PPO II - EmblemHealth

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2013 Evidence of Coverage for PPO II) II Chapter 2: Important phone numbers and resources SECTION 2 MEDICARE (HOW TO GET HELP AND INFORMATION DIRECTLY FROM THE FEDERAL MEDICARE PROGRAM) Medicare is the Federal health insurance program for people 65 years of age or older, some people under age 65 with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant). Th e Federal agency in charge of Medicare is the Centers for Medicare & Medicaid Services (sometimes called “CMS”). Th is agency contracts with Medicare Advantage organizations including us. Medicare CALL 1-800-MEDICARE, or 1-800-633-4227 Calls to this number are free. 24 hours a day, 7 days a week. TTY 1-877-486-2048 This number requires special telephone equipment and is only for people who have diffi culties with hearing or speaking. Calls to this number are free. WEBSITE http://www.medicare.gov This is the offi cial government website for Medicare. It gives you up-to-date information about Medicare and current Medicare issues. It also has information about hospitals, nursing homes, physicians, home health agencies, and dialysis facilities. It includes booklets you can print directly from your computer. You can also fi nd Medicare contacts in your state. The Medicare website also has detailed information about your Medicare eligibility and enrollment options with the following tools: Medicare Eligibility Tool: Provides Medicare eligibility status information. Medicare Plan Finder: Provides personalized information about available Medicare prescription drug plans, Medicare health plans, and Medigap (Medicare Supplement Insurance) policies in your area. These tools provide an estimate of what your out-of-pocket costs might be in different Medicare plans. You can also use the website to tell Medicare about any complaints you have about our plan: 23
24 2013 Evidence of Coverage for PPO II Chapter 2: Important phone numbers and resources SECTION 3 STATE HEALTH INSURANCE ASSISTANCE PROGRAM (FREE HELP, INFORMATION, AND ANSWERS TO YOUR QUESTIONS ABOUT MEDICARE) Th e State Health Insurance Assistance Program (SHIP) is a government program with trained counselors in every state. In New York State, the SHIP is called Health Insurance Information Counseling and Assistance Program (HIICAP). HIICAP is independent (not connected with any insurance company or health plan). It is a state program that gets money from the Federal government to give free local health insurance counseling to people with Medicare. HIICAP counselors can help you with your Medicare questions or problems. Th ey can help you understand your Medicare rights, help you make complaints about your medical care or treatment, and help you straighten out problems with your Medicare bills. HIICAP counselors can also help you understand your Medicare plan choices and answer questions about switching plans. Health Insurance Information Counseling and Assistance Program (HIICAP) (New York State’s SHIP) CALL 1-800-701-0501 TTY 711 (New York State Relay Service) WRITE New York State Offi ce for the Aging 2 Empire State Plaza Albany, New York 12223-1251 WEBSITE www.aging.ny.gov Tell Medicare about your complaint: You can submit a complaint about our plan directly to Medicare. To submit a complaint to Medicare, go to www.medicare.gov/MedicareComplaintForm/home.aspx. Medicare takes your complaints seriously and will use this information to help improve the quality of the Medicare program. If you don’t have a computer, your local library or senior center may be able to help you visit this website using its computer. Or, you can call Medicare and tell them what information you are looking for. They will fi nd the information on the website, print it out, and send it to you. (You can call Medicare at 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week. TTY users should call 1-877-486-2048.)
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PPO II - EmblemHealth

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