[Music] well I guess we're all ready to go the cameras are ready and uh I'm ready and uh everybody's seated uh first of all I want to welcome all of you here at
Summer this uh winter has been a rotten one as far as I'm concerned I don't know Carol she likes winter so anyway uh we hope that now we're in match we can get rid of all the ice
first for your information we have definite speakers for the months of April and May and before we put on today's speakers I'm just going to go over the uh ones we have for April and
May uh the April 1st meeting will we will have the members of the Plymouth County District Attorney's uh office uh with Tim Cruz and the the girls they're going to be taking uh the program and it's going to be on CPR so they will be
here doing that program for us on CPR the May 6 one uh meeting will be uh run by uh Plymouth County district attorney Tim Cruz he's going to be doing that program not me so that would be his
whole program with the girls from the Plymouth County district attorney too and it's going to be uh the Comfort dogs uh Tim Cruz is the originator of the Comfort dog origination uh of
Plymouth County so uh he said he'd be glad to uh give us the whole story of how it started and who's involved with it so Tim Cruz will be uh doing that program and at the meeting the next meeting will
be uh June and July which I'm working on people for that uh so I next me next meeting we have I can let you know who will be the June and July speakers uh today we're going to have
the SMP to speak uh and the senior medic the senior Medicare program Pro protol I guess that's what they call it is pro pro is that the right definition
okay okay the this senior program uh projects uh and receive grants from ACL which he will explain that to to recruit and train retired professionals and other adults and community members to
Pro prevent detect and Report Health Care fraud errors and abuse d these mnp team members participate in Outreach events to help educate Medicare and U
Medicaid so uh we'll introduce Dennis Dennis is here in Lorry so both of these people going to do the program and uh you can start right now and do your thing thank you very much um my name is
welcome Dennis and Lori Dennis and Lor [Music] [Applause] so my name is Dennis hoen Gasser I live in Taunton I've been a volunteer with the group called senior Medicare Patrol for about 7
years um my background I worked for the state for 33 years in training and staff development and when volunteer opportunities came up this seemed to be something I could probably do Lor's with me Lor's a staff member with uh senior Medicare Patrol up in
Lawrence we'll talk about a little about who we are and what we do as we go through the presentation how many people are on Medicare see my mother told me you should never ask anybody how old they are but now I got a general idea
here let me take out this CU we need this before I begin I have some questions I want to ask you first of all how many people have their Medicare card with them okay how many people have their social security card with them
okay um have you ever taken a look at your Medicare summary notice that you probably get every 3 months if you get them in paper or you get an explanation in Banner how many people take a look at those good um how many people have an
advantage plan people looking around what's an advantage well we'll talk about those too um have you ever had a tella Health visit with the doctor over the phone or in front of the computer with some kind of app good some people have some people
haven't um have you ever requested a new Medicare card prior to the new Medicare cards coming out about four years ago now what was your Medicare number Social Security number and that's
something you can't change unless you're probably in witness protection but you can't change that with the new Medicare cards now it's an alpha 11 character alpha numeric uh and if you think your card has been compromised and somebody's using your number there's a way of
requesting a new card now um how many people are caregivers some people have some people have been in the past um does anyone know anyone who's been a victim of
fraud anyone has has anyone been a victim of fraud me so we're going to talk about a couple things today who the senior Medicare Patrol is who we are and what we do the differences between fraud errors and abuse um how to protect detect and
report fraud errors and abuse I gave you something called a personal health care tracker and we're going to talk about what that is and why we think it's important to use in the benefits and then we'll talk about additional resources okay thank you so the senior Medicare Patrol Lor being a staff member
she is based out of Lawrence at AG span up there and we do a couple of things well actually um senior Medicare Patrol exists in all 50 states in the four territories again we're based up in Lawrence and we do take care of all in
Massachusetts we do a couple of things first of all we come out and do presentations like this to inform beneficiaries uh about their rights and responsibilities when it comes to Medicare we also do claims resolution if you have a problem with a bill that comes in and
you're not sure it's really yours or there might be something wrong with it a great place to start is to call Senior Medicare Patrol and I'll talk about the phone numbers in the back of the book a little bit later but ours is the first one there so if you have any problems you just don't understand a claim coming
in you're not sure if you should pay it or if it was denied we'll talk about that too but that senior Medicare Patrol can lead you through what what you what you should do next and we also do tabling events when if you have a health fair we will come in and do set up a
table and share information on on senior Medicare Patrol and on Medicare so what we do as a program we Empower and assist Medicare beneficiaries their family me family members caregivers to prevent detect and
report fraud errors and abuse and again we do we help claims resolution so what is Medicare fraud fraud is an intentional there is no mistake about it these are professional criminals or unscrupulous providers who
are billing Medicare for services that were never provided it's it's it's a crime and the Medicare budget is well over $600 billion a year it is a ton of
money 10% 60 billion goes to fraud and we are not talking about beneficiaries perpetrating the fraud we are the victims as well as the system we in fact are the first line of
defense to keep Medicare safe for ourselves going forward and people coming after us people who are turning 65 in the next next years coming ahead so fraud is always intentional there is no mistake as a matter of fact there was
an article in the Boston Globe last week this medical Pro Med durable medical equipment provider up in Stoten has been accused of builing Medicare for $30 billion and we'll talk about how why
these things happen as we go through so fraud is intentional no mistake about it they're ripping the system off errors and abuse are a little different errors occur are unintentional when you go to the doctor
now what do they if you're talking to the doctor what what are they doing all the time you're there well checking you of course but yeah on their computer click click click click click if they click the wrong thing they're clicking they may click a
wrong procedure code which now means Medicare is being built for a service that wasn't provided to you and the other thing is it be now becomes part of your electronic healthc care record you do not want bad information on your
record and your Healthcare record so they're unintentional they happen and they can be fixed by calling the provider and we'll talk about some of the ways to correct these things as we go through abuse isn't isn't really errors and it's not really fraud it's
sort of in that gray area they're pushing the envelope a little bit and it's involves wrongly or improperly performing tests and or procedures that are not consistent with sound medical physical or billing
practices it's not quite fraud and it's certainly not not errors but it's in between but it's something we need to watch out for and I've got some examples of that as we go through in either case it can result in payments for to Medicare for services
that that weren't provided or provided unnecessarily and it can also result in co-pays in deductibles that be that affects you directly too so what are the top fraud schemes out there for Medicare first of all billing for
services that were never provided couple years ago I did a presentation down in Dartmouth and we got talking about the explanation of benefits and one woman says oh yeah she says I got those she says I looked at they came in the mail I looked at mine looked at my husband's my
husband's look good my mine look good but I'm looking at my husband and says he was impatient in h in the hospital for 3 Days in Florida she says we've never been to Florida so what happened so either the
wrong number got put in there and it was buil to him or on on his health record or somebody got a hold of his his um number and is just buking the system it wasn't a mistake it was it was fraud it could be either or but it needs to be report reported and we'll talk about
that Home Health Care is another one has anyone ever had home health care okay some people have Home Health Care is another area where we see scams going on these can res these can happen
when your doctor prescribes 12 visits from home healthc care and after it's important if they build if they prescribe 12 you keep track of the 12 when they came and what they did and who came if all of a sudden
you're looking at your statement and it says 14 visits well they're billing for more services than than you were actually prescribed for you or they actually came to the house so we see people billing for more services than were actually um actually provided
x-rays wrong body parts or unnecessary x-rays we see that happening uh drug diversion or incorrect medication or the wrong amounts I have a friend when they get the pills from the pharmacy they take them out and count them to make sure we also see that um we know there's
an opioid crisis across the country this often times happen in skill skilled nursing facilities or rehab if you were in there and you you need pain meds usually an opioid and you're required to get four four doses a day how do you
know you're supposed to get four do you if I was there I wouldn't pick up the chart and start to read it I wouldn't know what I'm reading but if you what happens is that somebody is prescribed for and they're only getting two what's happening to the other two two
doses upcoding is another one upcoding is building for a higher service than what's actually performed one example if you go to the hos if you go to have an an MRI there's two types one with a die and one without what's more
expensive with the D so it's important to look at your medic care summary notice to make sure that you're you're only being built for a service that you received people will say well how do I know it was with a DI why because they're going to stick a needle in you to get the Dy into you that's why the
other thing about upcoding this was an article I read in the I'm I'm from Western Mass originally from years ago and so I keep track of the Greenfield Recorder Gazette newspaper and there was an article the other day that said that Regal care
which operates Skilled Nursing Facility and rehab facilities in Massachusetts and Connecticut 19 of them they are being investigated for billing 3.8 million for higher Services than were actually
needed or or even being provided for in a skilled nursing or rehab facility so it's important that we we always are aware of this kind of stuff unbundling this happens with labs when you go to a lab and this this is for anybody doesn't
make make any difference if you're on Medicare or not if when you go to a lab and they run a panel they blood test they run a panel and the panel checks for what five or six things your cholesterol your blood sugar uh kidney function liver function and two others
whatever they are so they build as a panel it's one entity one charge when they unbundle they charge for the sugar separately the cholesterol separately the liver function separ and added together it becomes a whole
bunch more than just the cost of a panel identity theft and medical identity theft if you have a problem with your credit card and you see some a charge on that that isn't yours what do you do call you call the credit card
company and what do they do they take it off usually they take it off we'll do the research and we'll take care of it nothing nothing happens I mean nothing happens to you medical identity theft is a little different if
somebody gets a hold of your Medicare number and starts to build Medicare for services you didn't receive two things happen one it becomes part of your health care record which shouldn't be there and number two if there's co-pays or deductibles guess
who's responsible for those you are you can't call Medicare and say geez someone got a hold of my number can you take it no it doesn't work quite that way it isn't quite as easy as dealing with a me with a credit card um some ceing credit
card number in Billing so be very careful about medical identity theft that's why we're going to keep we're going to talk about our Medicare cards in a minute false front front providers this is can happen in a couple of ways you have this pain or problem you I
going wonder what this is so now the internet is available to everybody and you go on to WebMD or Google and you Google your symptoms and Bingo and up comes a list of all the things you can do often times in these there's probably a link a link to somebody who can help
you and before you know it you're clicking on a link and you're giving personal information out either personal or your Medicare number so be careful about Googling anything when you're doing searches for trust your your
Physicians so Googling is one the other one is false front provider is getting a call getting a call and saying we can help you out with your problem we know that you have I mean how many people have how many people are diabetic across
this country you get a a call out of the blue about oh we can help you with your diabetic supplies we' like to all think we're special but we're not so special people are beating a path to our door to give us all kinds of free stuff they just aren't so be careful when you get a
phone call the other thing is when you get a phone call and you don't know who it's from what should you do not answer because think about is is you're growing up as they're all growing up as kids when you left the house what' your parents say don't talk
to who's at the end of the phone yeah the other thing is getting emails or text messages saying that there's a quote problem with your Medicare with your Medicare card or your account all you need to do is click on
this link you should never do that so they're they're they're coming at us these false front providers at a number of different different ways durable medical equipment you probably think that this box right here has a whole bunch of free gifts for everybody in the
group The only free gifts you're getting are coffee and donuts over here um let me put this in my pocket let me put it over here cuz I don't want to click it durable medical equipment this box I picked up in
Mansfield a woman in Mansfield brought this into the senior center and said I got this in the mail I never ordered it she says would you think anybody here could use it one leg brace two leg braces a couple
arm splints and a back brace it all came to her she never ordered it Medicare was buil over $3,000 for this so somebody got a hold of her
number and started to build Medicare I mean you can't bring this to the senior center and say does anyone need it these devices have to be prescribed by a doctor one leg braces not the same as the other no different problems require different braces so you need to be careful with your medic
number so that nobody gets a hold of it and starts building Medicare I did a presentation in Taunton just before Thanksgiving and we got talking about this and one per two people said to me she oh yeah I checked my medicare summary notice and we had I was buildt
for three well Medicare was buil for $3,000 for catheter supplies I don't need catheters and two people got there and another guy said same thing he just got out of the hospital several weeks before
and he had some kind of um knee surgery and what came in the what came in the mail boxes of braces and when these boxes of braces are sent they're not sent as a brace like you see here they're what we call mummy kits you put them on all your all your parts and you
look like a mummy walking around be careful let me get my clicker again and the other one is scams for genetic testing the only one that can Pres describe a genetic test is your physician and they don't do it on a regular basis you can't go to a
health fair and have a table set up and someone saying oh do you have a problem with and fill in the blank well we can have a you can get a genetic test and Medicare will pay for it just fill out this information first of all you're giving personal information out to someone you really don't know the fact
is you're never going to get a test kit but what they have now is what your Medicare number like I said durable and medical equipment this is one of the biggest ripoffs we see whether it be braces with oxygen catheters what else are we seeing
up at um up that Carol works on mostly the jic equipment the bracelets and C are huge and it's thousands of dollars they build for these we have a quick Story Rita Vines is a was a she lived up in up in havil
she had a 10-year-old scooter here cuz she was diabetic and she really couldn't get around the seat was torn but she needed a new battery and she knew that Medicare would pay for a new battery before she could call Medicare her friend from upstairs from downstairs
comes up read a look at this brochure I got in the mail you could get a brand new scooter chair and Medicare is going to pay for it this sounded like a good deal to Rita so she ordered it and it came they upsold her to the Rolls-Royce version it was too big to get
comfortably down her corridors she bumped into some door casing she broke some toes this was not working so she called the the the the provider and said I need to get another one reluctantly they took it back and they gave her another one this one she could not get
from the scooter to her bed or scooter to her easy chair very well this was not working so she threw up her hands she called Medicare and they wouldn't take it back so she called Medicare and she said you know I I need a new battery for my chair they said ma'am we just bought
you a $4,000 new scooter chair we're not going to do a battery and it took the folks you call Senior Medicare Patrol and it took the folks at senior Medicare Patrol about 8 months to work through the process and the people that help do claims resolution and people have health insurance backgrounds and some medical
background on her own I don't think Rita would have been able to solve the problem on her own we use this graphic because Medicare can be a puzzle there is two types of Medicare traditional Medicare or sometimes called original
Medicare and something call Medicare Advantage plans about 50% of all beneficiaries are on traditional Medicare that's what I chose and the other 50% are in Advantage
Plans I can't tell you which is better for you I know who can give you information to help you make an informed decision does anyone know who that might be sh shine exactly the shine counselor right here in Halifax they they can tell you what the options are they'll never
tell you what to do but they're going to give you all the options so you can make an informed decision so traditional Medicare A is called a which people say well we get it for free no we don't get it for free we paid for it all of our working lives so we don't pay for it now
so part A Part B people pay if they opt for Part B they can it's it's about 180 something dollars a month now and then Part D which is the prescription drug plan which is Private health insurance so Federal Federal private and then we have the advantage
plan which is all Private health insurance as with all Private health insurance their MO one of their biggest concerns is for their investors how do they make money and that's what they that's what their job is to make money to keep people healthy but to make
money that is not what this does the only problem I have with the Advantage Plans is their marketing you've seen it on TV the woman comes into the doctor's office and said oh I'm here for my annual checkup and I'm on Medicare now
oh let me see your card she says oh I see you have traditional part A in Part B but you don't have part C at which point I just want to scream no part C is not an add-on you have this or you have
this but you cannot have both and it just just sends me right over the edge it's I think it's unfair marketing you don't get part C automatically no you don't get Part B automatically you have to have to apply for Part B so the their marketing really
kind of sends me a little bit crazy you could tell so let's look at let's let's do some care comparison so we have original Medicare here and we had Advantage Plans Here original Medicare um it's it does have
higher monthly premiums as opposed to um Medicare Advantage plans which have lower premiums so some of it is cost related but also with lower premiums they share the cost with you sometimes it's higher higher deductibles higher
co-pays and higher co- insurance so there's there's trade-offs for both of those um as a original Medicare uh beneficiary I don't need to get a get a a referral to go to a specialist you do though under
under Medicare Advantage plans and you have to wait for them to decide if it's going to be okay um uh the other thing is I can go to any provider anywhere across this country to get if as long as they accept Medicare I can go to any provider
anywhere under a Medicare Advantage plan you're restricted if it's an HMO you can only go to when they listen listen to their ads call to see what's available in your area or your ZIP code which means you if
you have a doctor in Boston and you're living down here and that's a cardiologist you see on a regular basis you'd want to make sure that that cardiologist is part of this whatever whichever Advantage plan you're going with cuz you were restricted the other
thing is there are some Advantage Plans that that will that will be that you can go to doctors with out outside your area they're not as not as common as as the ones where you are restricted for instance if you were a snowbird going to Florida
and all your doctor you have a Advantage plan and all your doctors are up here and you get sick down there guess who pays the bill down there you do unless it's coded as an emergency and then they will pay everything to get you out of that emergency situation going forward
after that it's it's up to you um so I talked about referrals um non um Medicare services and skilled nursing facilities are are may not be covered under traditional Medicare and
they may be may be included in some we also we also hear with the Advantage Plans dental vision and hearing um so that's one benefit that they have and like I said covered anywhere versus um
coverage only in your area so part A under Medicare pays for inpatient Hospital skilled nursing facilities Hospice Care um home health care for the homebound beneficiary so you have to be
Homebound and it pays pretty much 100% Part B and that's where most of the charges on a regular basis come under Part B pays for doctors Outpatient Care Home Health Care Physicians uh uh Physical Therapy occupational therapy and this whole thing called durable
medical equipment braces crutches everything but it only pays how much 80% so if the bill is $1,000 Medicare is going to pay $800 you're going to pay two uh part and then you need also Part
D for a um prescription drug plant this is private it's offered by lots of different companies but you need three and what happens with pirate B A friend of mine uh gets most of his um care through the
VA and applied for Medicare termin 65 but didn't well you I get most of my stuff at the VA so I'm not going to apply for Part B couple years afterwards you know if we're traveling around and there's not a VA facility
nearby and I need care I probably should have Part B so bought Part B 3 years afterwards if you wait if you delay your purchase of Part B you start paying a premium every month so he
is not paying $183 he's paying $24 every month forever the same thing happens with prescription drugs if you choose well you know person say well I'm not in I'm in Medicare now but you know I don't take any any drugs fine if you want to
delay purchasing it if you wait the longer you wait the long the larger the penalty is it once you finally decide oh God now look at these the prescription drugs I need and then as I said so we have ab
and then we have C remember you notice how none of these C is not attached to anything because C is separate it is a complete it's Private health insurance so what as beneficiaries there's three things we can do we can
protect we can detect and we can report to protect we need to protect our Medicare cards I asked how many people have their Medicare card with them you should not carry it on a regular basis there is no need to if someone gets if
you lose your wallet and someone gets a hold of that they can start stealing your medical identity you should only carry it when you go to the a doctor specifically a new doctor I get their notifications all the time saying um your appointment is
scheduled for next week make sure you bring all your medical cards with you I don't because this is a doctor I see on a regular basis with the first time you go to a doctor what do they they want two pieces of information what are
they Health Care cards and photo ID to make sure that face goes with that name and that card and what do they do with it they scan it in so that when you check in they call up your name and there's your picture there's your all your
health insurance so you do not need to carry it on a regular basis social security cards you should lock that away and never take them out there is absolutely no reason that is a cart blanch to any any scammer not just
Medicare but any scammer you should never ever carry your Medicare uh your social security card with you and of course we're safe with our credit cards as I mentioned before don't talk to strangers and that's who at the end
of these phone calls and be careful of postcards you get in the mail um deceptive tv ads phone calls and question questionable surveys every six months I get this large envelope in the mail and it says something about
Medicare and Survey it's not coming from Medicare Medicare doesn't do that they want you to answer a whole bunch of questions I have no idea who these people are I have no idea where this information is going so do not complete
surveys when something that you have no idea it sounds like it's Medicare It Isn't So how do you currently keep track of all your medical appointments and your prescriptions and those types of things calar
calendar and anything else does anyone use a portal okay some people use a portal there's a couple things I gave you something called a healthc care tracker and let me take a look at that for let's all take a look at that for a
minute we think this is a neat tool for a couple reasons first of all when you go before you go to the I can't tell you how many times I've been to the before using this went to the doctor and left saying oh God I wish I had
asked fill in the blank or leaving the doctor saying did they say this or did they say that and it requires either another call back and waiting and waiting so this is one place you can keep all information for instance there's um a section where section where
you can write your appointment lists the doctor that you saw the date that you saw them what you saw them four in a place that you can put in all the questions before you get there and also space there that you can write the
responses what did the doctors say yeah sometimes they they give you a print out at the end but that doesn't sometimes answer the questions that you have right on right on your tip of your tongue so it's a great way of keeping all this in
keeping that each visit in one place the other thing is when you get your Medicare summary notice I mean I can't remember what I had for breakfast except when somebody brought in Donuts this morning but I can't remember what I had for breakfast I'm not going to remember
what happened two months ago or three months ago at the doctor unless I have it written down somewhere and can compare it to my medicare summary notice so it's a great place to keep all that information in one place you can also put in all your medications here any
care plan you have on a regular basis if you're a diabetic and need insulin that should be in here if you had a pacemaker that should be in here so all your information is in one place if you would take a look for a minute at page
10 I think that's the next slide here yes before you had this this isn't just for Medicare beneficiaries this is for anybody who's going to see a doctor anybody um here are 10 qu five questions that
you should ask before you have any test treatment or procedure first of all do I really need this tester procedure we make the Assumption well if I didn't need it they wouldn't prescribe it ask them they doctors like to have engaged
healthc care consumers asked these questions why do I you know do I really need this what's it going to show number two what are the risks or the side effects what are the risk and side effects of having any tester procedure
we assume that everything they tell us that they're going to do is going to be safe there's often times side effects are there simpler and safer options so what are my [Music] choices what happens if I don't do
anything or if I do if I do nothing if I don't do anything that happened to me God my ankle did it hurt oh for weeks it hurt to the point where it started to limp a little bit so I figured I'd go to the Bone guy and he looked it over and felt it around well we can do a couple things
he says I can give you a shot that that clears it up he says uh we can take some x-rays or my eyes and see if see what's going on or we can do nothing what did I choose I didn't do anything and within 4 weeks I was back I
don't know what the problem was but it cleared it up I didn't opt I did not opt for some kind of intervention and the last one is how much did it cost and will my insurance pay for it the doctor may not know but the front
desk will another story from me my GP was on maternity leave I went in for my annual checkup and the nurse practitioners looking over everything go she says you're du for a pneumonia shot
she's looking she's looking at my records you need a pneumonia shot stick it in and they did she did and 4 weeks later I get a bill for $475 so I worked with the doctor's office they they resubmitted it worked
for the group insurance commission and Medicare come to find out did you know that you were only allowed so many Pneumonia shots in a given period of time one or two things happened either she read my chart wrong or when they put my they converted my paper paper charts into Electronics something got in there
wrong so I argued the point with them they admitted it was their mistake and they dropped the charges but you need to if you don't think these charges are yours you need to fight them so to detect we you should take this every time you go to the doctor
write down the questions write down the answers keep keep all your medical information in one place carry it with you when you travel especially if you're going to be away from home I think that they just left us and they think that's where they're going I don't know where
but um you should take this and compare whatever all your doctor's appointments that you write in here with your Medicare summary notice or explanation of benefits so you're not being buil or Medicare is not being built and you're not having stuff on your medic um in
your health record that isn't for you and they say we should keep our statements for 3 years if you have a problem it can take a long time to resolve it now one of the things when I was
younger much younger an older friend of mine would say I keep on getting these things I don't understand these it says it's not a bill why should I be concerned well they should be concerned for a couple reasons so this is the this is and if you see a doctor lots of times
within a 3-month period period you can get a stack of papers in the mail all these claims um but if you break them up by visit they're not that complicated first of all you want to make sure that this is your name and your address and that is your Medicare number
that's all you need to look on this page the second page is looking at the exact claim let's blow that up okay so here's this actually is mine back almost a little over two years ago I had cataract surgery in January here
February here and then the third month I went in and they took a picture of my eyes to see how everything looks ah you got some fluid in the back of that eye they said we need to take care of that how well we could give you pills or we could give you injections into your
eye what did I say pills I said pills but she convinced me that the best way was to do injections and it's not that big of a deal they numb it up so you can't feel anything so this is this is one of the claims that came in when you look at these forms you want to look at the date is
this the date that you saw the doctor is this the the doctor or or uh um provider that you saw I Health Associates I saw Dr Alise Richards and I had an injection the
injection is here the first thing you want to look at is was the service approved that's critical if it saids says no Then you may be on the hook for it and we'll talk about how you can how you can uh um dispute that but was it first of all was it approved in this
case the shot and her service was this you don't even need to look at this column it doesn't make any difference how much did they charge it doesn't matter these are negotiated costs they know exactly what they're going to get paid this is what you would
pay if you didn't have health insurance in this case that medic a for one shot was $651 I almost fell off my chair when I saw that of which Medicare only approved 2165 that didn't come as a surprise she
knew what she was going to get Medicare only paid out of the 2165 159 which is about 80% because it's a Part B service which left me paying
$625 for each of those shots I've had six of them but I also have purchased when I work when I worked for the state when I retired I got part A and Part B and I bought a Medicare
supplement or some their supplements or sometimes they're called a metag gap policy they're not that cheap but it's something I needed to do and because of that I didn't pay anything so when you look at these was it
approved ignore this how much did um Medicare uh amount approve how much did they pay and is there anything left for you to pay so there it's not all that complicated break bre the if you have a whole stack of these break them down
down by visit and take a look at those do you think are these what we need to save for three years do I need to save these for three years that's what they say I get mine electronically there's two ways of receiving your Medicare summary notices
um I have a my my medicare account so I get them every single month electronically so I don't need to save paper um if you you don't have one if you don't have a my medicare and you don't get your your um your um explanation of benefits um or Medicare
summary notices monthly then you get them every three months and that that can be a lot of paper sometime so and consider what part B Covers Part most of what we receive is Part B doctor's visits and lab tests and those
things even a friend of mine is going for to have his gallbladder removed it's Day Surgery outpatient outpatient is Part B so it's amazing how much stuff is under Part
B I mentioned if you if Medicare said they are not paying for it then you have a right to appeal you have 120 days to appeal the fact that they denied the claim if you're not sure of how to do this call a senior Medicare
Patrol we can help you work through the process so folks who are on an advantaged plan don't get this thing called a Medicare summary notice M MSN what they do get is an explanation of benefits and it what could be Etna Blue Cross Signa humanit United Health
there's a whole bunch out there remember just because you have an advantage plan say with Blue Cross and you have an advantage plan with United Health doesn't mean they cover the same thing not all Advantage plans are the same they differ they're all negotiated
separately so if you're going to get an advantage plan you need to do your research exactly what is covered which which medications are covered because some of them have restrictions as to which prescription drugs they will cover so it's important to be informed
and do do your research and some folks will say well maybe uh you know this part this traditional Medicare is it's getting kind of expensive maybe I'll look at a um Advantage plan great look at the advantage plan but do your research to know what is covered and what isn't
covered so report if you think there's a problem report it call the senior Medicare Patrol I mentioned Home Health Care I've done so many of these presentations and I hear often times oh yeah I had home healthare but after the
second visit the the service was terrible I didn't want them back in my house so what do you do well you need to report it and this is one group you can report it to it's in the oh let me go back to this booklet for a
minute take a look at the very last Pages the last last two pages there are phone numbers if you have any problem of course senior Medicare Patrol is a great place to start but there are numbers for everybody that you would ever need to
contact relative to um having a problem with Medicare from Elder services to Medicare 1800 Medicare um but there's one over on this page here um second from the bottom First Column and it's
called keypr but they change their names they're not call not called as Centra phone same phone number if you think you have received poor service from say um home healthcare reported the chances are if you're getting poor service you're
not the only one this could be a pattern if you also have been if you think you were you were discharged from a hospital or Skilled Nursing Facility too soon um you want to let let somebody know and you can call this number they report all
this stuff to the office of the Inspector General I don't know if they exist anymore they may have been cut with this L latest latest round of whatever but you need to call this number to have it reported because if if
people don't report then nobody knows uh so the steps that we can do to report it one call the provider like I did with the uh with my pneumonia shot call one at 800 Medicare you can call the senior Medicare
Patrol um again all these numbers you don't need to write down because they're all in the book um so why don't people report why don't people report that they've been that they there's Fraud and Abuse going on first of all it's not impacting their pocket book well there was no co-pay no
deductible so I'm not going to let it ride it's important that you tell somebody because you are not the only person probably experiencing this and out of Po out of pocketbook your health care premiums for an advantage plan or with um uh Part B will go up I
don't want to bother the doctor do what I did bother the doctor uh you find the MSN or EOB kind of confusing I hope that little demonstration clears it up a little bit um you're part of a minority Community Based on R race ethnicity
religion country of origin sexual orientation and language and you're just uncomfortable asking for help some some some cultures people just don't ask for help or they they're uncomfortable asking for help sometimes they don't even know what questions to
ask and you probably think again I'm the only one having this problem no chances are that's not happening so trust your gut if something doesn't feel right it probably isn't I use I do a lot
of work with AARP and and we have two things if it sounds too good to be true it is if it sounds too bad to be true it probably is I'm sorry we're going to cut off your Medicare because you didn't fill out
certain forms I'm sorry you didn't fill out the survey your your your Medicare benefits are going to be terminated if it sounds too bad to be true it probably is seniors are great at this oh I got the bill I better pay it right away get the check in the mail if you're not a
th% sure that it is your responsibility don't pay it will you get the money back if you paid an eror eventually but it's going to take some time so in wrapping up a couple things don't carry a Medicare card with you don't provide your Medicare number over
the phone or to anyone you do not know and trust keep a record of all Medicare Medicare events review your MSN or eobs to make sure that all the stuff there is correct and that there's no bogus information on
your health care record and take action if something is wrong and there's our number that's all on the thing did anyone notice all these slides what's on the left side of that the picture on the left side of all these slides the key because as
beneficiaries we hold the key to keeping Medicare safe moving forward for ourselves and for our kids coming along questions if everybody uh if anyone wants to ask questions uh I have the microphone here and according to uh the
cameras they may not hear if you do it by yourself so if you have questions uh I'll bring the mic over to you you mentioned about not bringing your cards to the doctor's office but even doctors I've seen repeatedly still
ask for them do you just tell them no I'm not sure why they're asking if they have them already I would know what I would do oh don't you have that scanned in yet ask them um I've never been asked to a doctor I see on a repeated visit um to
ever but like last week and they said they up oh right they may be updating their records sure so if you're going to the doctor but you shouldn't carry them on a regular basis if you're going to the doctor you know one of the things I hear people say to me yeah but what if I'm out and I'm in an accident and they
bring me to the hospital and I don't have my cards with me what's going to happen I don't know you're going to die probably no of course not their what is their F primary concern to to address address the emergency and get you stable
their first concern isn't where are your medic care cards as a matter of fact any hospital or larger facilities and sometimes doctor's offices if you were to give them your social security number guess what they could look up your Medicare number so I understand that yes if
they're updating their records and sometimes they change from one building system to another and they may want to scan them in again yeah so yeah but so if you're going to a doctor bring them but on a regular basis you should not carry them but thank you for that question has happen even when they Haven
set them up yeah so so when you go to the doctor bring them but you shouldn't carry them as a regular and when you go there if you don't have them they're not going to deny you they won't throw me H they won't throw me out no they won't throw no no no they usually say bring
them next time you come in any other questions did I saw that oh the the ambulances oh God ambulances years ago yes ambulances an ambulance transport if
you go to a go to have blood work done and they run a panel you can go anywhere across this country across the state here and it's always the same ambulances aren't the same every transport is almost an entity unto
itself um depending on who the provider is is it is it local is say a town ambulance versus uh something someone they contract with I did a presentation in um New Bedford this woman says oh yeah she says I have an advantage plan
and I needed an ambulance they came to the house put me on the stretcher took me out and before they put me in the ambulance the EMT said we need a three $300 copay first before we take you you are putting me in that ambulance
now she said um it's important especially if you to do to do some research it God forbid we need an ambulance and when we need an ambulance how we're going to pay for it usually isn't our biggest concern at that
point um but be care be aware that ambulance transports can be can be build differently um as a matter of fact this uh pamphlet was put together by S&P and up in Mass up in Lawrence and
I was in the in the task force that helped work on that and Dennis Cataldo was part of that Dennis catalo is the president of the Massachusetts uh Ambulance Association and also owns cldo ambulance and some of the stories he was telling us of horror shows with
ambulance transports it can be you know thousands of dollars to go three miles um it really is important that we ask questions um again if if you need an ambulance right now that that isn't probably right in the top of your head about you know
is going to pay for we just assume it's going to pay um but just don't pay the bill cart blanch and do your research before you pay the bill yeah ambulances are are a it's a big topic it's a big topic yes it's so because of the diversity of how it pays
you know exactly yes I remember we we were doing that research oh I know I no I remember cuz I remember Dennis Dennis has been doing this for a long time and I am so appreciative that you were able to come out today and and do
this um but I started back off in the uh shine World um back in 2000 when I should give you a hug for being I didn't pretend I just thought it would be fun um and it was and it was a great opportunity to meet the senior Medicare
Patrol people at that time they were separate from the age wave or the um age span and now they've expanded so it means that it's such an important part of our our lives and as we age we're aging community no matter what um it's
so important to understand all aspects of what we're going to encounter at some point some of us are already there and in the midst of it but it um October um 15 to December 7th you know that's the opening Roman period so sometimes it's
good to store all this information uh either in a file or up here um but to remember that that time comes and you can change but you have to adapt to what's going on in your life at the time so whatever fits yesterday may not fit today so it's always good to change and
even especially with the um medications situations today every Pharmacy that the I can go into a long story on that that's another topic but the um uh benefit um managers actually they don't always pass that dis discount off to the
consumer and we end up paying for that so we're hoping that that sometimes in the future we'll be able to change some of these uh things that are happening to us as consumers um and I'm hoping that especially with medications today you know when a drug uh for especially for
diabetes um and it's very expensive for people that do have diabetes and trying to control that with uh you know the various um uh medications out there so we're hoping that we can work in it you guys doing a wonderful job Lua um she's
amazing woman and um lucilia I call um but she Portuguese so um but anyway she's been a wonderful asset to us and uh shine program of course and uh I thank you yeah thank
you any more questions I think the coffee is over there now right okay Dennis thank you very much [Applause]
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