Medicare Health Plan Options

The U.S. Congress passed a law in 1997 called the Balance Budget Act. This law included a section called Medicare + Choice, which provided new types of Medicare health plan options. Some of these options may be available in your area. Under the Medicare Modernization Act of 2003, Medicare + Choice was given a new name, Medicare Advantage. You are still assured all of the same Medicare coverage you now have. There are several resources available to get Medicare information. Some of these resources are listed below:

1-800-MEDICARE

Established by the Centers for Medicare and Medicaid Services (CMS), the Medicare Advantage toll-free telephone line is now available throughout the United States.

This nationwide phone line gives Medicare beneficiaries across the country one more tool to get help with their questions about Medicare and their Medicare health plan options.

Callers to 1-800-MEDICARE (1-800-633-4227) can talk to a customer service representative in English or Spanish 24 hours a day, 7 days a week to get:

• Medicare-Approved drug discount card information
• general information about Medicare
• general information about Medicare health plan options in their community, including original fee-for-service Medicare and, where available, managed care;
• specific quality and satisfaction information about managed care plans
• general information about Medicare supplemental insurance (Medigap)
• telephone numbers for help with a variety of related issues, such as billing questions about Medicare claims or for help with more complex questions about health insurance.
• request Medicare Publications or audio tapes in English or Spanish,
• request updated information about health plans available in their area,
• request a new medicare card

Callers with access to a teletypewriter (TTY) or telecommunications device for the deaf TDD), can call 1-877-486-2048.

Pennsylvania callers with specific claim or coverage issue questions for:

• Highmark Medicare Services (Part A hospital, skilled nursing facility & hospital outpatient claims; Part B doctor services, lab, x-ray, etc.)
• National Heritage Insurance Co. (Part B wheelchairs, walkers, diabetic supplies, etc.)

Call 1-800-MEDICARE Monday-Friday 9:00 am to 4:30 pm and speak the option for billing information. When asked, you can then speak the appropriate option for the contractor you wish to contact, for example:

WWW.MEDICARE.GOV

WWW.MEDICARE.GOV - The official U.S. Government site for Medicare information established by the Centers for Medicare and Medicaid Services. This site has useful information for Medicare beneficiaries and those involved in helping them with their health care decisions. The main topics are:

• What is Medicare? : Medicare information, including eligibility and enrollment, and how to read a Medicare Summary Notice.
• Medicare Personal Plan Finder: Medicare health plan options, Medigap options and educational materials. (Visitors can access "Medicare Compare" from this page to get information about health plans in their area.)
• Who to Contact: information by State on the organizations that can help answer Medicare related questions.
• Publications: Medicare publications in English and Spanish available to view, download, and print.
• Wellness: information on Medicare prevention benefits to help keep you healthy, and facts about health issues such as peptic ulcers, and pneumonia.
• Fraud and Abuse: how to identify and avoid common abuses of Medicare
• Nursing Homes: payment, patient rights, and nursing home survey results.
• Prescription Drugs and Other Assistance Programs: Identify programs that may assist with your prescription drugs and other health care costs.

Medicare & You 2006

The Centers for Medicare and Medicaid Services (CMS) have published the "Medicare & You" handbook. This book provides basic information that is accurate to Medicare beneficiaries in an easy to read format with clear referrals for more detailed information using English, Spanish, audiotapes and Braille. The handbook has been mailed to all current Medicare beneficiaries.

Medicare & You 2006 is CMS’s primary Medicare publication. The Balanced Budget Act of 1997 mandates that general and plan comparison information be mailed to all current Medicare beneficiaries by October 15 of each year, beginning in 1999.

The Medicare & You 2006 Handbook is now available online in PDF format.