Nebraska Department of Insurance

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THE NEBRASKA HEALTH INSURANCE INFORMATION, COUNSELING, AND ASSISTANCE (NICA) PROGRAM

JUNE 1999 NICA NEWS

QUESTIONS AND ANSWERS

Q. What is the Social Security Administration?

A. The Social Security Administration is a federal government agency that helps the Health Care Financing Administration administer certain aspects of the Medicare program for beneficiaries, including determining whether a beneficiary is eligible for Medicare.

The Social Security Administration (SSA) also determines eligibility for retirement, survivor, and disability benefits. SSA also assigns a social security number for individuals and mails replacement cards for Medicare and Social Security people. The Social Security Administration also determines Supplement Security Income (SSI) benefits.

For further information contact the Social Security Administration at: 1-800-772-1213 or the NICA Program Office for a brochure on the SSA or SSI. (402) 471-2201.

Q. Can more than one physician from the same group practice see a patient and bill that patient? A. Yes. Medicare permits this as long as all of the requirements for the CPT consultation codes are met. The consultation, as for an office visit or surgery, must be documented to the attending physician. Under certain conditions, more than one consultation is allowed.

A Healthy Way to Reduce Stress

As discussed, too much stress is bad for you. Often a simple attitude adjustment is enough to keep stress in check. One of the most overlooked attitudes is the attitude of gratitude.

If we change our perceptions and reactions to stress-causing events and people, we can live a more serene life. Here are some additional tips on adopting the attitude of gratitude.

Make a list of people, things and events for which you're thankful. This can include family, friends, gifts, jobs, vacations, professional accomplishments, etc.
Make a list of why you're grateful for each of those people, things and events.
Determine ways in which you can identify more of those people or create more of those situations in your life.
Find ways to acknowledge and show your gratitude. They can include an e-mail, a note of thanks, a visit, a card, etc.
Increase your awareness of common events for which you are grateful, from a sunset to the completion of a minor task or chore.
Be grateful to yourself. If you catch yourself being harder on yourself than others, stop and reframe into the positive.

MEDICARE, SOCIAL SECURITY OR RAILROAD RETIREMENT?

In the past several weeks, the NICA Program Office and the NICA Volunteers have received several calls regarding Medicare and Railroad Retirement. When you read the "1999 Guide to Health Insurance for People with Medicare" on pages 6 and 7, the Social Security Administration and the Railroad Retirement Board appear to be used interchangeably. In other words, does a person who worked for the Railroad have the option to take Medicare or Medicare insurance through the Railroad? The Railroad Insurance for retirees and their families is also called Medicare. The difference is that those individuals covered under Medicare Railroad Insurance are administered by the Railroad Retirement System. In Nebraska, you can call the Railroad Retirement System directly with questions at 402-221-4641. This office does not answer claim questions; it will only answer questions about coverage and general Medicare knowledge. There are people on the telephone to answer questions.

One other indication of a person having Railroad Retirement is his or her Medicare card. Although it looks like a standard Medicare Card, the letters are at the beginning of the social security number, instead of at the end. The spouse and family have the same number as the insured (social security number) and the family numbers begin with two letters, like MA. (This is the most typical.) For example, if you were covered under Railroad Retirement through your spouse's employment with the Railroad, your Medicare Card would look like this: MA 000-00-0000, showing the same Social Security number as your spouse's.

If there are questions regarding claims, calls can be made to 1-800-833-4455. The same confidentiality will be required as when calling the Social Security Medicare Claims Division.

Did you know that Medicare would cover the cost of a whirlpool for pain?

Here are the rules:

You must be "homebound" just as you need to be for Home Health Care.
You need to demonstrate that a whirlpool could give you "substantial therapeutic benefit."

Your physician, at this time, must write a letter to Medicare certifying that your medical condition meets these requirements. You must purchase the medical equipment from an approved supplier in order for Medicare to cover part of the cost.