Your Weekly Medicare Consumer Advocacy Update
Introducing a Clear Path to Learning Medicare
Medicare Rights Center Launches Medicare Rights University
This week, the Medicare Rights Center launched Medicare Rights University (MRU), a web-based curriculum designed to empower professionals to better help their own clients, patients, employees, retirees, and others navigate a multitude of Medicare questions. Building on Medicare Rights’ 25 years of health care counseling and educational expertise, MRU offers a 17-course, video-based Core Curriculum complete with a self-assessment tool, in-depth and user-friendly Medicare content, quizzes to test knowledge, and downloadable materials.
MRU subscribers can:
- Learn online, anytime, and review key concepts as needed.
- Stay up-to-date on the changing Medicare program.
- Gain access to exclusive materials developed by our Medicare experts.
- Train staff without having to devote time to developing new content.
MRU is structured as a four-level Core Curriculum, with four to five video-based courses in each level designed to build on information learned as users progress through each level. Advanced courses feature in-depth case studies to help users assist others in real-life situations. A Special Topics portion of MRU addresses subjects not covered in the Core Curriculum, such as Medicare Fall Open Enrollment and Medicare and health reform. A free assessment places users into the appropriate course and level, and quizzes and downloadable materials accompanying each course test subscribers’ knowledge.
MRU is available today. To learn more, please visit www.medicarerightsuniversity.org.
Over Four Million Medicare Summary Notices Not Delivered in 2012
A recent report from the Office of Inspector General (OIG) revealed that over 4.2 million Medicare Summary Notices (MSNs) were not delivered to Medicare beneficiaries in 2012. An MSN is the notice from Medicare that lists Medicare services and items received over the previous three months. It shows the amount the provider billed Medicare, Medicare’s approved amount for the service, the amount Medicare paid, and what the beneficiary has to pay. The MSN is not a bill, and only people with Original Medicare receive it. While MSNs can be accessed online at www.medicare.gov, many people only receive them by mail.
It is important for beneficiaries to receive their MSNs for a few reasons. First, MSNs provide a summary of the services charged under the beneficiary’s name. If there is any fraudulent activity, the MSN provides the perfect opportunity to spot it. Second, for certain services, Medicare reimburses the beneficiary after the fact. This reimbursement is often sent as a check in an MSN. Third, if Medicare denies coverage for a service, a beneficiary often starts the appeal process using the MSN. Clearly, not receiving an MSN is a concern for both beneficiaries and the Medicare program.
There was one other troubling finding of the OIG report—the Centers for Medicare & Medicaid Services (CMS) has not provided its contractors that distribute MSNs with guidance on how to handle undeliverable MSNs. This has led to inconsistent and varied tracking of undelivered MSNs and efforts to identify why the MSN was undeliverable. In some cases, nothing was done to rectify the situation, which resulted in millions of dollars remaining undelivered to beneficiaries and less detection of potentially fraudulent activities.
However, CMS has promised to follow up on these issues. First, it will develop policy on what contractors should to do with undelivered MSNs. Second, it will work to identify what can be done to reduce the large number of undeliverable MSNs. Finally, it will make sure that beneficiary addresses are being properly transferred to the contractors from the Social Security Administration. These three changes, once in place, should help to make sure that Medicare beneficiaries are more likely to receive this important notice.
Volume 5, Issue 4
The flu shot is one of three vaccines that is typically covered by Medicare Part B instead of Part D. Medicare Part B covers 100 percent of the cost of a flu shot once every flu season with no Part B deductible required. This is true for both Original Medicare and Medicare Advantage plans (private health plans). If you have Original Medicare, you can go to any Medicare provider. If you have a Medicare Advantage plan, you must see an in-network provider to receive the flu shot at no cost.
The flu season usually runs from November through April. Therefore, Medicare may cover a flu shot twice in one calendar year. For example, if you get a shot in January 2013 for the 2012/2013 flu season, you could get another shot in October 2013 for the 2013/2014 flu season.
Part B will also cover the pneumonia and Hepatitis B vaccines. It will also cover vaccines and immunizations if you are exposed to a dangerous virus or disease. Most other vaccines are covered under Part D prescription drug coverage.
A new fact sheet from Social Security Works says cost shifting to people with Medicare is an indirect cut to Social Security. Most people with Medicare receive Social Security benefits, and many live on modest, fixed incomes with Social Security being their main source of income. In order reduce the national deficit, many policymakers have considered policies that would shift costs to people with Medicare, eating into their Social Security income.
This fact sheet addresses many of the policies that would shift costs to beneficiaries and offers alternative solutions that would reduce Medicare costs without increasing out-of-pocket costs and indirectly reducing Social Security benefits.