What’s new for 2016?
• Additional access to information on physicians’ services (Physician Compare)
- Medicare beneficiaries will have additional access to information on physicians and providers, such as the number of services provided as well as submitted charges and payments for these services.
• Extended services: Extension of the Medicare therapy cap exception process. Beneficiaries who have reached the annual cap on rehabilitation services, such as occupational, physical, and speech therapies, can continue to receive services through the exception process. Extension for specialized Medicare Advantage Plans for special needs individuals. Permanent extension of the Qualifying Individual (QI) program.
• Protecting Medicare integrity: Social Security numbers will no longer be included on Medicare cards. Medicare Summary Notices can now be received electronically.
• Changes to Medicare Advantage (Part C): Rewards and incentive programs have been expanded to encourage participation in activities that promote improved health, prevention of injuries and illness, and efficient use of health care resources.
• Changes to prescription drug coverage (Part D): Beginning in 2016, beneficiaries in the Coverage Gap (or Donut hole) will be required to pay 45% of brand-name drugs and 58% of generic drugs. CMS will publish information on Preferred Cost-Sharing Pharmacies (PCSPs) for each plan offering preferred cost-sharing by geographic area.
• New preventive services: Multi-target stool DNA test for individuals at risk for colorectal cancer; One time Hepatitis C screening for individuals born between 1945 – 1965; Lung cancer screening
Beware of Medicare Open Enrollment Scams
Medicare scams are a year-round concern, but the coming weeks warrant special attention. Open enrollment runs from Oct. 15 through Dec. 7. For identity thieves, it's open season.
The most common ploy: Posing as employees from the Centers for Medicare & Medicaid Services (CMS) or other government agencies, scammers claim that new cards are being issued. To get yours, they say, you need to verify or update sensitive information, including your Medicare number, which likely is also your Social Security number.
So closely guard your Medicare number. Take these other steps, too.
• Don’t give out any account numbers: Scammers may angle for a bank account number, saying they need it to process payment on an overdue medical bill. Don't be fooled if they accurately cite a few digits from your checks. Just hang up.
• Don’t trust caller ID. It can be easily manipulated to display whatever name or phone number the scammers choose.
• Flee from “free”: Phone calls promising free medical supplies are often bids to harvest your personal information — a credit card number for alleged shipping charges, for instance. Also, be careful with pop-up storefronts and traveling clinics offering free health checkups that require personal data.
• Nix supplemental swindles:Open enrollment is prime time for unscrupulous salesmen to pressure you to buy supplemental insurance products that will supposedly save you thousands. Before signing anything, compare medigap policies at medicare.gov.
• Nix bilking billing: Are you told that something isn't usually covered by Medicare, but there's a way around the rule? Or that you can get a kickback for providing your Medicare number or undergoing unnecessary treatment? You may get this kind of offer if you go to a free medical checkup that is offered by a shady group. No matter how it's said, it spells fraud — and possible criminal charges against both you and the other person. When in doubt, check with Medicare or your supplemental insurance provider.