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Medicare

Medicare health and drug plans can make changes each year – including cost, coverage, and what providers and pharmacies are in their networks. You can change your Medicare health plan and/or Medicare drug coverage during the annual open enrollment (OEP) later this year. In the meantime, click here for up-to-date Medicare information.

Before the Medicare OEP, you’ll get notices in the mail about changes to your coverage for the coming year. You should always review the materials you get from your plan, like the “Evidence of Coverage” (EOC) and “Annual Notice of Change (ANOC). If your plan is changing, make sure it will still meet your needs for the next year. If you’re satisfied with your plan, you don’t need to do anything.

For a helpful Medicare guide, please click here.

MEDICARE FREQUENTLY ASKED QUESTIONS

I lost my Medicare card. How do I get a new one?

If you lose your card, contact your local Social Security Administration office at 1-800-Medicare or visit the Medicare website immediately to get a new one.

Please protect your Medicare card just as you would a credit card. Your Medicare card in the wrong hands can be used to submit fraudulent claims.

I recently moved to another state. How do I update my address with Medicare?

To protect you and to ensure a timely receipt of your benefits, please alert the Social Security Administration office of your address change. The number for the Social Security Administration is 1-800-772-1213.

Does Medicare Part B pay for prescription drugs?

Currently, Medicare does not include a prescription drug benefit.

If coverage guidelines are met, Medicare allows payment for some immunosuppressive, oral, anti-emetic and nebulizer drugs. The Benefits Improvement and Protection Act of 2000 requires Medicare suppliers to accept assignment on Medicare-covered drugs.

Although I am able to walk, I have a difficult time walking long distances. Would Medicare allow payment for a wheelchair or Power Operated Vehicle (POV)?

Medicare wheelchair and POV coverage guidelines indicate that in order to allow payment for a wheelchair, a person with Medicare must be bed or chair-confined without the use of a wheelchair.

To be eligible, all of the following criteria must be met:

You require a wheelchair to maneuver in your home;
You cannot operate a manual wheelchair;
You can safely operate the controls of a POV;
You can transfer safely to and from a POV and have adequate trunk stability to safely ride in a POV.

You will need a prescription from your physician prior to purchasing the POV, and the physician and supplier must complete a Certificate of Medical Necessity (CMN).

For further information on your Medicare plan, please see the most up-to-date version of the Medicare & You 2024 Handbook you may also download or call 1-800-Medicare to request a copy be mailed to you.

I’ve linked here the site which helps you navigate Arizona hospitals that participate in Medicare and in Medicare Advantage/Medicare health plans. The site allows you to select multiple hospitals and then compares aspects like the overall star rating, patient survey rating, hospital type, if they provide emergency services, and more. 

Schweikert suggests using this helpful tool linked above to compare which hospital can best meet your needs. Some individual factors worth prioritizing or considering might be:

  • Does the hospital have experience treating patients with your condition or
    doing the procedure you need?
  • How do patients rate their experience with this hospital and the care they
    got? For example, were patients satisfied with their communication with
    doctors or nurses, the responsiveness of hospital staff or the hospital
    cleanliness?
  • Will I need care after leaving the hospital, and, if so, what kind of care?
    Who will arrange that care? Do I need to meet certain requirements to get
    care after I leave the hospital?
  • Do you have a specific doctor or surgeon in mind? Does your specific doctor or surgeon participate in Medicare and in your Medicare Advantage or Medicare health plan?
  • Is your doctor or surgeon affiliated with (or do they have privileges at) any
    hospitals?

You can also write to your State Survey Agency or call 602-364-2536 for copies of any survey reports or other quality information they have on the hospital. State Survey Agencies can also handle complaints about any accredited hospitals. 

If you would like my help with a Medicare issue, please print out my Privacy Release Form and fax or mail it to my office with a brief summary and any supporting documentation. If you have any questions, feel free to call my District Office at (480) 946-2411.

Inpatient hospital care

Your costs in Original Medicare

You pay this in each benefit period:

  • Days 1–60: $1,632 deductible.
  • Days 61–90: $408 each day.
  • Days 91 and beyond: $816 each day while using your 60 lifetime reserve days.
  • Each day after you use all of your lifetime reserve days: All costs.

Medicare-covered inpatient hospital services include:

  • Semi-private rooms
  • Meals
  • General nursing
  • Drugs (including methadone to treat an opioid use disorder)
  • Other hospital services and supplies as part of your inpatient treatment

Medicare doesn’t cover:

  • Private-duty nursing
  • A private room (unless medically necessary)
  • A television or phone in your room (if there’s a separate charge for these items)
  • Personal care items (like razors or slipper socks)

Click here to read more.