Senior Medicare Patrol Newsletter, May 2014

May, 2014 Monthly News You Can Use

Medicare’s Durable Medical Equipment Benefits

            People on Medicare can help save the Medicare program from fraud and wasted benefits if they understand what the program covers.  As our life expectancy keeps increasing, it’s likely that some time in our lives we’ll need some medical equipment in our home.  “Durable medical equipment” means

  • Reusable equipment to help a medical condition;
  • Equipment likely to last three years or more;
  • Designed for use in your home and some types might be carried with you away from home;
  • Common examples are walkers, wheelchairs, oxygen, diabetes testing equipment, and CPAP;
  • A doctor’s prescription is required, usually written after an office visit. 

      If you are on original Medicare, usually your doctor’s office can explain the Medicare coverage rules to you, or you can call 1-800-Medicare for an explanation.  If you are in a Medicare Advantage plan, you must check with your plan to find out the coverage rules before you arrange to purchase the equipment.

       How could problems with Medicare fraud and errors or financial scams be connected with medical equipment?   Here are some real life examples:

  • A person on the phone pretends to be a salesperson from a medical equipment company and convinces you to give your Medicare number and credit card or bank account information.  What’s wrong? This is a financial scam.
  • A person on the phone or at your door represents a medical equipment company, asks if you have diabetes or pack pain and offers to arrange with your doctor for “free” equipment for you.  They take your Medicare number and doctor’s name from you.  What’s wrong? You don’t know if the company is approved by Medicare.  Medical equipment companies who cold call people who aren’t already their customers are breaking rules.  You and your doctor need to talk first, before any arrangements are made with an equipment company.
  • When you read your Medicare Summary Notice that shows Medicare paid for your medical equipment, be sure the description on the notice matches what you actually received.  A company could make a mistake or abuse Medicare by billing for a more expensive item than what they gave you. 

If you have a concern or problem with anything like this, contact Iowa Senior Medicare Patrol for information and assistance.  You can talk to a “live”  person here in Iowa at 1-800-423-2449.   

Everyone Agrees – Choosing Medicare Plans Can be Confusing!  What to Do…….

            A recent survey confirms what we all know – choosing a Medicare Prescription Drug Plan or an alternative to original Medicare within the Medicare Advantage plans --  is difficult and confusing.  The Kaiser Family Foundation, a respected organization which analyzes health care issues, recently published their report, “How are Seniors Choosing and Changing Health Insurance Plans?”  Some of the key findings were:

  • People used many factors to make a plan choice when they first enrolled in Medicare.
  • Many people said they didn’t want to change their plan in subsequent years because the process of choosing a plan is so frustrating.
  • It is difficult to compare plans because so much information comes in the mail and through media it is hard to sort through.  Many people didn’t find the information on the Medicare website to be as helpful as they’d like.

There is a way to overcome this!  Use the services of Iowa’s Senior Health Information Program, known as SHIIP.  It is a free, confidential service of the State of Iowa that helps Iowans make informed decisions about Medicare and other health coverage.  SHIIP offers confidential, one-on-one counseling throughout Iowa from trained volunteers who have been in your shoes.  Call them at 1-800-351-4664 or visit their website at   Many Iowans need to get ready for the open enrollment for Medicare plans that will start this fall – a few short months away. 

  • News prepared by Deb Yankey, Iowa Senior Medicare Patrol Coordinator, Northeast Iowa Area Agency on Aging (NEI3A), Waterloo, IA,

This document was supported, in part, by Grant #90MP0161-02, from the Administration for Community Living/Administration on Aging, Department of Health and Human Services.  Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions.  Points of view or opinions do not, therefore, necessarily represent official Administration on Aging policy.      


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