4 - Wilmington Town Crier - Wilmington Memorial Library

C
! Wilmington senior topics
16 TOWN CRIER WEDNESDAY. SEPTEMBERS. 1997
11 i
WILMINGTON - Many
: questions arc being asked about
Medicare coverage for seniors who
have enrolled in an HMO. What
are their rights, will they receive
any protection when needed?
j: Every person who reaches the age
] of 65 and has paid into the Social
Security System while they
worked, is covered by Medicare.
That means whether you receive
your health care coverage through
an HMO or you remain in the
Federal Medicare Program, known
as fee for service, you have the
f same protection and rights.
Why! because you have $43.80
subtracted from your Social
Security check every month. Il
pays 80% of the approved cost of
your medical treatment if under
the Federal Medicare program. If
you have enrolled under the HMO,
your HMO will receive a specify
amount of money monthly to cover
the cost of your Medical Care.The
,( difference between the two
programs is the $43.80 is given lo
, the Federal Medicare Program.
Doctors and hospital send their
. bills directly to the Medicare Fee
for Services Program. 80*
percent of the approved payment
will be paid. You will be expected
to be enrolled under a supplement
policy paid by you to cover the
additional 20%. (In the Slate of
Massachusetts medical providers
who wanted a Medicare payment
for a seniors treatment had to
accept the decision of what
Medicare said the treatment was
worth. The supplement will only
pay for 20% of Medicare's
payment. The bill will be
completely paid for. This is called
the Balance Billing Law. Every
state is not covered by this type of
Law. There is only one other state,
I know of that is covered under a
Balance Billing Law. The
Massachusetts Legislature passed
this Bill many years ago. Several
other states are trying to have one
passed. Remember this Law covers
only seniors under the Federal
Medicare Program. When you
receive a statement from Medicare
on the amount Medicare will pay
for your medical treatment, look at
the bottom of the sheet, it will say
the provider has accepted
assignment. You will know when
your supplement pays the 20%,
your bill is paid.)
On die other hand if you are
-enrolled under an Medicare
approved HMO, Medicare will
send the HMO a certain amount of
money a month as stated above for
your medical care. The HMO will
cover the cost of your medical
care. That does not mean the HMO
is paying all of your bills,
remember the HMO is receiving a
large amount of money from
Medicare, on your behalf.
To protect our rights under
either programs. Congress created
in 1982 " The Peer Review
Organization. "Its purpose is lo see
thai Medicare beneficiaries in both
programs are receiving quality
health care, in hospitals, nursing
homes, assisted living facilities,
skilled nursing care and the
treatment we receive from our
doctors.
As a Medicare beneficiary you
have the right lo question the
quality of your care, you should be
fully informed about your medical
condition and receive a written
discharge plan from a hospital. To
file a qualify care complaint to the
Peer Review Organization, send
your name. Medicare number,
doctor and hospital's name, service
dates and reason for the complaint
to Mass Pro c/o Medicare
Operations 235 Wyman St.
Waltham MA 02154-1231.
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The September Therapeutic
Social will be held on Thursday
September 25. at the
Tewksbury/Wilmington Elks.
Music will be provided for dinner
and dancing, a chicken pie dinner
with all the trimmings will be
served at 7 pm. Sign up will be on
Tuesday September 16 a $3.00 non
refundable deposit will be required
to help defray the cost of the
evening. Table numbers will be
assigned at that time.
Activity programs next week
31
i
*****
Monday 15, Exercise class 10-11,
Whist starting at 12 noon, art class
1-3, Tuesday 16. Nutrition 9-12.
Commissioners Meeting starling at
1:30. Wednesday 17. Exercise class
10-11. Craft and Ceramic classes
9-12. Thursday 18. Sewing.
Knitting and Crocheting class 9-12,
Dance class 1-2:30. Nurse Blood
Pressures and Diabetes test starting
at 1:30, Friday 19, Exercise class
10-11, Bingo. I to 3 p.m.
Edie Cunningham
Water color classes
WILMINGTON The
Wilmington Council for the Arts
has announced that Ms. Louise
Anderson will again act in her
capable capacity as instructor in a
series of watercolor classes for its
fall, 1997 season. Not only is she
respected for her great talent as an
artist, but her pleasant and happy
disposition makes her classes
congenial as well as instructive.
All classes will be held at the
Wilmington Center for the Arts
(Old Town Hall) across from the
Congregational Church on
Middlesex Avenue. This is Route
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62.
Beginning Friday, October 3,
morning and afternoon watercolor
instruction will be offered Fridays
from 9:30 a.m. to noon and again
from I lo 3:30 p.m.
There will be eight classes in
each series, and in conformance
with the Arts Council policy the
fee will be minimal. For
registration or more information
call Liz White at 658-2042. Checks
should be made payable to
Wilmington Council for the Arts.
The Center is accessible to disabled
individuals.
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