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We are dedicated to making Medicare's program work well for all beneficiaries. Your feedback from your own or your client's concerns and experiences with Medicare, will guide our Medicare advocacy efforts with key policy and decision-makers in both California and nationally with the Centers for Medicare and Medicaid Services (CMS) and Congress.

  • 22Jul

    Here’s a brief 2-min TV video on IRS scams that are affecting seniors around the state. Tatiana Fassieux, Program Manager for the Health Insurance Counseling and Advocacy Program (HICAP) in No. California reminds people how to spot such scams and what to do when encountering them. She shares that she also received this scam call. “You will never get valid and true information from a cold call. It’s always a scam,” says Tatiana.

    A few points to remember, include:

    • The Federal government will never call you.
    • Don’t give out personal information over the phone.
    • If you think a legitimate business is calling, look up the number yourself from their official website.
    • Jot down time and date of suspicious calls and report them to our Senior Medicare Patrol at 855-613-7080.

    Here’s another article on an IRS scam to be aware of. Also, see our Medicare Fraud section for more information on fraud and tips to detect, protect and report!

  • 16Jul

    One of our Social Security Public Affairs Specialists for Northern California, Deogracias Santos shares a fun article about how the online program, My Social Security, offers an easy way to add more simplicity to your life. And, with National Simplify Your Life week coming up in the first week of August, this is a great time to get a jump start on some simplicity! :)

    MY SOCIAL SECURITY SIMPLIFIES YOUR LIFE

    By Deogracias Santos

    Social Security Public Affairs Specialist in the Northern Area of California

    So many people buzz through extremely busy and complicated schedules these days. A smartphone in one hand, a computer in front of you, and a digital task list that never seems to end. In addition, to complicate things just a little more, there’s another event you need to add to your list—National Simplify Your Life week. This event takes place August 1 through 7. Put it on your calendar so you don’t forget!

    Most organized people agree that planning ahead is a great way to simplify your life. Whether you’re planning tomorrow’s schedule, next summer’s vacation, or your retirement.

    We have a suggestion that can help you simplify your life when it comes to Social Security. If you haven’t already (it’s probably on your task list), open your own personal my Social Security account.

    What’s my Social Security? It’s a free, secure, online account that allows you immediate access to your personal Social Security information. During your working years, you can use my Social Security to view your Social Security Statement to check your earnings record and see estimates of the future retirement, disability and survivor benefits you and your family may receive based on your earnings. If you already receive Social Security benefits, you can use my Social Security to check your benefit information, change your address and phone number, change your electronic payment methods, and even obtain a benefit verification letter. Check it out and sign up for my Social Security at www.socialsecurity.gov/myaccount.

    After you check your online Social Security Statement, be sure to visit our Retirement Estimator. Like my Social Security, you can use it as many times as you’d like. The Retirement Estimator lets you compute potential future Social Security benefits by changing variables, such as retirement dates and future earnings. You may discover that you’d rather wait another year or two before you retire to earn a higher benefit. To get instant, personalized estimates of your future benefits just go to www.socialsecurity.gov/estimator.

    There are many tools at www.socialsecurity.gov that are simple and convenient to use. Open a my Social Security account today by visiting www.socialsecurity.gov/myaccount and simplify your life.

  • 08Jul

    We’re getting several reports of fraudulent providers and durable medical equipment (DME) suppliers who are offering beneficiaries “free” services or equipment in exchange for their Medicare numbers. “Free” is the red flag. If the services or treatments were truly free, no Medicare number would be needed. Fraudsters ask for these numbers because then they can sell them to other crooks and/or bill Medicare directly for services and equipment beneficiaries don’t ever receive.

    Things to remember:

    • If your Medicare number is requested for a “free” service or item, it is not free as advertised. It is most likely a scam. Medicare is often billed. If Medicare denies payment, you could be stuck with a bill for something you never received. If the fraudster bills Medicare with your number for too many services or too much equipment, your Medicare number may be flagged as an “over-utilizer.” This could make it hard to get the services and supplies you may need in the future if/when you need them.
    • Beware of people who say they know how to get Medicare to pay for something. Medicare pays for services and items based on medical necessity — meaning a service or item you really need for your medical condition. Also, most durable medical equipment requires a prescription from your doctor. People making these offers will have no concern or mention of either of these requirements.
    • If it’s “too good to be true,”…it probably isn’t true! When it comes to scams and fraud, this is a good rule of thumb to follow.
    • Beware of phone scams where callers claim to be from Medicare, Social Security, the IRS or other government entity and ask for your Medicare number or other personal information. These entities won’t call you. They already have your Medicare number and will not ask you for it or other personal information.

    If you or someone you know comes across such scams, let us know. Together we can stop fraud! Call the Health Insurance Counseling and Advocacy Program (HICAP) at 1-800-434-0222, or the Senior Medicare Patrol at 1-855-613-7080.  Thank You!

     

  • 03Jul

    Here are a couple pictures of Paula Holden, our SMP Regional Liaison, and Dan Boutwell, the Rite Aid Wellness Ambassador, at last week’s Savvy Senior event in Northern CA. Paula and Dan worked together to form what is now a flourishing and expanding outreach partnership, called Health In Pharmacies (HIP). The HIP program involves volunteers with the Health Insurance Counseling and Advocacy Program and Senior Medicare Patrol (HICAP/SMP) and Rite Aid and Walgreens pharmacies around the state. HICAP/SMP volunteers set up outreach tables and offer free information on Medicare and Medicare fraud prevention in participating Rite Aid and Walgreens pharmacies on certain days of the month. Both Dan and Paula who have started this whole trend were at this outreach event last week and visited each other’s tables.

    Paula Holden, SMP Regional Liaison and Dan Boutwell, Rite Aid Wellness Ambassador

    The HIP program is spreading in both Northern and Southern California and currently is operating in at least 10  Rite Aid stores and  4 Walgreens stores. We are finalizing a HIP tool kit to help our partners get “hip” and start this HIP outreach in their own area. More info on that soon!

    Here’s an article about how this partnership all began: SMP Forms Fruitful Community Outreach Partnership with Local Pharmacy.

  • 25Jun

    The traditional phone scam keeps morphing and now shows up as email scams, post office scams, delivery scams, bank scams…it seems the morphing is endless! But all of these scams do have something in common. They are fishy. And as one of my colleagues says, “If it looks like fish, smells like fish, then it’s fishy and is best to avoid.” Below are a few brief examples of some of these “fishy” scams to watch out for. Knowing the shapes and sizes they come in helps identify a range of scam morphing phenomena and will help you and others both avoid and report them.

    FedEx Delivery Scams

    The wife of one of our Senior Medicare Patrol volunteers recently received an email from “FedEx”. They claimed they were trying to deliver a package to the house and wanted to verify her address and other personal information. Well this was certainly “fishy” as FedEx would never call to verify an address. They already have the address and if they did have a question, they would ask the sender, not the recipient. This woman was expecting a package but not from FedEx. She went to her post office to check and they confirmed that this indeed was a scam.

    Notice to Appear – Court Case Scams

    Another SMP colleague says she receives email scams daily. A recent one was titled “Notice to Appear.” It was a short letter saying she was being called to attend a hearing for her case and that a copy of the court notice was attached. It was signed from the “Clerk to the Court, Emily Mason.” Again this is fishy, as my colleague has no case pending in court. It is just another way to get her to call a number, or “verify” and give away some of her personal information.

    Bank Email Scams

    Other common email scams are appear to be from banks, credit card companies or other financial institutions and, as scammers can easily copy and paste official logos into email graphics or websites, their emails and websites can look legit. But again, there will most likely always be something that seems a bit off, or is fishy. These bank scams often say they are updating their files and want you to verify some personal information. If you get an email like this, it’s best not to go to any of their linked websites or use their phone numbers. Instead, go to the phone book or go to one of your bank statements and use the customer service number listed there. In many cases, your bank will verify that this email is a scam.

    These are just a few of the morphed scams to watch out for. Again remember, if it looks fishy, smells fishy, then it’s fishy and should be avoided and reported! If you or someone you know comes across such a scam, please report it to our Senior Medicare Patrol (SMP) at 1-855-613-7080.

    See our Medicare fraud section for more information on health care fraud.

  • 17Jun

    Below is a humorous but sadly too true commentary on the outrageous prices of drugs and how the pharmaceutical industry does everything in its power to avoid discussing prices….and to distract our attention by…looking at squirrels!

    Wow, this drug is really expens — Look! A squirrel!!

    For years, the pharmaceutical industry has had a pretty simple strategy for discussing the prices it charges for its drugs: don’t.

    Indeed, whenever the high price of pharmaceuticals is in the news, drugmakers try desperately to change the subject and distract from the issue. Now more than ever, that strategy is on full display as the industry is under increasing fire for the prices of specialty pharmaceuticals – some priced at more than $100,000 for a single course of treatment. Shifting blame may have been effective in the past, but when public health and access to life-saving drugs is being threatened by these increasingly outrageous prices, it just won’t do the trick anymore. As the drugmakers ramp up yet another campaign of distraction, here are some simple facts to consider:

    FACT: Astronomical prices for specialty drugs will blow up Medicare Part D budgets and force higher premiums for seniors

    An analysis in Health Affairs last week found that the price of the important hepatitis C drug Sovaldi could increase the cost of Medicare Part D and premiums for seniors by 8%. From this one drug alone, seniors on Part D could see an 8% premium hike.

    FACT: Astronomical prices for specialty drugs will devastate state Medicaid budgets and displace important priorities like education and infrastructure

    One recent analysis highlighted on Vox illustrated that, because Sovaldi is so expensive, California could potentially spend more administering the drug for people on Medicaid than it does for K-12 and secondary education combined. Yes, you read that correctly.

    FACT: Astronomical prices for specialty drugs put upward pressure on premiums for all consumers

    At its core, the cost of health insurance is a reflection of the cost of health care. The skyrocketing prices that drugmakers are charging has a ripple effect throughout the system, raising premiums and increasing health care costs for individuals, families, and employers.

    FACT: Health plans offer consumers a range of coverage options, including policies with lower cost-sharing

    To distract from their unjustifiable pricing, drugmakers have latched onto distorted coverage comparisons that ignore the range of cost-sharing options consumers can choose from. Hey, anything beats talking about the actual price.

    FACT: Consumers have out-of-pocket limits that mean health plans and state and federal governments rather than patients are paying the vast majority of the cost of these stratospherically priced drugs

    Pharmaceutical companies know that consumers’ out-of-pocket costs are capped under the Affordable Care Act, allowing them to ask for what amounts to a blank check from insurers and government programs. Not surprisingly, drugmakers are making the law work for them.

    BONUS FACT: Drugmakers have no straight-face explanation to justify the increasingly astronomical prices they have been charging for their medications

    That’s why they want to talk about anything – ANYTHING – other than the prices they are charging.

    The most important fact is that we all want patients to have access to the best treatments. That’s why we cannot afford to allow pharmaceutical companies to have us simply look the other way any longer when it comes to pricing. These unsustainable drug prices threaten our health care system – public and private – access for patients, as well as the very innovation that pharmaceutical companies relish. We cannot have sustainable innovation without sustainable prices to support it, and that’s why health plans and a diverse set of stakeholders have called on drugmakers to come to the table to find a private sector solution to this challenge before the government feels like it needs to.

  • 10Jun

    Scams are getting bolder, so ramping up our campaigns to warn and protect beneficiaries of such scams is of increasing importance.

    One recent scam reported last week by the Health Insurance Counseling & Advocacy Program (HICAP) in Chico was of a local woman who received a call from a Mr. Davis with the IRS. Mr. Davis said there was a pending lawsuit against her. The call came from 202-223-0880, and appeared to be from Washington, D.C.

    The supposed IRS representative wanted to give this woman information about the “lawsuit” and asked a few questions. He said the lawsuit involved a contractor. Yet, luckily the woman challenged the caller and said she wanted everything sent by mail. He said he would send a fax to the local county offices, and then hung up. This woman then called her local HICAP office to report this scam.

    When searching this phone number on the Internet, HICAP found it to have many reports similar to this one.

    This scam provides yet another opportunity to remind beneficiaries and their families that these types of calls are bogus and are a way to fraudulently obtain personal information, such as Social Security or bank account numbers, even Medicare numbers. We urge seniors to never give information to callers of this nature.

    If you receive a suspicious call, get as much information as possible, such as a name and telephone number and nature of the call, and then report it to our Senior Medicare Patrol (SMP) office at 1-855-613-7080. We will report it to the appropriate local and federal authorities. You can also call the police and event the local district attorney’s office.

    See our Medicare fraud section for more info on fraud, abuse and recent scams.

    This blog is edited from the article, Seniors: Remain Vigilant to Avoid Scams.

  • 05Jun

    Did you know that an estimated 5 million elders are victims of elder abuse each year in the U.S.? And this number does not reflect the fact that for every reported case of abuse, there may be up to 14 unreported cases. A big part of addressing and preventing elder abuse is promoting public awareness. World Elder Abuse Awareness Day is June 15 and is a good platform to do just this, educating both the public and our Congress on this issue.

    What is elder abuse?

    Elder abuse is broad category that includes physical, emotional, sexual, and financial abuse as well as exploitation, abandonment and neglect. Ninety percent of elder abuse perpetrators are family members.This silent epidemic takes aways seniors sense of dignity and safety and sometimes their lives.

    In 2010 the Elder Justice Act was passed as a part of health care reform but it still needs to be fully funded and several additional bills need to be passed to support this comprehensive protection for elders on a national level. Some of the items to be accomplished include:

    • Educating law enforcement on the problem of elder abuse
    • Increasing the Department of Justice’s ability to address elder justice issues
    • Securing funding for the Elder Justice Act and elder abuse protections in the Older Americans Act

    Below is a list of elder abuse resources put together by the National Council on Aging, as well as a video An Age for Justice: Confronting Elder Abuse in America. This video, produced by the Elder Justice Now campaign, shows stories of families and individuals whose lives have been turned upside down by elder abuse. It provides stark proof of the financial, emotional, and physcial and psychological impact of the violence and abuse that an estimated 5 million Americans face every day.

    List of resources to learn more

    Review the Administration’s FY 2015 Elder Justice Initiative request (pdf), the EJC webinar, and the Consumer Voice fact sheet

    Get resources from the National Center on Elder Abuse (NCEA) and view William Mapother’s new PSA

    Take action with the Elder Justice Coalition (EJC) and Ageless Alliance

    Read NCOA’s FAQs on elder abuse

    Access elder financial abuse prevention resources from the Women’s Institute for a Secure Retirement, the Elder Financial Protection Network and the CFPB Office of Older Americans

    Access stories to strengthen your advocacy from NCEA and the National Adult Protective Services Association (NAPSA)

    Where to report elder abuse

    If you suspect any form of elder abuse, neglect or exploitation, contact California’s Adult Protective Services. If someone is in immediate danger, call 911 or the local police department.

  • 29May

    “Part D already costs about $80 billion a year and is on track to double by 2022 as benefits improve and Baby Boomers retire. For two reasons, a significant chunk of that money is wasted on overpayments to drug companies: When Part D began, millions of patients were shifted over from Medicaid, the state-federal program for low-income people that gets far lower drug prices than Medicare. Suddenly, the cost of providing drugs to the same people shot up. Congress barred Medicare from negotiating the way Medicaid and the Department of Veterans Affairs do with drug makers to get lower prices. Instead, lawmakers insisted the job be done by private insurance companies.”

    This is a quote from a USA Today editorial and it highlights the absurdity of prohibiting Medicare from negotiating prescription prices with drug makers, especially in a time  when government calls for cuts in Medicare and ways to reduce Medicare spending. Both Medicaid and the Department of Veteran Affairs negotiate for lower prices, but Medicare Part D, from it’s inception in 2006, is barred from doing this.

    This is a very different scenario than in other countries, like Canada and Europe, where all government health plans bargain with the drug companies to protect their citizens. “Per capita drug spending in the U.S. is about 40% higher than in Canada, 75% greater than in Japan and nearly triple the amount spent in Denmark,” according to an article in Health Care for America Now.

    And, it’s no accident that the law prohibits Medicare to negotiate lower drug prices. A recent article by the National Committee to Preserve Social Security & Medicare points out that “the drug lobby worked hard to ensure Medicare wouldn’t be allowed to cut into the profits which would flow to big Pharma thanks to millions of new customers delivered to them by Part D.”

    For years these big Pharma companies have used the argument that negotiating lower drug prices would actually hurt seniors in the long run because it would take away the necessary funds for innovative research and development to “save lives.” Yet, this just isn’t true. “Half of the scientifically innovative drugs approved in the U.S. from 1998 to 2007 resulted from research at universities and biotech firms, not big drug companies, research shows,” according to an article in Health Care for America NOW. The article also notes that “despite their rhetoric, drug companies spend 19 times more on marketing than on research and development.” In fact, 5 pharmaceutical companies have reported million-dollar increases in their spending on lobbying the federal government during the 1st quarter of 2014 alone.

    Join us and many other advocacy groups in helping Americans and our government save money by urging Congress to allow Medicare the same drug negotiate powers as Medicaid and Veterans Affairs.

    For more information see, Negotiating for Lower Drug Costs in Medicare Part D.

  • 15May

    The new Medicare card scam is one that took off in the fall of 2013 with the beginning of Obamacare’s open enrollment and Medicare’s annual open enrollment period. Scammers took advantage of the widespread confusion and invented a plethora of new scams. A common scenario on the new Medicare card scam is depicted here in the video, and is performed by 2 of our Senior Medicare Patrol Liaisons, Ray Jones and Paula Holden. This skit serves as both an educational tool to share with others and for inspiration to create and perform your own such skits to help educate the public on Medicare fraud.

    For more information on fraud, how to detect, report and prevent it, see our Medicare Fraud section. If you have questions or a similar scam to report, call our California SMP office at 1-855-613-7080.

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