Written by Jodie Jackson
Spoiler alert: You’re about to get a lively, fun, crash course on Medicare.
“Coffee With CLAIM” is Quality Talk’s fifth Medicare-related episode, highlighting the work CLAIM does as Missouri’s State Health Insurance Assistance Program (SHIP). Though CLAIM works in Missouri, the information presented in this episode applies to all SHIP programs and Medicare beneficiaries across the country.
Put simply, “We help people navigate Medicare,” says Carol Beahan, CLAIM executive director.
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CLAIM staff featured in this conversation with Quality Talk host Jodie Jackson Jr. and Beahan also includes Tracey Wetzel, lead trainer; Xavier Vaughn, Outreach/MIPPA project coordinator; Cindy Carr, Region 1 liaison (central Missouri); Julia Allen, Region 2 liaison (eastern Missouri, St. Louis area); Stacey Childs, Region 5 liaison (southwest Missouri); CLAIM newcomer Kori Ross, Region 6 liaison (Kansas City metro area and northwest Missouri); and Elizabeth Swanson, Region 7 liaison (northeast Missouri) and AmeriCorps project manager.
The conversation focuses on the annual enrollment period, Oct. 15-Dec. 7, with discussion also touching on the new Medicare cards that beneficiaries have already received or will receive – depending on the area of the coutry.
Previous episodes of Quality Talk that discussed Medicare topics and questions included Episode 27, “Coffee With CLAIM: Aging Into Medicare,” Episode 10, “New Medicare Cards Are Coming,” and Episode 6, “Medicare Panel Discussion.”Episode 4 featured vital information and tips for the 2017 fall Medicare open enrollment period.
Topics: Medicare enrollment
CLAIM’s community partner, Shepherd’s Center Central was highlighted on National Council on Aging (NCOA) webinar in February and highlighted on their website. Read the article below.
Established in 1972, Shepherd’s Center Central in Kansas City, MO, offers a variety of programs for seniors that are primarily volunteer driven at three sites throughout the metropolitan area. The Medicare Assistance Program (MAP) is available at two locations staffed by two part-time persons and 12 certified CLAIM (Missouri State Health Insurance Assistance Program) volunteer counselors. MAP is a multi-faceted program providing Medicare/Medicaid education and individual counseling for beneficiaries and caregivers, and includes the SHOEBOX Project, which began in 2015 with a MIPPA special projects grant from CLAIM and continues today.
The idea for the SHOEBOX Project originated with the Apple Project at Southeast Missouri State University in Cape Girardeau, MO, which has been doing similar work since 1993. The name alludes to the variety of containers in which people who come in keep personal paperwork, such as a grocery bag, big purse, backpack, or a box that originally held a pair of shoes. It also attempts to generally describe the services offered:
Services are provided in Shepherd Center offices, or in senior centers and apartment complexes, and are always free of charge.
The target audience of the SHOEBOX Project is primarily, though not limited to, low-income seniors and disabled persons who may have limited education or cognitive issues, vision impairment, or those for whom English is a second language who need assistance in reading and understanding various forms and letters sent to them. The goal is to be in a position to screen and enroll this population in the various benefit programs for which they may qualify.
The project is advertised to Shepherd’s Center’s large constituency on several social media outlets, and email blasts to various partners and agencies providing services to the aging community, including social workers, coordinators in senior apartment complexes, hospital case managers, etc. A “counter card-style” publicity flyer with a distinctive logo was developed and widely distributed.
A cloth-like document bag, imprinted with the project’s contact information, is given to each client who comes for paperwork sorting, along with a set of neatly labeled folders in which to file important documents. The goal is to assist persons with organization, form completion, and education about what is junk mail and what is important to keep, thus reducing stress levels in their lives.
In 2016, a new feature was added to make the program more accessible, which is to provide a “Walk-in Center” at one site where people can come in without an appointment to be seen by a staff member or volunteer counselor. This service has attracted many who are new to Medicare, want to compare Part D plans, or seek other types of counseling, but who are not necessarily low income. This prompted us the addition of a monthly “lunch and learn” class called Medicare 101. This class is purposely kept small so that the dozen or so attendees can ask questions that are related to their individual situations.
Response to the program seems to increase each year. In 2015, the Shepherd’s Center set a goal of reaching 50 clients; 61 people were served.
In 2016, 87 people sought the services of the SHOEBOX Project, and in 2017, 156 were seen by a counselor and provided the various services. Walk-in Center hours have been increased from three hours on two days per week, to five days per week, 9:00 am to 3:00 pm.
It’s tax time, which of course brings out the scam artists. That means it’s time for a little primer from the Missouri SMP (Senior Medicare Patrol) to keep you from being a victim. Thousands of people have lost millions of dollars and personal information to scammers. First of all, if you are going to file a tax return, do so as soon as possible to keep an impostor from doing it using your information.Fraudsters use the telephone, email and snail mail to scam individuals.You need to remember that the IRS will not initiate contact with you by phone, email, text messages, Facebook or Twitter to request personal or financial information.
But, scammers claim to be IRS employees using fake names and badge ID numbers. They may change their caller ID’s so that it looks like the IRS is calling. These guys may know a lot about you. They probably found the information by Googling you. They tell you that you owe money that needs to be paid either by a gift card or wire transfer. DO NOT do it. They may threaten to have you arrested. They may tell you they are going to suspend your driver’s license. They can be hostile and insulting.
They may tell you that you have a refund coming, but ONLY if you provide your banking information for a direct transfer. They often tell you the matter is urgent. Some have even gone after deaf or hard of hearing people through video relay services.
DO NOT fall for it. The IRS does NOT demand immediate payment using a prepaid debit card, gift card or wire transfer. If you were to owe taxes, you would receive a bill in the mail.
The IRS will NOT threaten to have the police or sheriff’s office arrest you for nonpayment. The IRS will NOT demand payment without giving you a chance to question or appeal. And, they won’t ask for credit, debit or Social Security numbers over the phone. If you feel like you are a victim of a scam, report it to your police department.
As always, report suspected Medicare fraud to the Missouri (SMP) Senior Medicare Patrol at (888) 515-6565. SMPs are funded through the U.S. Department of Health and Human Services, Administration for Community Living, Administration on Aging.
*This project was supported, in part by grant number 90MP0204, from the U.S. Administration for Community Living, Department of Health and Human Services, Washington, D.C. 20201.
Missouri Rx – Missouri’s State Pharmaceutical Assistance Program has been reauthorized by the state legislature for another 5 years until August, 28, 2022. Missouri Rx works with a person’s stand alone Part D plan or Medicare Advantage plan to pay 50% of a person’s costs at the pharmacy. Eligibility benefits for MO Rx benefit has been reduced to only those Medicare beneficiaries that are also enrolled into Medicaid. This change affects 64,000 enrollees. Our certified counselors can help you determine your options if you have lost this benefit. You have not lost your Medicare drug coverage.
Missouri Rx coverage will no longer pay 50% of the cost of Part D prescriptions for people enrolled in Medicare whose
CLAIM Counselors can provide the following.
www.rxassist.org – provides info and application links to assistance programs
www.needymeds.org – provides info and application links to assistance programs
www.rxoutreach.org – discount purchasing program website
We encourage you to call or contact us to understand any options available to you.
1 in 3 American adults is at risk for kidney disease. Medicare Part B covers preventive screening tests that help detect diabetes and high blood pressure – 2 conditions that may lead to kidney damage. Visit Medicare.gov/coverage/preventive-and-screening-services.html for more information.
Medicare Part B also covers up to 6 sessions of kidney disease education services if a person has Stage IV chronic kidney disease that will usually require dialysis or a kidney transplant. For more information, visit Medicare.gov/coverage/kidney-disease-edu.html.
JOPLIN, Mo. – Now until December seventh is annual open enrollment. If you’re enrolled in Part D, Medicare’s drug coverage, you have the chance to either switch or stick with that insurance.
Karen Wells and her husband visited Mercy Hospital Joplin Friday to speak with CLAIM, the Missouri State Health Insurance Assistance Program about being enrolled in Part D, Medicare’s drug coverage.
“Confused, cause there’s so many plans and I work in the health care field, but still it’s all like Greek to me. So she helped to dispel a little bit of that and told me how they’ll use a computer and input a lot of our data and tell us which plans will probably be best for us,” Wells says.
Experts say from year to year, coverage changes, which means providers may not carry the same prescription drugs or the cost of coverage may increase. And it can get very confusing for the average person.
“We can’t imagine someone that doesn’t deal with this all the time to even understand it and the problem being if they don’t understand it and they don’t make necessary changes now, they’re in it for a year, so they can be out a lot of money simply from one little mistake,” Stacy Childs, Claim Missouri Regional Liaison Trainer for the Southwest District of Missouri.
To read the full story, click here.
Today, the Social Security Administration announces the launch of a new Health IT initiative with the Department of Veterans Affairs (VA) that enables all Social Security disability case processing sites to receive medical records electronically from all VA facilities. Veterans will receive a faster decision on their Social Security disability claim, speeding them and their dependents through this new process. Both agencies will save time and money with an automatic request through the eHealth Exchange.
“President Obama has said, ‘we must maintain the sacred covenant we share with our veterans by ensuring they have the care and benefits they deserve,’ and I could not agree more,” said Carolyn W. Colvin, Acting Commissioner of Social Security. “We are committed to providing our veterans with the world class service they so richly deserve and improving the speed and efficiency of our disability program.”
The new Health IT program was tested successfully at Social Security locations around the country. On Veteran’s Day, November 11, the eHealth Exchange will go live, nationally, to all Social Security disability case processing sites.
Social Security requests nearly 15 million medical records annually from healthcare providers and organizations to make medical decisions on about three million disability claims. Medical documentation is essential to make a disability determination. Historically, the agency obtained medical records through a manual process (mail, fax, secure mail). This new national initiative puts in place an automated process to obtain medical records electronically without human intervention.
“VA is currently improving quality of life by enabling Veterans to share their health information with federal partners and integrating their data into a safe and secure health-related consumer application,” said Dr. David Shulkin, Under Secretary for Health of the Department of Veterans Affairs. “Currently, when eligible Veterans apply for Social Security Disability Insurance benefits the average wait time for Social Security to receive paper records from VA can take months; this partnership allows Social Security and VA to share the Veteran’s health information electronically in minutes. The Social Security and VA partnership allows VA to continue to be a leader in interoperability efforts among federal partners while improving overall quality of life for our Veteran patients.”
This partnership adds the VA to Social Security’s more than 50 other Health IT partners, including the Department of Defense, in approximately 7,000 facilities across the United States providing electronic health records. Social Security’s goal is to continue expanding the number of healthcare organizations and federal agencies providing electronic health records within a safe and secure environment.
To learn more about Health IT, please visit www.socialsecurity.gov/disabilityssi/hit.
Social Security offers two other programs to expedite disability claims filed by veterans. Wounded Warriors and veterans with a VA disability compensation rating of 100% Permanent & Total have their Social Security disability claims treated as high priority and receive expedited decisions. For more information about these programs, please visit www.socialsecurity.gov/people/veterans.
To get more Social Security news, follow the Press Office on Twitter @SSAPress.
Call your local SHIP program. The phone number is listed on your copy of the Medicare and You handbook. In Missouri, call 1-800-390-3330. Have your Medicare card and list of medications ready. The SHIP volunteer will help you choose the best plan for you based on your current medications, pharmacy of choice, least restrictions and best prices.
Sometimes, you may feel that you don’t know how to care for the person with Alzheimer’s. This is a common feeling among caregivers of people with Alzheimer’s because each day may bring different challenges. Learning about the disease can help you understand and cope with these challenges. Here is some information about Alzheimer’s and ways you can learn more about it.
Alzheimer’s disease is an illness of the brain. It causes large numbers of nerve cells in the brain to die. This affects a person’s ability to remember things and think clearly. People with Alzheimer’s become forgetful and easily confused and may have a hard time concentrating. They may have trouble taking care of themselves and doing basic things like making meals, bathing, and getting dressed.
Alzheimer’s varies from person to person. It can progress faster in some people than in others, and not everyone will have the same symptoms. In general, though, Alzheimer’s takes many years to develop, becoming increasingly severe over time. As the disease gets worse, people need more help. Eventually, they require total care.
If you’re caring for someone with Alzheimer’s, a powerful technique in helping them carry out daily activities is task breakdown. Breaking down a task into small steps can help the person manage it with less difficulty.
For other ways to approach activities for a person with Alzheimer’s, click here.
For more, see “Caring for a Person with Alzheimer’s” from the Alzheimer’s Disease Education and Referral Center (ADEAR) of the National Institute on Aging (NIA).
The information on Alzheimer’s Caregiving was developed for NIHSeniorHealth by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) at NIH
Have you heard that some of Social Security’s rules about claiming benefits are changing? Well, it’s true. The Bipartisan Budget Act that passed last November closed two complex loopholes that were used primarily by married couples. We want you to know why this happened, how it might affect you, and what you should do next.
But first, don’t forget that one of the best ways to increase your Social Security retirement benefit is to delay claiming it between ages 62 and 70. Each month you delay results in a higher monthly benefit for the rest of your life. The new law doesn’t change this.
The new law closes loopholes that allowed some married couples to receive higher benefits than intended. Only a small fraction of retirees used these loopholes. Closing them helps restore fairness and strengthens Social Security’s long-term financing. Click here to read more!