Frequently Asked Questions
The following are answers to some of the most common
questions asked by Medicare consumers. Health Care
Excel serves as the Medicare Quality Improvement
Organization for Indiana and Kentucky. If your
question is not listed here, contact 1-800-MEDICARE, or visit
www.medicare.gov. Can I get help paying for my medications?
Medicare offers prescription drug coverage for everyone with Medicare. This is called “Part D.” This coverage may help lower prescription drug costs and help protect against higher costs in the future. It can give you greater access to drugs that you can use to prevent complications of diseases and stay well.
To find the actual costs of the Medicare drug and health plans in your area, visit www.medicare.gov on the web. Select “Compare Medicare Prescription Drug Plans.” Or, call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.
How do I get a new Medicare card?
There are three ways to ask for a replacement Medicare card.
- Call the Social Security Administration at 1-800-772-1213*.
- Request a replacement Medicare card online at http://www.ssa.gov/mediinfo.htm.
- Visit your local Social Security office.
Who do I notify to change my address for Medicare?
Call the Social Security Administration at 1-800-772-1213*.
*Railroad retirees should call their local Railroad Retirement Board
Offices, or the Railroad Retirement Board Helpline at 1-800-808-0772.
Medicare Coverage
Does Medicare pay for eyeglasses?
Medicare pays for one pair of eyeglasses with standard frames after cataract surgery.
Does Medicare cover diabetic services?
Medicare covers glucose monitors, test strips, and lancets for people with diabetes (both for insulin users and non-insulin users). Medicare covers 20% of the Medicare approved amount after the annual Part B deductible.
How often does Medicare cover a screening mammogram?
Medicare covers a screening mammogram once per year for all females who are on Medicare and age 40 or older. Eighty percent of the Medicare approved amount is covered with no Part B deductible.
Does Medicare cover the cost of medical equipment?
Medicare Part B covers some durable medical equipment (DME). DME is equipment that can withstand repeated use and is used primarily for medical purposes. Oxygen tanks, hospital beds, and walkers are examples of durable medical equipment that may be covered by Medicare. For more information, and a list of approved suppliers, contact the Durable Medical Equipment Regional Carrier in your state, or call 1-800-MEDICARE (1-800-633-4227).
Medicare Part A & B
What is Medicare Part A?
This is the Medicare program that helps pay for care while you are in a
hospital, skilled nursing facility, critical access hospital, or if you are
receiving some home health, or hospice care services.
How do I enroll in Medicare Part A?
Most people get Part A automatically when they turn age 65. You can call the
Social Security Administration at 1-800-772-1213 to find out if you have
Part A, or to ask for information about purchasing Part A.
Who do I call for questions about Medicare Part A coverage, bills, and
services?
Call 1-800-MEDICARE (1-800-633-4227), or visit
www.medicare.gov.
What is Medicare Part B?
Medicare Part B is the program that helps cover medically-necessary services
like doctors’ services, outpatient care, and other medical services. Part B
also covers some preventive services. You can find out if you have Part B by
looking at your Medicare card.
How do I enroll in Medicare Part B?
You can sign up for Part B anytime during a 3-month period before you turn
65. For more information, visit
www.medicare.gov, and select “Find Out if You are Eligible for Medicare
and When you Can Enroll.” To sign up, visit your local
Social Security office, or call the Social Security Administration at
1-800-772-1213.
What is the cost of Medicare Part B?
For information on the current Part B monthly premium, call
1-800-MEDICARE
(1-800-633-4227) or visit www.medicare.gov.
Your Medicare Rights
The hospital wants to release me, but I don't feel well enough yet. What do I do?
- If you are told that you must leave the hospital before you feel well enough, you have the right to appeal that decision. You may ask Health Care Excel, the Indiana Medicare Quality Improvement Organization (QIO), to review your case at no cost to you. ALL Medicare consumers have the right to appeal their discharge decision, including those in HMOs or other managed care plans.
- If a beneficiary is in an acute care hospital, he/she or his/her representative will receive a notice from the provider informing the beneficiary of his/her rights. This notice is called the Important Message from Medicare. If the beneficiary or representative feels that he/she is being discharged too soon, the beneficiary or representative may call the Indiana Medicare QIO at 1-800-288-1499 and request an appeal.
- Once you get the notice, call the Indiana Medicare QIO by 12:00 a.m. midnight on the day of discharge at 1-800-288-1499. For example, if you receive your notice at 8:00 a.m. on Monday, you have until 12:00 a.m. midnight on Monday to contact the Medicare QIO. If you are not able to contact the Medicare QIO within this timeframe, you may still request a review; but it will not be considered "immediate".
- While you are in the hospital, the Medicare QIO will review your condition to see if you need to stay. You cannot be sent home or billed by the hospital until the Medicare QIO completes the review of your case. You cannot be billed for the time you spent in the hospital while the Medicare QIO was reviewing your case.
Get written instructions about your medication and follow-up care before you leave the hospital. The hospital can help arrange for the care that you will need when you leave the hospital.
What should I do if I am concerned about or not satisfied with the quality of care I received?
- Call the Medicare Quality Improvement Organization (QIO) at
1-800-288-1499 and describe your concern. One of our trained staff will
listen and help you decide what to do. One of your choices is to make a
formal complaint.
- If you decide you want to make a formal complaint, we can help you put it in writing. Once the Medicare QIO receives the written complaint, the quality of care review will begin. This is a free service for persons with Medicare.
Call 1-800-MEDICARE (1-800-633-4227), or visit www.medicare.gov.
Who conducts the review and what does it include?
Depending on the case, any of our physician reviewers can review your complaint. (A physician reviewer is a practicing physician who works with the Medicare Quality Improvement Organization (QIO) to address quality of care concerns.) A nurse case manager will contact you once the complaint is filed and serve as your point of contact throughout the process.
The physician reviewer looks at all aspects of care surrounding your complaint, and makes an initial finding that is shared with the health care provider or facility your complaint is related to. Your health care provider or facility also has the opportunity to comment. The Medicare QIO works directly with you and your provider to resolve the problem and make sure that you and other Medicare beneficiaries receive the best care possible.
The entire process takes anywhere from three to six months.
If I am concerned about the quality of health care I received in another state, can Health Care Excel, the Medicare Quality Improvement Organization, review it?
Each state has an organization like the Medicare Quality Improvement Organization. To request a review or to file a complaint about the quality of care that you received outside Indiana, you must call the appropriate organization. Call 1-800-MEDICARE (1-800-633-4227) to obtain the phone number.
