On the Healthcare Front
Issue #12: February 2023
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when should you call kepro?
- If you are not ready to be discharged from the hospital.
- If your Medicare skilled services are ending too soon. Examples of skilled services include things like physical therapy and nursing services.
- If you have a concern about the quality of care you received.
- If you have a concern about your medical care that needs to be taken care of right away.
Click on the link below for the phone number for your state. These services are free for people who have Medicare.
february is american heart month
February is American Heart Month, a time when people can focus on heart health.
Visit our heart month page and look under the section called Resources for Everyone for information for older adults:
Read more about heart month: www.keproqio.com/heartmonth
when you should call your local state health assistance insurance program
They can help you navigate the complexities of Medicare.
Learn more about how SHIPs help people who have Medicare by listening to our podcast:
Your Medicare coverage and costs can change each year, so it is important to understand and review your benefits.
This is an overview of what is included in this article:
- New Medicare costs for 2023
- Some changes to the Medicare enrollment periods
- Medicare’s new, limited immunosuppressant coverage
- “New” Medicare card schemes
This article was written by the State Health Insurance Assurance Program, also referred to as SHIP.
Read the article: What's New in 2023?
SHIPs are trained by Medicare to provide Medicare information. They can help you understand your healthcare benefits, the difference between a wellness and a preventative service. They explain Medicare Parts A,B,C and D, the Advantage plans, and the difference between Advantage plans and supplemental insurance. They are impartial and provide personalized counseling through presentations, counseling, health and benefit fairs, and with their community partners.
Find your state's SHIP organization:
Depending on your state, your SHIP may go by another name. Use SHIP's online SHIP Locator (www.shiphelp.org) or call 877-839-2675 (and say “Medicare” when prompted) to find your local SHIP.
If you have Medicare and have a concern about the health care (or related medical services) you had, you can do something about it. You can call Kepro and ask about Immediate Advocacy services. This process can be used to resolve an issue quickly.
immediate advocacy services can help when you need an answer from your healthcare provider right away
Recently, a local pharmacy was given the ability to do flu testing at their location. Pharmacists already face busy days, but this testing provides an additional way for patients to access care.
However, the pharmacists at this pharmacy don’t have prescriptive rights. When a patient tests positive for the flu, the pharmacist still needs to get a prescription (doctor’s order) for an antiviral from the patient’s primary care doctor. When treatment is started within two days of becoming sick with flu symptoms, antiviral drugs can lessen fever and flu symptoms and shorten the time you’re sick.
Getting prescriptions from doctors’ offices hadn’t been an issue. But, on one occasion that changed.
Ben wasn’t feeling well and had some flu symptoms. He went to the pharmacy where he tested positive for flu. The pharmacist sent a prescription request to Ben’s primary care physician (also called a PCP) along with a copy of the positive test results, but the office was closed.
The pharmacist called the doctor’s office the next morning. Right away the doctor’s office staff asked why the patient didn’t contact the doctor himself and that they would leave the request on the doctor’s desk for when she got in. After a few hours, there was no word from the doctor’s office. And, of course, now the doctor is busy with patients, and the request is still on the doctor’s desk. The patient needs to start the antiviral soon for it to work. The pharmacist remembered reading about Kepro’s Immediate Advocacy services for people who have Medicare in Kepro’s newsletter. He called the patient to let him know what was happening and suggested they call Kepro together to use Immediate Advocacy to work through this issue quickly.
The pharmacist and Ben called Kepro together and talked about what was happening. Kepro called the doctor’s office and was able to explain that the patient went to the pharmacy for flu testing because it was quicker and easier for him to get there. Kepro talked with staff and explained the urgency of the request. With Kepro’s help, the pharmacist was able to get the needed prescription for the antiviral for the patient in time for it to do its work.
If you are on Medicare and are not happy with the care you received or if you need help working through an issue that needs to be taken care of right away, please call Kepro and ask about Immediate Advocacy services.
What you should know about flu antiviral drugs: https://www.cdc.gov/flu/treatment/whatyoushould.htm
Similarities and Differences between Flu and COVID-19: https://www.cdc.gov/flu/symptoms/flu-vs-covid19.htm
Read about Immediate Advocacy services: www.keproqio.com/ia
Publication No. R146810-289-1/2023. This material was prepared by Kepro, a Medicare Quality Improvement Organization under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy.