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Information on Medicare Health Coverage and Veterans' Health Insurance Benefits

Appendix B: Sources of Information and Advice on Specific Health Insurance Problems Page 6

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Medicare

The following booklets are available from the Medicare Rights Center

  • "How To Avoid Overpaying Your Doctor under Medicare: Part B" and "Your Doctor's Bills" (an explanation of the rules regarding assignment, limiting charges, and other related issues);
  • "How to Receive Medicare Home Benefits" (a discussion of the rules relating to Medicare coverage for home care);
  • "Medicare and Employer Health Insurance: How They Work Together" (a discussion of the question of how to determine whether Medicare is primary or secondary in situations in which a Medicare beneficiary's spouse is covered by an employer-sponsored group health insurance plan);
  • "Medicare Basics - Your Medicare Health Insurance Options" (an overview of the Medicare system);
  • "Medicare HMOs" (a discussion of issues related to the question of whether to join a Medicare HMO or to continue with the traditional Medicare plan);
  • "Medicare Supplemental Insurance" (an outline of the standardized Medigap plans and a discussion of related issues);
  • "Your Appeal Rights Under Medicare: Part B" (an explanation of the Medicare appeals system in regard to out patient claims);
  • "QMB and SLMB: Programs for Low-Income Beneficiaries" (an explanation of the federal Qualified Medicare Beneficiary program and the Selected Low-Income Medicare Beneficiary program).

The Medicare Survival Kit includes all of these booklets, as well as additional information on Medicare and Medigap policies. Other booklets are published from time to time. For a list of current prices and for further information, write to Medicare Rights Center, 1460 Broadway, 8th Floor, New York, NY 10036 (A John Miller), or call 1-212-869-3850.

The following booklets are available from the United Seniors Health Cooperative

  • "Medicare HMOs: Some Tips for Consumers" (a review of rules related to Medicare HMOs);
  • "Medicare, Medigap, and Managed Care: Consumer Update" (an overview of Medicare, Medigap, and managed care programs);
  • "Managing Your Health Care Finances: Getting the Most Out of Medicare and Medigap Insurance" (a review of current rules for Medicare and Medigap policies);
  • United Seniors Health Repod Newsletter, published five times a year (reviews recent changes in Medicare and Medicare-related programs).

Other booklets are published from time to time. For current prices and information, write to United Seniors Health Cooperative, 1331 H St. NW, #500, Washington, DC 20005-4706 (Telephone: 1-202-393-6222; Fax: 1-202-783-0588).

The Medicare Handbook, which lists many of the current Medicare rules, is available from your local Social Security Office.

The following organizations and agencies offer help with specific problems related to Medicare and Medigap policies

  • Medicare Inspector-General (issues related to Medicare fraud; to report possible Medicare fraud call or write Health and Human Services, Office of the Inspector-General, P.O. Box 17303, Baltimore, MD 21203-7303; Telephone: 1-800-368-5779);
  • Medicare Rights Center (Telephone: 1-212-869-3850);
  • State-sponsored counseling programs, operated by trained volunteers (the programs have different official names in each of the states, but are generally supervised by the state Department of Insurance or the Division on Aging);
  • United Seniors Health Cooperative (Telephone: 1-202-393- 6222; Fax: 1-202-783-0588).

In addition, if you have access to a computer you can find a variety of information on Medicare deductibles, co-insurance, and related issues on Medicare's home page. The address is http://www.hcfa.gov/.

Veterans' Benefits

For information on veterans' benefits related to home health care, coverage for prescription medications, or long-term care, call your local Veterans' Administration office, or call the Paralyzed Veterans' of America at 1-202-872-1300 (in the New York area, call the Eastern Paralyzed Veterans' Association at 1-718-803-EPVA).

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