Medicare

Welcome to Medicare & You 2012

This is an extraordinary time for health care in our Nation’s history. We are working to make sure you have health care you can depend on—care that’s focused on you, and is safe, effective, and timely, at a cost you can afford. You may have heard about some of the exciting new changes Medicare has been making to help improve your health care—like more free preventive services and lower  prescription drug costs.

There are some actions you can take right now to help keep yourself well. Medicare offers a number of preventive services to help keep you healthy and to find diseases early when treatments work best. Look at the checklist on the next page and take it with you on your next visit to your doctor or other health care provider. Use it to review and keep track of the preventive services that are right for you. Our goal is to help you achieve better health, better care, and lower costs.

One important new Medicare benefit—offered free of charge—is the Yearly “Wellness” visit. This is a chance for you and your doctor or other health care provider to review your health and talk about what you can do to stay as healthy as you can. To help you figure out what can help you stay well, your clinician may ask you to answer a short questionnaire called a Health Risk Assessment, as part of this visit. For more information about this and other important preventive services, visit www.medicare.gov/share-the-health.

The Medicare and You handbook is the best and official source of answers to your Medicare questions. We also have other helpful resources for you. Visit www.medicare.gov, or call 1-800-MEDICARE (1-800-633-4227) to get specific answers to your questions. You can also call your Nevada State Health Insurance
Assistance Program (SHIP) or visit Medicare.gov

Medicare Annual Enrollment Date has changed this year!

Choose your Part D Plans between October 15 - December 7, 2011

Contact your local SHIP office for Free assistance:

Southern Nevada Toll Free Hotline: 800-307-4444

Northern Nevada Toll Free Hotline: 877-385-2345

The Nevada Senior Medicare Patrol (SMP) educates Nevadans on how to detect and report healthcare fraud in Medicare and Medicaid in order to protect these vital healthcare programs for the future.

Every year the Medicare system is drained of billions of dollars as a result of fraud, waste, errors and abuse – almost $134 MILLION in Nevada in 2008 alone! The Nevada SMP is funded and supported by the U.S. Administration on Aging, and works closely with the Centers for Medicare & Medicaid Services. There is a SMP in every state whose mission is to educate Medicare beneficiaries and their caretakers to become critical health care consumers enabling them to identify suspicious situations or billings so that we can increase the chance that the Medicare system is solvent for future generations.

Examples of abuses can include, but are not limited to:

• Billing for services different than those actually provided
• Providing and billing for unnecessary procedures or services
• Overcharging for services
• Billing for a service or procedure provided by an assistant at a level that by regulation may only be charged by a doctor
• Billing for a higher level of service than what was actually provided (e.g. billing the level allowed for a new patient when actually the beneficiary is an existing patient)

Examples of fraud can include, but are not limited to:

• Billing for services not received
• Billing non-covered services as covered services – i.e., billing routine nail care as a foot surgery.
• Offers of “FREE” or medically unnecessary services and then billing Medicare.
Medicare beneficiaries play a vital role in detecting these instances of abuse and we rely on them to report the errors to the Medicare system.

Here are some ways to protect yourself and the system:

• Protect your Medicare number! In the wrong hands, it is a license to steal. Unless you need it for a doctor’s visit, leave your Medicare card at home, in a safe place.
• Record your doctor’s visits in a Personal Healthcare Journal, which is available from the Nevada SMP
• Carefully review your quarterly Medicare Summary Notice and/or your Explanation of Benefits (from another insurance company). Check the dates of service to make sure there are no duplicate billings for services received and verify that the billing is for a service that you did receive.
• Don’t be influenced by advertising for services, medications, or products. Educate yourself and make your own decisions.

We are responsible for helping citizens across our state to identify issues to protect themselves and their loved ones from being victimized. We do this in a number of ways.
• We deliver presentations for interested parties to educate them on the signs of fraud, waste and abuse.
• We also recruit senior professional volunteers from the community to help. These dedicated seniors work at healthcare fairs, one-on-one counseling sessions and by networking with the State’s senior service provider system to get our message into the community.
• We provide resources and referrals to other senior support agencies and non-profits in the state.
• Finally, we maintain a statewide, TOLL-FREE hotline (888-838-7305) so that Nevada beneficiaries have a local resource to resolve and/or investigate these complicated issues.

The Nevada SMP is here to help you! Please call us if:
• You suspect fraud, errors, waste or abuse to Medicare.
• You are a retired professional senior who would be interested in volunteering.
• You are a member of senior group, law enforcement agency or other interested community group that would like a presentation.

Our statewide, toll-free number is 1-888-838-7305. We can also be reached by email at sdschott@adsd.nv.gov

Contact:
Mary Matiya, SMP Project Officer
1840 E. Sahara Ave, Ste 110
Las Vegas NV 89104