Tuesday, October 18, 2016

Fight health care fraud: guard your Medicare number!

Medicare open enrollment is here (October 15 to December 7), which means fraudsters and identity thieves will increase their efforts to get and abuse Medicare numbers from people.

Fortunately, there are many measures you can take to fight health care fraud:
  • Guard your Medicare number. Protect it the same way you do for your credit card numbers. Medicare will never contact you for your Medicare number or other personal information. Don’t share your Medicare number or other personal information with anyone who contacts you by phone, email, or by approaching you in person, unless you’ve given them permission in advance. 
  • Don’t ever let anyone borrow or pay to use your Medicare number.
  • If you’re looking to enroll in a Medicare plan, be suspicious of anyone who pressures you to act now for the best deal. There are no “early bird discounts” or “limited time offers.” Any offer that sounds too good to be true probably is.
  • Be skeptical of offers for free gifts and free medical services. A common ploy of identity thieves is to say they can send you your free gift right away—they just need your Medicare number to confirm. Decline politely but firmly. 
  • Do your part to protect your friends and neighbors: remind them to guard their Medicare numbers, too.
  • Check your Medicare Summary Notice (MSN)–which gives you information on services submitted under your Medicare number–to make sure you and Medicare are only being charged for services you actually received. While the MSN is only mailed to you every 3 months, you can access your Original Medicare claims at any time on MyMedicare.gov. You’ll usually be able to see a claim within 24 hours after Medicare processes it.
You can report suspected fraud by calling 1-800-MEDICARE (1-800-633-4227).
TTY users should call 1-877-486-2048. 

To learn more about how to protect yourself from health care fraud, visit Medicare.gov/fraud, or contact our state’s local Senior Medicare Patrol (SMP), which is the OIC's Statewide Health Insurance Benefits Advisors (SHIBA) program.

Tuesday, October 4, 2016

Outdoor, indoor features that you think are covered may surprise you

Many consumers think their homeowner policy covers everything they own, both inside and on their premises outside of their home. However, you should be aware that most homeowner policies do not cover everything you own. 

Creative Commons Backyard Pool by
Alvin Smith is licensed under CC BY 2.0 
Here are some common features that people may think is covered by a standard homeowner policy. 

Outside your home:
  • Retaining walls
  • Pools that sit above and below ground
  • Gazebos
  • Spas/hot tubs 
  • Rockeries and other landscaped areas
  • Driveways
  • Sidewalks
  • Foundations
  • Fences
  • Pump houses
  • Garden sheds
  • Greenhouses 
  • Playground equipment
Inside your home:
  • Collectibles
  • Money
  • Jewelry
  • Artwork 
  • Musical instruments
Talk to your agent or broker to find out if items like these are covered.  If coverage isn’t available, you’ll want to maintain and safeguard the property at your own cost, and do the best you can to keep it from damage. It’s a good idea to have a discussion about these types of property before you buy a policy.

Read more about homeowner's insurance on our website. Questions? You can contact our consumer advocates online or at 1-800-562-6900.

Wednesday, September 7, 2016

Areas hit by wildfire are at risk for flood damage – are you covered?

We are reaching the end of a “normal” fire season, thanks to this year’s snowpack and spring rain. While that is good news, the more than 15,000 acres that have burned are at higher risk for flash flooding and mudflows. Vegetation absorbs water and reduces runoff that causes mudflows. Even areas that are not historically prone to flood are at risk due to the landscape changes caused by fire. Flood risk remains high until vegetation grows back, up to five years after the fire. That means that the million-plus acres that burned the last two summers are still at higher risk for flooding and mudflows. 
Photo courtesy Washington state Department of Natural Resources

Homeowner’s and commercial insurance policies do not cover flood or mudflow damage. Consumers who want to protect their property must purchase a flood policy, available only through the National Flood Insurance Program (NFIP). Most properties qualify for flood insurance, as long as it is located in a community that participates in the program.

Typically, there is a 30-day waiting period before your flood insurance policy takes effect. This time of year is a good time to do some research into flood insurance, before the fall and winter weather that can bring floods start in earnest.

More information:
Questions? Get more information about flood insurance or contact our consumer advocates.

Tuesday, August 9, 2016

Consumers should be wary of short-term health plans

Consumers looking for health insurance outside of the annual open enrollment period should be wary of short term health plans. These plans may be marketed as alternatives to Affordable Care Act (ACA) health insurance, but they could leave you without adequate coverage and facing financial penalties at tax time. 

Originally, short-term health plans were sold as a stop-gap measure until you could get real major medical coverage. After the ACA kicked in, people had many other options for coverage, but these limited plans were still being marketed to consumers as a viable alternative. However, short-term  plans do not count as 'minimum essential coverage' under the ACA - meaning you'll have to pay a tax penalty. They also do not cover the 10 essential health benefits, can limit your annual benefits to $100,000 or less, and deny you coverage for any pre-existing conditions. 

These policies are sold year-round, unlike ACA-plans that must be purchased during the annual open enrollment period, unless you qualify for a special enrollment. Some states allow for coverage to last up to a year and policies can be renewed. This effectively takes people out of the insurance pool that the ACA was designed to expand, leading to increased costs for everyone. 

In an effort to bring the limited short-term health plans back to their original purpose and to protect consumers, the federal government is proposing a regulation to limit the duration of these policies to three months and increase consumer awareness of their limitations.

Insurance Commissioner Kreidler agrees with this effort and sent a letter yesterday in support of the new regulation.

Friday, August 5, 2016

Learn more about Medicare at free event Aug. 6 in Kent

Are you new to Medicare? The Office of the Insurance Commissioner’s Statewide Health Insurance Benefits Advisors (SHIBA) will be at the Kent Senior Activity Center from 10 a.m. to 2 p.m. on Saturday, Aug. 6

You will learn about:
  • Medicare parts A, B, C and D
  • Your Medicare benefits and options
  • How to get help paying for Medicare if you qualify
Find registration and parking information for this event.

Other resources:
Do you have Medicare questions? Call 1-800-562-6900.

Monday, August 1, 2016

Breastfeeding and insurance: learn your rights

This week is World Breastfeeding Week, when people from all over the world celebrate breastfeeding. It may surprise you to hear that there’s a connection between breastfeeding and insurance.

The Affordable Care Act requires most health insurance plans to provide breastfeeding and lactation support, equipment and counseling to women during and after pregnancy as long as they are breastfeeding.

  • While insurers must cover breast pumps, plan vary by what type of pump they cover, if they help pay for a rental or purchased pump, and if the pump needs to be pre-authorized. Contact your insurance company to find out what your plan covers. 
  • Insurance plans must also cover lactation support for mothers and babies who are having trouble with breastfeeding or pumping. 

According to womenshealth.gov, babies who are breastfed have lower risks of many health conditions including asthma, ear infections, SIDS, type 2 diabetes and respiratory infections. Breastfeeding also benefits mothers’ health, promotes infant-mother bonding and is more economical than buying formula.

Find more information:

Read more about women’s health insurance rights on our website. Questions? You can contact our consumer advocates online or at 1-800-562-6900.

Friday, July 8, 2016

Consider your options when you lose your employer-sponsored insurance

Finding out you are being laid off is stressful, and in addition to that, you have to make important decisions about health insurance that can save you—or cost you—thousands of dollars at a critical time. It’s important to consider all your options when deciding between COBRA or buying your own plan.

What is COBRA? COBRA stands for the Consolidated Omnibus Budget Reconciliation Act, which is a federal law that allows you and any of your immediate family members to stay on your employer’s health plan under certain circumstances :
  • You lose or quit your job 
  • You get a divorce 
  • The employee dies 
  • You are no longer covered as a dependent due to your age
Only employers with 20 or more workers in the previous year are required to offer COBRA coverage. State and local governments fall under COBRA, but the federal government and certain religious organizations do not.

COBRA can be expensive. People who choose COBRA coverage must pay the entire premium, including the portion previously paid by the employer, plus a 2 percent administrative fee. Be warned, if you enroll in COBRA and later on want to switch to a health plan directly to an insurance company or through the Washington Healthplanfinder, you will have to wait until the next open enrollment period if you don’t qualify for a special enrollment.

Options other than COBRA
Before you decide to go with COBRA, find out if you can buy a health plan through the Washington Healthplanfinder and receive a subsidy to help pay your insurance premiums. You can also purchase coverage directly from an insurance company, broker or agent if you don’t qualify for any subsidies.

If you choose a health insurance plan, you likely will be responsible for a full yearly deductible. Generally, health insurance deductibles are not prorated for partial-year enrollees, no matter how few months are left in the plan year. Individual or family qualified health plans operate on a calendar year, from January through December. There is no way to transfer the money you spent toward another plan’s deductible when you switch plans mid-year.

Read more about losing your health insurance on our website. Questions? Contact our consumer advocates online or at 1-800-562-6900.

For COBRA- specific laws and questions, contact:

U.S. Dept. of Labor, Employee Benefits Security Administration
Seattle District Office
300 Fifth Ave., Ste. 1110
Seattle, WA 98104

Tuesday, July 5, 2016

Learn more about Medicare at free event July 9 in Seattle

Are you new to Medicare? The Office of the Insurance Commissioner’s Statewide Health Insurance Benefits Advisors (SHIBA) will be at the Seattle Central Library from 11 a.m. to 1:30 p.m. on Saturday, July 9.

You will learn about:
Medicare parts A, B, C and D
Your Medicare benefits and options
How to get help paying for Medicare if you qualify

Find registration and parking information for this event.

Other resources:
Find out more events on the SHIBA calendar.
Read more about SHIBA and how it can help you.
Do you have Medicare questions? Call 1-800-562-6900.

Thursday, June 23, 2016

Kreidler speaks to consumers in Shoreline about Medicare

Attendees to a Medicare birthday event on Saturday morning got to hear Insurance Commissioner Kreidler talk about why Medicare is important and what SHIBA does for Washington consumers. 
Commissioner Kreidler and Judy Ellis, SHIBA volunteer  with Sound Generations in Shoreline
Commissioner Kreidler and Judy Ellis, SHIBA volunteer
with Sound Generations in Shoreline 

SHIBA stands for Statewide Health Insurance Benefits Advisors. It’s a statewide network of nearly 400 highly trained volunteers who have been helping seniors and others understand their health insurance options for more than 35 years in Washington state. Washington was the first state in the nation to establish a SHIBA program, before the federal government offered assistance in reaching out the consumers who are or are about to be enrolled in Medicare.

Medicare provides health coverage for nearly 45 million Americans who are age 65 and older, and for 7 million younger adults with permanent disabilities. Medicare has been in existence for 51 years, which really isn’t that long ago. 
Shoreline Medicare event attendees
Attendees at the Medicare birthday event 
on June 18 in Shoreline 
Commissioner Kreidler recalled for the attendees a time before Medicare existed when his grandmother had to move in with his parents because she was ill and didn’t have health coverage. Her medical bills prohibited her from living on her own. If Medicare had existed, it would have provided a lifeline for her to have access to the health care she needed.

SHIBA offers free, unbiased assistance with health care choices, including Medicare, to more than 100,000 Washington residents each year. You can find more SHIBA events around the state at http://bit.ly/SHIBAevents.

Friday, May 20, 2016

Department of Health looking for experts on patient out-of-pocket costs

During the last legislative session, Washington's Department of Health was charged with convening a task force on patient out-of-pocket costs. Senate Bill 6569 directed the task force to focus on two key areas:

1. Evaluating factors that contribute to out-of-pocket costs for patients and to the state.
2. Considering the health and economic impact of out-of-pocket patient costs to patients and to the state.

If you have particular expertise in this area and represent patient groups, insurance companies, pharmacists, pharmacy benefit managers, unions, business associations, or biotechnology representatives please consider joining this important task force.

Members of the task force will be asked to attend no more than four half-day, in-person meetings in the Puget Sound region between July 1 and Dec. 1, 2016.

To be considered for the task force, please respond to DOH Secretary John Weisman's letter by COB May 24, 2016 via email to C4PA@doh.wa.gov