 Hello, I'm Hugh Downs, and today we're going to look at Medicare in simple terms. Now I can almost hear the groans from here. Many people think that the words simple and Medicare are a contradiction in terms. It can be complicated to get help and to find answers to questions about this big, complex program, but there are easy-to-use resources to help us. What are they? Well, here's one right here. The Medicare Handbook. Now to be honest, I've read through a lot of this booklet, and while it's full of valuable information, I don't remember much of it. But then I don't have to, because this booklet is for reference. It's like a dictionary or a telephone directory. When I need to know something, I can look it up in here. The index helps me find information quickly when I need to find it. But there are other sources of help, too. You can call for it. There are nearly 40 teleservice centers operated by Social Security throughout the country, but you only have to call one number, 1-800-772-1213, or, as I discovered, 1-800-SSA-1213. The SSA stands for Social Security Administration. Let's try it. 1-800-SSA-1213. Social Security, Miss Mayfield speaking. How can I help you? That's all there is to it. We've asked one of the thousands of teleservice representatives to answer a few questions for all of us today. Miss Mayfield, you provide information about a wide variety of social security topics. What kinds of Medicare questions could you answer for us? Well, we can answer questions about your Medicare eligibility, for example, and provide you with information about how and when to enroll in Medicare. And if you've lost your Medicare card, we can see that it gets replaced. And if you have any other general questions about Medicare, or if you need to replace your copy of the handbook, we'd like to help. And if your problem means that you need to see your local Social Security office, we can set up an appointment for you. Now, many people have had frustrating experiences with long delays in calling those 800 numbers. What can we expect from you? Well, certain times of the day are busier than others. And if you call during those times, there can be a short wait, but I can give you a couple of tips on how to get your calls through much easier. Please do. Okay. Well, first of all, you can call us any workday between 7 in the morning and 7 at night. But if you want to get your call through to us quicker, call before 9 in the morning and after 5 p.m. That's when we're the least busy. Anything else? Well, if your question can wait, it's better to call after the first week of the month. Social Security checks go out during the first week of the month, so we get a lot of extra calls about that. It's less busy after the first week. Good tips to save time. Thank you, Ms. Mayfield. Thank you. But what if your questions have to do with a specific claim for a doctor's services or a Medicare decision about your stay in the hospital? For questions about doctor's claims, you can contact the Medicare carrier in your area. You'll find them listed in the Medicare Handbook. Now, if a state has more than one such number, like this one, find the carrier in the county where you receive your doctor's services. Now, a carrier is simply an insurance company hired by the government to process claims for anything covered under Medicare's medical insurance, which is called Part B. George Banks works for Massachusetts Blue Shield in Boston, and he's with us now at his firm's processing center. Mr. Banks, what can you tell us to make things simpler for us? Well, first of all, you can save time by contacting the correct carrier. It should be the carrier in the state or county where you actually receive your Medicare services, even if you don't live there. Now, this is our processing center, and from here we issue payment checks and send you a form called an explanation of Medicare benefits after processing your claim. Now, this is not a bill. It's simply a summary of Medicare decisions and payments. It also shows your carrier's name, address, and phone number at the bottom. Now, the back of the form tells you how to appeal your decision or ask for a review if you disagree with something. What kind of questions can you help us with? Questions about claims, but only claims that concern Part B services, such as doctor services, lab services, or medical equipment. Also, questions about how to appeal or questions about possible fraud or abuse of the Medicare program. Contact us also if you have any questions about this form we just looked at, the explanation of Medicare benefits. And this can come in handy. Ask us for a free copy of this directory. It lists all the participating doctors and suppliers who agree to accept Medicare's approved charges as payment in full. Thank you, Mr. Banks. Thank you. I now have standing by Mrs. Gladys Hazen, a Medicare beneficiary in Dayton, Ohio, who has discovered another way that Medicare has been made just a little bit simpler. A new rule says that doctors and suppliers must now file Medicare claims for any Part B services performed after September 1, 1990. Mrs. Hazen, how is this affecting you? I know some doctors have done this for a while, but I always had to fill out my own claims for medical services and send them in. I like the idea of not having to do this anymore. I can't remember the last time the government did something that meant less paperwork for me. Thank you, Mrs. Hazen. Well, beneficiaries like Mrs. Hazen and you will have a little relief from the paperwork. We've learned that the carrier can help with questions about the medical insurance part of Medicare, but how about the hospital insurance part? What if Medicare disagrees with my doctor who wants to hospitalize me for cataract surgery, for example? Can I challenge that decision? Again, in the back of the helpful Medicare handbook, there's a directory of organizations called PROs. It stands for Peer Review Organizations. These are made up of doctors and other healthcare professionals who are paid by the government to review these kinds of Medicare decisions and to investigate your complaints about the quality of care. There is one in your area. Well, our last guest today is Mary Price, a hospital social worker. Mary, if I went into the hospital, I probably would have forgotten to bring along my copy of the Medicare handbook. What would I do then? Well, don't worry about it. If you're a Medicare patient, you'll receive a special notice when you're admitted to the hospital. It's called an important message from Medicare. It explains your rights as a hospital patient and has other information you need, too, including the name, address, and phone number of the Peer Review Organization in your area. There's a copy of this notice in the Medicare handbook. Thank you, Ms. Price. Thank you, Hugh. The handbook also tells you how to order other helpful literature, including this guide for people with Medicare. It has useful tips on how to shop for insurance to supplement Medicare, so-called Medigap Insurance. Well, what have we learned about Medicare? Well, help is just a phone number or a few flips of the page away. Call the Teleservice Center at 1-800-SSA-1213. And we'll help with your questions about Medicare eligibility, enrollment, replaced cards, or any other general Medicare questions. Contact the carrier in the state where you receive Medicare services, and we'll help you with your questions about claims. Remember, the rule says your doctor files your medical claims now. When you're in the hospital, the information you need to have is included in this important message from Medicare. Remember, the Medicare handbook is packed with information, phone numbers, addresses, answers to questions, and you don't have to remember these things. Just know how to use the handbook and keep it where you can easily find it. Well, this has been our look at Medicare in simple terms. I'm Hugh Downs. Thank you for watching.