Tag Archives: healthcare

Happy Medicare New Year

Steps to a Happy “Medicare” New Year

Winter preparations are done. Winter festivals have ended, and end-of-year holiday celebrations are over. Just when you think you can sit back and relax, there is still one last item you may need to consider.

If you made any Medicare changes during the past Annual Enrollment Period (October 15 to December 7), there are some actions you can take that may help you have a happy Medicare new year.

If you enrolled in a new plan or your plan had changes during the Annual Enrollment Period, you should make sure you’ve received your new member ID card. This card contains the newest info for your 2019 care. Be sure to show your new ID card to the doctor’s office and pharmacist on your first visit of the new year so that they have your newest information on file. It’s also worth mentioning that with the new cards for the new year can come new deductibles (depending on the plan you choose), which start over at the beginning of the year.

If you decided to stay with Original Medicare, you’ll still use your Medicare card for hospital and doctor services. If you have not received the new Medicare card that the Centers for Medicare and Medicaid Services began issuing in April 2018, be on the lookout because they are all scheduled to be mailed by April 2019.

If you joined a Medicare prescription drug plan that works with Original Medicare, then the plan will mail you a card so you can fill your prescriptions. If you joined a Medicare Advantage plan (like an HMO, PPO, or POS), you’ll also get a new card to use for both healthcare visits (doctor and hospital) and for picking up your prescriptions.

If you need medical care or need to fill a prescription before you receive the ID card but after the effective coverage date, you may be able to use other proof of plan membership. Some examples are the welcome letter you got from the plan or even your enrollment confirmation number and the plan name and phone number.

If you elected to have your plan premium withheld from your Social Security check, don’t be alarmed if you don’t see it deducted right away. It may take up to 3 months from the time you made the premium withhold request before you start seeing your premium withheld from your Social Security payment.

The 2019 year is a great time to take advantage of your one-time “Welcome to Medicare” or annual wellness visit your plan offers to you. This benefit is usually no cost to you! It is designed as a preventive measure to help you take charge of your health, be advised of future needed preventive services, and establish a baseline for personalized care. And speaking of preventive measures, many Medicare Advantage plans come with a fitness benefit or provide access to physical fitness activities at no cost to you.

I wish you all a happy and healthy 2019!

Morgan Gunder is a community and broker liaison for Reid Health Alliance. Born in the South and raised in the Midwest, she is a wife and mother with a passion for traveling, learning, and technology.

In Case of Medical Emergency

Long View: What Is a Medical Emergency?

According to Medicare.gov, a medical emergency is a situation where “[Y]ou believe you have an injury or illness that requires immediate medical attention to prevent a disability or death.”

It seems pretty straightforward, so why are there so many questions around the decision to get treatment at your local emergency room?

An emergency room (ER) provides some of the most sophisticated diagnostic options in a hospital and the most immediate care to patients in crisis.

The list of possible emergencies is endless, so it’s important for you to recognize how serious your injury or illness is and to know the best way to get treatment for it.

Many of us have heard about folks with medical emergencies driving themselves to get treatment or catching a ride with a family member. Please don’t. Driving yourself puts you and others in jeopardy and delays the start of your treatment. Dialing 911 brings you the treatment quickly and gets you to an emergency room faster than a white-knuckle trip across town, dodging traffic lights.

Dr. Frank Friedman, one of our medical directors who specializes in emergency care, said, “A true emergency is one that can’t wait. It is something causing such severe pain or such a risk to life or limb, for oneself or a loved one, that it can’t wait hours, or a day or two, to be seen by one’s own doctor or healthcare provider.”

If it’s not an emergency but you need medical care to keep an illness or injury from getting worse, call your doctor. If your doctor can’t see you right away or the office is closed, urgent care (or convenient care) can help you get treatment quickly.

Over the years, I have heard some interesting and alarming questions from our members. This FAQ can help answer those questions.

Q. I just got one of your policies, and I’m having severe chest pain. Will you cover me for an ER visit?

A. This is one of the most unsettling questions we receive. If you’re experiencing severe chest pain, don’t call your plan, call 911. It’s as simple as that.

Q. Do I have to pay a copay when I get there?

A. No, they should be able to bill you, so there’s no reason to wave your credit card around as they wheel you through the front door. In fact, under federal law, an ER has to evaluate and stabilize you in an emergency medical situation, without regard for your ability to pay.

Q. What if I have special conditions they need to know about?

A. Keep a list of your medications with you. MedicAlert’s medical IDs or the Yellow Dot program can also help you share this information. And many smart phones have features that let you add emergency contacts and medical information. Plan ahead.

Q. What are some examples of when I should go to the ER and when I should go to my doctor or urgent care?

A. Visit the ER for emergencies like chest pain, broken bones, poisoning, shortness of breath, fainting, and seizures. For things like a constant fever, strep throat, sprains, the cold or flu, earaches, or minor infections like pink eye, call your doctor or visit urgent care.

Will you recognize a medical emergency? Probably yes, so trust your judgment, act quickly, and please be careful out there.

Patrick Harness is a community liaison with a long history of experience in health insurance. If you ask him to pick a color, he always chooses orange, and he is known for his inability to parallel park.