Medicare Resources for Consumers
Frequently Asked Questions
Medicare Coverage | Medicare Part A & B | Your Medicare Rights | Quality of Care Complaints
General
How do I get a new Medicare card?
You have one of three options:
- Call the Social Security Administration at 1-800-772-1213
- Request a replacement Medicare card online at www.ssa.gov/medicarecard
- Visit your local Social Security office, which can be found online at www.ssa.gov/locator
Who do I notify to change my address for Medicare?
Call the Social Security Administration at 1-800-772-1213.
Where can I get general information about Medicare?
Call Medicare at 1-800-MEDICARE (1-800-633-4227) or visit www.medicare.gov.
Your Medicare Rights
The hospital wants to release me, but I don't feel well enough yet. What do I do?
- Ask for the hospital to give you the decision to release you in writing, sometimes called a "Notice of Noncoverage" or "Denial Notice".
- Once you get the notice, call Delmarva by noon of the next business day at 1-800-492-5811. For example, if you receive your notice at 8:00 a.m. on Monday, you have until noon on Tuesday to contact Delmarva. If you are not able to contact Delmarva within this timeframe, you may still file a complaint, but it will not be considered "immediate".
- While you are in the hospital, Delmarva will review your condition to see if you need to stay. You cannot be sent home or billed by the hospital until Delmarva completes the review of your case. You cannot be billed for the time you spent in the hospital while Delmarva was reviewing your case.
I feel my health was put at risk because I received poor healthcare treatment. What do I do?
Call Delmarva at 1-800-492-5811. We review your concern along with the services provided under Medicare and send you written documentation for your records. If we find a problem, we also work with your healthcare provider to improve the care they give to patients in the future.
I'm being released from the hospital, and I need follow-up care. What do I do?
Get written instructions about your medication and follow-up care before you leave the hospital. The hospital must arrange for the care that you will need when you leave the hospital. If you have problems securing your follow-up care call 1-800-492-5811.
I want to make sure my medical wishes are carried out if something happens to me and I can't speak for myself.
You have the right to complete an Advance Directive. There are several types, but the Durable Power of Attorney for Health Care is the most common. These documents allow you to state your wishes regarding treatment, and to name someone who'll make medical decisions for you at times you cannot. Complete your Advance Directive in case you have a medical emergency in the future. If you have to go to the hospital:
- Tell your doctor and hospital staff that you have an Advance Directive.
- Bring a copy with you to the hospital and ask it to be entered into your record.
- Give copies to your family, physician, and the person you name to act for you.
- Keep your original in a safe place.
Advance Directives can be revoked by simply telling or writing your doctor that you've changed your mind. This can be done without legal help or fees.
More information on Medicare Rights
Medicare Coverage
Can I get help paying for my medications?
Yes. CMS has developed a Medicare beneficiary website with information related to medication coverage, call 1-800-MEDICARE (1-800-633-4227) or visit www.medicare.gov.
Does Medicare cover diabetes services?
Yes. Medicare covers glucose monitors, test strips, and lancets for people with diabetes (insulin users and non-insulin users). Diabetes self-management training is covered if requested by your healthcare provider. To learn more about other preventive services covered by Medicare, call 1-800-MEDICARE (1-800-633-4227) or visit www.medicare.gov.
Medicare Part A & B
What is Medicare Part A?
This is the Medicare program that helps pay for care while you are in a hospital, skilled nursing facility, or critical access hospital, or if you are receiving hospice care, and/or some home health care.
How do I enroll in Medicare Part A?
Most people get Part A automatically when they turn age 65. If you are not sure if you have Part A, look at the lower left corner of your Medicare card for "Hospital Part A". You can call the Social Security Administration at 1-800-772-1213 for more information about purchasing Part A.
Who do I call for questions about Medicare Part A coverage, bills, and medical services?
Call the Fiscal Intermediary, United Government Services, at 1-866-804-0684 or
Mutual of Omaha at 1-877-647-6528.
What is Medicare Part B?
This is the Medicare program that helps pay for doctors' services, outpatient hospital care, and some other medical services that Part A does not cover, including the services of physical and occupational therapists, and some home health care. Part B helps pay for those covered services and supplies when they are medically necessary.
How do I enroll in Medicare Part B?
You can sign up for Part B anytime during a 7-month period that begins 3 months before you turn 65. For example, if your 65th birthday is June 1, you may sign up for Part B from March 1 to September 1. To sign up visit your local Social Security office, which can be found online at www.ssa.gov/locator, or call the Social Security Administration at 1-800-772-1213.
What is the cost of Medicare Part B?
For information on the current monthly premium call 1-800-MEDICARE (1-800-633-4227) or visit www.medicare.gov. You must enroll in Medicare Part B. Your monthly premium will be deducted from your Social Security benefits.
Who do I call for questions about Part B coverage, bills, and medical services?
Call the National Heritage Insurance Company (NHIC) at 1-800-952-8627 or 1-530-634-7538
(TDD for the hearing impaired). In Southern California call NHIC at 1-800-675-2266.
Quality of Care Complaints
What should I do if I am concerned about or not satisfied with the quality of care I received?
- Call Delmarva at 1-800-492-5811 and describe your concern. One of our trained staff will listen and help you decide what to do. One of your choices is to make a formal complaint.
- If you decide you want to make a formal complaint, we can help you put it in writing. Once Delmarva receives the written complaint, the quality of care review will begin.
This is a free service for Medicare members.
Who conducts the review and what does it include?
Depending on the case, any of our physician reviewers can review your complaint. (A physician reviewer is a practicing physician who works with Delmarva to address quality of care concerns.) A case manager will contact you once the complaint is filed and serve as your point of contact throughout the process.
The physician reviewer looks at all aspects of care surrounding your complaint, and makes an initial finding that is shared with the healthcare provider or facility your complaint is related to. Your healthcare provider/facility also has the opportunity to comment. Delmarva works directly with you and your provider to resolve the problem and make sure that you and other Medicare members receive the best care possible.
The entire process takes anywhere from three to six months.
If I am concerned about the quality of healthcare I received in another state, can Delmarva review it?
Each state has an organization like Delmarva. To request a review or to file a complaint about the quality of care you received in another state, you must call the appropriate organization. Call 1-800-MEDICARE (1-800-633-4227) to obtain the phone number, or visit MedQIC.Org to find the quality improvement organization for each US state and territory.
