Medicare | Olivia K. Smith, Attorney at Law

Medicare Scams and How to Avoid Them

October 11, 2021Filed Under: Senior Living

Insurance companies are frequently subject to being scammed. Scammers frequently target government insurance like Medicare by stealing newly issued medical ID cards and then stealing identities. The Coalition Against Insurance Fraud estimates that tens of billions of dollars are lost annually to these types of fraud. Additionally, medical identity theft is now a top complaint received by the Federal Trade Commission. Billing fraud is also responsible for huge losses to Medicare funds and is difficult to assess as it can be a billing error or intentional fraud.

How does this affect a senior on an individual level? Scammers typically pose as Medicare officials and ask people to pay for their new cards which in reality are free. Or they phone a potential victim with false news of a refund and ask for the person’s ID number and bank account number to deposit the refund. “Right now … everyone is being inundated with TV commercials, brochures, and other official-looking documents in the mail about all the Medicare Advantage plans. It’s so confusing, and in an environment like that, fraud is rampant,” says Micki Nozaki of the California Senior Medicare Patrol. There are more than 50 million Medicare beneficiaries who can annually opt to swap Medicare Advantage and Part D prescription drug plans which provide scammers with the opportunity to prey on vast numbers of seniors.

The Centers for Medicare and Medicaid Services have a list of tips to help prevent fraud. The first and foremost is to protect your Medicare and Social Security numbers vigilantly. It suggests treating your Medicare card like you would a credit card and do not provide the number to anyone other than your doctor, or people you know should have it. Become educated about Medicare with regards to your rights and what a provider can and cannot bill to Medicare. Review your doctor bills carefully, looking for services billed for but not provided to you. Remember that nothing is free with regards to medical care; never accept offers of money or gifts of free services. Be suspicious of your provider if they tell you they know how to “bill Medicare” to pay for a procedure or a service that is not typically covered. Before leaving your pharmacy check to be sure your medication is correct, including the full amount prescribed and whether or not you received a generic or brand name medicine. If your prescription is in error report the problem to the pharmacist before leaving.

Remember Medicare will never visit, call, or email you and ask for personal information such as your Medicare number, Social Security Number, address, or bank account number. Medicare already has this information and does not need you to provide it. Even when Medicare issues new cards that no longer contain your social security number in April of 2019 you will not be required to do anything. You can assume that anyone who claims to be helping you with Medicare and asks for your personal or financial information is a scam artist so close the door, hang up the phone, or delete the email.

When it is time to compare plans be sure to meet with a trustworthy advisor. Some insurance representatives give the industry a bad name by selling you a policy or plan that does not suit your needs or your budget. Some agents go so far as to ask you to sign a release form allowing them to make decisions on your behalf. Never sign anything related to Medicare without first reading it carefully. Additionally, it is a good practice to have a family member or lawyer review the document before signing it. The non-profit National Council on Aging (NCOA) has a free, brief assessment that allows you to compare plans online. You can also contact your local State Health Insurance Assistance Program (SHIP). SHIP is a provider of free, federally-funded Medicare counseling via a trained volunteer or staff member.

Medicare fraud wastes billions of taxpayer dollars annually. Carefully review your medical bills and have inaccuracies corrected. Guard your personal information vigilantly and be wary of people asking you to provide that information. Meet with a trusted insurance advisor or compare medical plan options using the sites listed above. If you are unsure about something call Medicare directly for clarification. If you’d like to discuss your particular situation, please don’t hesitate to reach out. Please contact our Cincinnati office by calling us at 513-771-2444 with any questions.

Do You Understand Medicare?

March 22, 2021Filed Under: Uncategorized

If you are interested in information on Medicare, understand that applying for the benefit sometimes seems like a double-edged sword. On the one hand, Medicare is obviously a good resource because it provides medical benefits to seniors who are often on a fixed income. On the other hand, however, navigating the ins and outs of Medicare can be seriously confusing, causing many to give up in exasperation. If you are a senior and in need of medical care do not despair—there are numerous resources available to help you navigate the complicated details and minutiae of Medicare.

Consider hiring a qualified local elder law attorney sooner than later. Their professional knowledge of the ins and outs of the Medicare system combined with their experience working with senior citizens allows you to get the help and coverage you need as quickly as possible.

There are multiple websites you should check out. Medicare.gov, the official site of Medicare should be a starting point, as it provides numerous facts on the program and allows you to search for providers. The Social Security Administration website also has information on Medicare eligibility and enrollment. These are just two, but you can perform an Internet search on Medicare information and you will receive a list of several sites to review.

If you are uncomfortable working with computers it would be in your best interests to ask a friend or relative to help you because some of the information on the internet is very valuable. However, for those who would rather talk to a person, you may call 1-800-MEDICARE (800-633-4227) for more information.

Another great resource is the American Association for Retired Persons, commonly known as AARP. AARP is a well-established advocate for senior citizens in the United States. The organization offers helpful, reliable resources such as Information-packed webinars featuring experts who can break down some of the Medicare facts that applicants need to know.

There also may be support available at the state level like State Health Insurance Assistance Programs, or SHIPs. These programs offer free counseling for seniors who receive Medicare. Medicare applicants and their loved ones should visit shiptacenter.org for more information.

But if you want to save yourself hours of confusing computer research and potential headaches, the best idea is to speak with an experienced local Elder Law attorney before the Medicare application process even begins. A good Elder law attorney can assist you with the complex process, ensuring that you get the benefits you are entitled to more quickly. If you have questions, contact a local Elder law office today. Please contact our Cincinnati office by calling us at 513-771-2444 with any questions.

What You Need to Know About Medicare and Telehealth Services

September 11, 2020Filed Under: Uncategorized

In response to the COVID-19 outbreak, the Centers for Medicare & Medicaid Services (CMS) recently announced that it has increased access to Medicare telehealth services. This means that Medicare beneficiaries can receive more benefits from their doctors without having to travel to a healthcare facility.

The terms “telehealth” and “telemedicine” refer to the ability to exchange medical information from one site to another through electronic communication to improve a patient’s health. With the rapid rise of COVID-19 cases, there is the urgency to expand the use of technology to help people who need routine care. Telehealth will keep vulnerable beneficiaries and those with mild symptoms in their home, but with access to the care they need by phone and video rather than requiring an office visit.

Prior to this change, Medicare would only pay for telehealth on a limited basis, and only for persons in a designated rural area. Now Medicare beneficiaries will be able to receive the following services through telehealth: common office visits, mental health counseling, and preventive health screenings. This will help keep more of the at-risk population (Medicare beneficiaries) able to visit with a doctor from home, rather than traveling to a doctor’s office or hospital which puts the beneficiary and others at risk. Telehealth visits will be treated the same as regular, in-person visits and will be paid by Medicare at the same rates.

These changes go into effect for services starting March 6, 2020, and will continue for the duration of the COVID-19 Public Health Emergency. For more information, view the fact sheet prepared by CMS.

Better access to telehealth is a big step in getting Medicare beneficiaries appropriate care in the least restrictive way. If you have questions or would like to discuss your particular needs, please don’t hesitate to call.

Connection Between Family and Healthy Aging

October 30, 2019Filed Under: Senior Health and Wellness

One cannot overstate the importance of family presence in a senior’s life. Family creates a consistent social network and connection that directly impacts the senior’s overall quality of life. Prioritizing family relationships provides continuity as a senior experiences change in their social network. Friends may change, become ill and unavailable, or even pass away, but family is multi-generational and, as such, has an enduring presence for an aging family member. The stability of family relations, even with the ups and downs of disputes, is a familiar source of social and emotional grounding, as well as practical help. A study by the United Health Group reports more than half of older Americans will cite faith or spirituality, and a loving family as the top reasons they have a positive outlook. That positive outlook brings tremendous benefits to a senior’s health and well being.

Sadly, not all seniors have the benefit of a nuclear family or close extended family. Yet, these connections were deemed more important than financial resources, according to the majority of participants in the United Health Group survey. Aging seniors who integrate into their family system are more prone to live healthier and longer lives than those seniors who remain isolated from family. Even in the case of those seniors living with later stages of dementia, family contact can reduce disease symptoms and may stave off faster mental decline. How is it that family brings about higher rates of longevity?

Family contact helps to maintain a senior’s immune system. Family social connections create optimism, which in turn may lead to stronger cell-mediated immunity, the immune cells that are responsive to bacterial or viral invasions. The senior immune system can also become more adaptive and robust due to low-level exposure to a variety of pathogens when interacting with their family in person. Social seniors, even those in non-family settings, often have stronger immune systems because of human contact.

Other techniques to improve an aging immune system include nutritional supplements or vitamins along with a healthy, nutrient-rich diet. Also, regular exercise, maintaining vaccinations, reducing stress, restful sleep, proper hydration, washing hands, and a positive outlook can all boost a senior’s immune system. When a senior has an actively involved family, many of these health systems are put into play, especially the positive outlook. Having a family who cares about and cares for their elder members reduces feelings of depression, which feeds the cycle of optimism, improving overall health.

A higher level of cognitive functioning is linked to a family connection, as well. Brain health acquires benefits from being happy and socially engaged in activities that challenge memory and thinking skills. Human interaction goes beyond the more repetitive brain teaser challenges and puzzles because the social dynamic is fluid and unpredictable. A senior must engage all of their senses when responding while being in a family group. Holiday meals, birthday celebrations, family reunions, and many other typical family activities are good brainwork for an aging family member. According to a study published in the Public Library of Science, elderly and even middle-aged adults who maintain active social circles appear to be at a lower risk of developing dementia. A family system is the ultimate pre-made social connection. “This finding could feed into strategies to reduce everyone’s risk of developing dementia, adding yet another reason to promote connected communities and find ways to reduce isolation and loneliness,” said the study’s lead author, Andrew Sommerlad, Ph.D., of University College London.

Family roles shift throughout time. Parents who used to care for their children now experience an evolving family structure and the inevitability of their mortal decline. When the roles of parenting reverse, it brings challenges for all involved. Financial support is often needed when a parent is in declining health, and the ability of family members to contribute such help to the senior offers great relief and helps to reduce stress. Even if a family system is unable to provide financial support, emotional support does wonders for the aging process of a family member. Positive conversations and interactions can increase their level of contentment, reduce worry, and bring family inclusiveness and a sense of belonging to the senior.

Not all seniors have a family who can play an active role in their life. However, with extra effort, relationships can be forged that will be mutually beneficial, especially in the digital age of social media. While friendships oftentimes never replace an actual biological family, the adage that “friends are the family you give yourself” rings true and can create lasting and meaningful connections.

All of these connections are really about feeling loved. The benefits of being grounded in love, and what that brings to a person is profound. What if you never felt alone? What if you always felt loved? What if you could live your life knowing that someone was always in your corner, still there for you? The answer is the same to all of these questions – you would have a better chance at living your best life physically, mentally, and emotionally.

Strengthen family connections and friendship relations. Modern technology has made it easier than ever to be a part of someone’s life. Text, email, video chat, and social media platforms provide interaction when it is not possible to physically be with a family member. However, do not overlook the more traditional methods of contact, which include personal visits, a phone call, and a handwritten letter or a card sent via snail mail. While these “old school” methods may not seem relevant to younger generations, they are particularly meaningful to a senior.

Every connection can make a difference. A close family can learn, share, and grow together. Outcomes from these shared experiences benefit all members, but in particular, the older family members. Younger generations are also gaining an invaluable lesson. The digital world is reconfiguring human experiences electronically and is leaving many people wanting of human connection.

If you have questions about planning for yourself or a loved one, or if you would like to talk about your particular situation, please don’t hesitate to contact our Cinncinatti office by clicking here to send us a message or call us by dialing (513) 771-2444.

Medicare Scams and How to Avoid Them

Do You Understand Medicare?

What You Need to Know About Medicare and Telehealth Services

Connection Between Family and Healthy Aging

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