for Medicare is 1-800-MEDICARE , TTY 1-877-486-2048. You may call Medicare 24 hours per day, 7 days per week, and help is available in both English and Spanish.
When calling Medicare, you may receive help with any of the following:
- Claim statusCheck the status on a claim that has been filed on your behalf.
- Coverage and benefitsNot sure if a service or item will be covered by your Medicare insurance? You can call to find out.
- Premium paymentsInquire about the status of a Medicare plan premium payment or ask a question about your balance.
- Preventive examsMedicare covers a number of preventive exams, and you are encouraged to call and find out which exams are eligible for Medicare coverage.
- DeductiblesNeed to know how money you have paid towards your Part A or Part B deductible? Call to find out and to find out if a particular service or item will count toward your deductible.
- Replacing a lost or stolen Medicare cardMedicare fraud can happen as a result of a lost or stolen card, so be sure to call if you lose your Medicare card.
You may also speak to someone in person regarding your Medicare eligibility or enrollment by visiting your local Social Security office.
When Should I Not Call 1
Do not call 1-800-MEDICARE if you have specific questions about your Medicare Advantage or Part D plan. Because these policies are administered by private insurers, you must contact your plan insurer directly . This includes questions on plan premiums, deductibles, claims status, and other issues that are plan-specific.
You can also call 1-800-MEDICARE for general Medicare questions not mentioned in this article.
Jesse Migneault is a journalist and editor who has written about business, government and healthcare including public and private-payer health insurance. His articles have appeared in HealthPayerIntelligence, the Hartford Courant, Portsmouth Herald, Seacoastonline.com, Fosters Daily Democrat, and York County Coast Star.
In addition, his work has been cited by health industry stakeholders such as the Eugene S. Farley Health Policy Center, Association of Healthcare Journalists, American Academy of Actuaries, Kaiser Permanente, blueEHR, San Diego Law Review, Medicare Agent News, healthjournalism.org, and Concierge Medicine among others.
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What Are My Rights As A Medicare Beneficiary
As a Medicare beneficiary, you have certain guaranteed rights. These rights protect you when you get health care, they assure you access to needed health care services, and protect you against unethical practices.
You have these rights whether you are in Original Medicare or another Medicare health plan.
Your rights include, but are not limited to:
The Right to Receive Emergency Care
If you have severe pain, an injury, or a sudden illness that you believe may cause your health serious danger without immediate care, you have the right to receive emergency care. You never need prior approval for emergency care, and you may receive emergency care anywhere in the United States.
The Right to Appeal Decisions About Payments or Services for Medical Care
If you are enrolled in Original Medicare, you have the right to appeal denial of a payment for a service you have been provided. If you are enrolled in another Medicare health plan, you have the right to appeal the plan’s denial for a service to be provided.
The Right to Information About All Treatment Options
You have the right to know about all your health care treatment options from your health care provider. Medicare forbids its health plans from making any rules that would stop a doctor from telling you everything you need to know about your health care. If you think your Medicare health plan may have kept a provider from telling you everything you need to know about your health care options, then you have the right to appeal.
Medicare Secondary Payer Records In Cms’s Database
The BCRC is the sole authority to ensure the accuracy and integrity of the MSP information contained in CMS’s database ). Information received because of MSP data gathering and investigation is stored on the CWF. MSP data may be updated, as necessary, based on additional information received from external parties . Beneficiary, spouse and/or family member changes in employment, reporting of an accident, illness, or injury, Federal program coverage changes, or any other insurance coverage information should be reported directly to the BCRC. CMS also relies on providers and suppliers to ask their Medicare patients about the presence of other primary health care coverage, and to report this information when filing claims with the Medicare program.
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Provider Requests And Questions Regarding Claims Payment
MACs, intermediaries, and carriers will continue to process claims submitted for primary or secondary payment. Claims processing is not a function of the BCRC. Questions concerning how to bill for payment should continue to be directed to your local Medicare claims paying office. In addition, continue to return inappropriate Medicare payments to the local Medicare claims office checks should not be sent to the BCRC. Questions regarding Medicare claim or service denials and adjustments should continue to be directed to your local Medicare claims office. If a provider submits a claim on behalf of a beneficiary and there is an indication of MSP, but not sufficient information to disprove the existence of MSP, the claim will be investigated by the BCRC. This investigation will be performed with the provider or supplier that submitted the claim. The goal of MSP information gathering and investigation is to identify MSP situations quickly and accurately, thus ensuring correct primary and secondary payments by the responsible party.
Laxalt Makes Campaign Push In Important Nevada County Mocking Biden
SUMMERLIN, Nev. Predicting a red wave that will be deep and wide, Adam Laxalt, the Republican challenging Senator Catherine Cortez Masto in Nevada, rallied supporters Saturday by mocking President Biden, who he said has done more to destroy this country than we could have ever imagined.
Mr. Laxalt has been touring other more rural parts of Nevada by bus for several days but planned to spend the weekend in Clark County, the states largest county and most important battleground. Mr. Laxalt appeared with several other Republican candidates as well as Tom Cotton, a Republican senator from Arkansas who is frequently mentioned as a potential presidential contender.
Mr. Laxalt pointed out that Mr. Biden skipped over Nevada during a recent campaign visit, saying that it indicated Ms. Cortez Masto, a Democrat, absolutely does not want him to come to this state. He drew cheers from the crowd when he cited a recent moment in which Mr. Biden mistakenly said his son died in Iraq, saying, This guy cannot tell the truth anymore.
We cannot forget that we are a less safe world today because Joe Biden was the commander in chief, Mr. Laxalt said. He then criticized the withdrawal from Afghanistan, saying, That was the day Americans understood that Joe Biden was simply not up for the task.
On Saturday, Mr. Laxalt disputed the presidents recent remarks that democracy was at stake in the election.
Jonathan Weisman
Jonathan Weisman
Jonathan Weisman
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Write To Insurance Companies
You may write your insurance companies with questions that you have about your coverage. If possible, type up your letter and make sure to keep a copy that indicates the date on which you mailed it.
If you arent able to type up your questions, make sure to write in clear, concise print, leaving plenty of space in between your questions. Be sure to include your contact information in any correspondence that you mail to your healthcare provider.
Before sending mail that contains important documents or your private health information, call ahead and make sure that you have the correct contact information. Mail that is sent to the wrong address is not always forwarded to the right place, especially in places that receive a high volume of mail.
Addresses for major insurance companies that provide Medicare policies:
Aetna Inc.
If your ability to talk on the phone is limited because of a health condition, you can still reach out to Medicare. TTY users can call 1-877-486-2048 to reach a hotline compatible with their devices.
You can also email Medicare at [email protected], or send a letter explaining your need to:
Centers for Medicare & Medicaid ServicesOffices of Hearings and Inquiries 7500 Security Boulevard, Mail Stop S1-13-25Baltimore, MD 21244-1850
Termination And Deletion Of Msp Records In Cms’s Database
Medicare claims paying offices can terminate records on the CWF when the provider has received information that MSP no longer applies . Termination requests should be directed to your Medicare claims payment office. MSP records that you have identified as invalid are reported to the BCRC for investigation and deletion.
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Dhp Pcp Incentives Provider Advisory Comments Q& A Viewed Only On Webex
Claim Appeals may be submitted via:
- DHP Provider Portal
You may also submit your Claim Appeal by mail:
Claims Administration
Phone Number: 1-877-220-6376 or 1-855-425-3247 Fax Number: 361-808-2725Email:
Once you have gone through the Driscoll Complaint Process, and you are not pleased with the response, you may file your complaint directly to the Health and Human Services Commission by calling toll-free 1-866-566-8989. If you would like to make your complaint in writing, please send it to the following address:
Texas Health and Human Services CommissionHealth Plan Operations H-320P.O. Box 85200Austin, TX 78708-5200
If you can get on the internet, you can send your complaint in an email to
Visiting The Medicaid Office
If you do not want to call the Medicaid office number and speak to a representative, you can go to the office. This is a helpful option if you would benefit from speaking to a program official in person. However, keep in mind that your Medicaid office may require you to schedule an appointment before you can meet with a representative. If this is true for your facility, call the office to schedule your meeting time.
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Democrats Are Outpacing Republicans In Early Voting In Senate Battleground States
With just three days until Election Day, voters in 11 Senate battleground states are turning out early at rates that nearly match the blowout numbers from the last midterms in 2018.
Democrats are outpacing Republicans by 3.5 percentage points among the nearly 14 million Americans who have already cast ballots in those states, according to the latest update from TargetSmart, a Democratic data company that incorporates early vote numbers along with its own proprietary estimates.
TargetSmart classifies Arizona, Colorado, Florida, Georgia, North Carolina, New Hampshire, Nevada, Ohio, Pennsylvania, Utah and Wisconsin as Senate battleground states. Republicans need to flip just one seat currently held by Democrats to retake the majority.
The data is incomplete because three of those states Ohio, Georgia and Wisconsin do not register voters by party. It also does not show how people voted, just the party to which they belong. This year, moreover, polls suggest that independent voters angry over rampant inflation, above all else are trending Republican.
Using basic registration data alone yields a narrower margin: a 2.4 percentage point edge for Democrats. Unaffiliated voters make up 43.6 percent of the electorate in Senate battlegrounds so far. TargetSmarts mathematical model assumes a slight majority of those Americans are Democrats.
Alan Rappeport
Get Your Health Insurance License
Obtaining a health insurance license in your residential state is the very first step in becoming a Medicare insurance agent. Its also probably the step thats going to take you the longest. Youll need to take a course either in a classroom, online or by self-study and work hard to understand the material.
Youll learn about deductibles, coinsurance costs, claims adjudication, insurance networks, healthcare laws, ethics, and compliance standards. Some states require a specific number of hours of study prior to taking the exam, and some do require that you have classroom training. This training is usually completed within a week. Some vendors offer life insurance training in addition to the health insurance portion. If you are able to do it, it can be beneficial to get this completed at the same time.
Once you have completed the learning and studying phase, youll take an exam. If you pass, youll have your license in just a few days!
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Obama Acknowledging Pocketbook Issues Urges Voters Not To Overlook Threats To Democracy
PHILADELPHIA Former President Barack Obama on Saturday issued a stark warning about threats to American democracy, even as he acknowledged that many voters were consumed by a range of other urgent issues in the final stretch of the midterm campaign.
I understand that democracy might not seem like a top priority right now, especially when youre worried about paying the bills, Mr. Obama said at a get-out-the-vote rally in Philadelphia, not far from the Liberty Bell. But when true democracy goes away, weve seen throughout history, weve seen around the world, when true democracy goes away, people get hurt. It has real consequences.
Mr. Obamas comments came as he and President Biden rallied with Democratic candidates for governor and senator in the evenly divided state of Pennsylvania, stressing the high stakes of the elections to a crowd gathered at Temple University and lacing into the Republicans on the ballot.
They appeared together to support Lt. Gov. John Fetterman, the nominee for Senate, and Josh Shapiro, the state attorney general and nominee for governor.
Mr. Fetterman is in a highly competitive race against Dr. Mehmet Oz, the celebrity physician and Republican nominee. Mr. Shapiro has strongly outpolled his rival, Doug Mastriano, the far-right state senator.
Mr. Mastriano chartered buses to the Jan. 6, 2021, rally that led to the attack on the Capitol, and Mr. Obama noted associations between the Oz campaign and Jan. 6.
Michael C. Bender
Michael C. Bender
Accreditation Of Medicare Certified Providers & Suppliers
Section 1865 of the Social Security Act permits providers and suppliers accredited by an approved national accreditation organization to be exempt from routine surveys by State survey agencies to determine compliance with Medicare conditions. Accreditation by an AO is voluntary and is not required for Medicare certification or participation in the Medicare Program. A providers or suppliers ability to bill Medicare for covered services is not impacted if it chooses to discontinue accreditation from a CMS-approved AO or change AOs. Section 1865 of the Act provides that if the Secretary finds that accreditation of a provider entity by a national accreditation body demonstrates that all applicable conditions are met or exceeded, the Secretary may deem those requirements to be met by the provider or supplier. Before permitting deemed status for an AOs accredited provider entities, the AO must submit an application for CMS review and approval.
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At A Trump Rally In Pennsylvania Mastriano Imagines His First Day In Office
LATROBE, Pa. There was a time earlier this year when the name of Doug Mastriano, the Republican candidate for governor in Pennsylvania, could send Donald J. Trump into a tailspin.
The former president was annoyed that Mr. Mastriano constantly talked on the campaign trail about a brief call they had about the 2020 election results. Mr. Mastriano had failed to make any progress in overturning President Bidens victory in the state.
But Mr. Mastriano eventually won Mr. Trumps endorsement, and has since won over much of the Make America Great Again camp.
The Republican candidate earned big applause at the Trump rally on Saturday with a speech in which he mocked Josh Shapiro, his Democratic opponent, and outlined a first day in office in which hed declare war on sex traffickers and put an end to transgender bathrooms.
On Day 1, woke is broke, Mr. Mastriano said.
Mr. Mastriano did not mention Mr. Trump. And while his ball cap was indeed red, it was not the signature Trump accessory, but a Philadelphia Phillies hat.
Addressing a crowd gathered at the Arnold Palmer Regional Airport tarmac, Mr. Mastriano admired a rainbow in the distance and said that the perfect weather at the rally was a sign from God.
Minutes after he finished, the skies opened up with rain.
How To Qualify For Medicaid Long
To qualify for Medicaid long-term care, you must be 65 or older, permanently disabled or blind. You also must be a resident of the state in which you are applying for Medicaid. Then you must meet functional and financial requirements.
âFunctional requirements: Applicants must need a nursing facility level of care to qualify for Medicaid long-term care coverage. However, there isnât a federal definition for nursing facility level of care, so states can establish their own definition. Typically, states require that applicants need assistance with a certain number of activities of daily living.
âFinancial requirements: There are limits on both the income and assets an applicant can have to qualify for Medicaid. The income limit can vary by state, but it typically is $2,382 per month for an individual. If an applicant is married, only the applicantâs income is consideredânot the spouseâs income. For state-specific income limits, visit MedicaidPlanningAssistance.org.
The asset limit is typically $2,000 for an individual, but there are some assets that are exempt. For example, a home is exempt as long as the applicant is living there and it is the applicantâs primary residence, estate planning attorney Goldberg said. Personal belongings, an automobile, prepaid funeral expenses and life insurance policies with cash value no greater than $1,500.
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