Lumaktaw sa pangunahing content

Know Your Rights

Your right to access your personal health information
By law, you or your legal representative generally has the right to view and/or get copies of your personal health information from health care providers who treat you, or by health plans that pay for your care, including Medicare. You also have the right to have a provider or plan send copies of your information to a third party that you choose, like other providers who treat you, a family member, a researcher, or a mobile application you use to manage your personal health information.

These includes:
  • Claims and billing records
  • Information related to your enrollment in health plans, including Medicare
  • Medical and case management records (except psychotherapy notes)
  • Any other records that contain information that doctors or health plans use to make decisions about you

Generally, you can get your information on paper or electronically. If your providers or plans store your information electronically, they generally must give you electronic copies. Also, you shouldn't be charged by viewing, searching, downloading, or sending your information through an electronic portal.

You have the right to get your information on time, but it may take up to 30 days to fill the request.


If you need help getting and using your health records, the Office of the National Coordinator (ONC) in the U.S. Department of Health and Human Services (HHS) created "The Guide to Getting & Using Your Health Records". This guide can help you through the process of getting your health record and show you how to make sure your records are accurate and complete, so you get the most of your health care.

How does Medicare use my personal information?
Medicare protects the privacy of your health information. 


Notice of Privacy Practices for Original Medicare
This notice describes how medical information about you may be used and disclosed and how you can get access to this information.

The law requires Medicare to protect the privacy of your personal medical information. It also requires us to give you this notice so you know how we may use and share the personal medical information we have about you. 


We must provide information to:
  • You, to someone you name, or someone who has the legal right t act for you
  • The Secretary of the Department of Health and Human Services, if necessary
  • Anyone else that the law requires to have it

We have the right to use and provide your information to pay for your health care and to operate Medicare. For example:
  • Medicare Administrative Contractors use your information to pay or deny your claims, collect your premiums, share your benefit payment with your other insurer(s), or prepare your Medicare Summary Notice.
  • We may use your information to provide you with customer services, resolve complaints you have, contact you about research studies, and make sure you get quality care.

We may use or share your information under these limited circumstances:
  • To state and other federal agencies that have the legal right to get Medicare data
  • For public health activities
  • For government health care oversight activities
  • For judicial and administrative proceedings
  • For law enforcement purposes
  • For research studies that meet all privacy law requirements
  • To avoid a serious and imminent threat to health or safety
  • To contact you about new or changed Medicare benefits
  • To create a collection of information that no one can trace to you
  • To practitioner and their contractors for care coordination and  quality improvement purposes
  • We must have your written permission to use or share your information for any purpose that isn't described in this notice. 
You have the right to:
  • See and get a copy of the information we have about you,
  • have us change your information if you think it's wrong or incomplete, and we agree. If we disagree, you may have a statement of your disagreement added to your information.
  • Get a list of people who get your information from us.
  • Ask us to communicate with you in a different manner or at a different place
  • Ask us to limit how we use your information and how we give it out to pay claims and run Medicare. We may not be able to agree to your request.
  • get a letter that tells you about the likely risk to the privacy of your information.
  • get a separate paper copy of this notice.

If you believe your privacy rights have been violated, you may file a privacy complaint with:

Filing a complaint won't affect your coverage under Medicare.

The law requires us to follow the terms in this notice. We have the right to change the way we use or share your information. if we make a change, we'll email you a notice within 60 days of the change. 


Mga etiketa:

Mga Komento

Mag-post ng isang Komento

Mga sikat na post sa blog na ito

Medicare and Hospital Discharged Planning

Hospital  discharge  planning is a process that determines what kind of care you will need after you leave the hospital. This discharge plans can help prevent future readmissions , and they should make your move from the hospital to your home or another facility as safe as possible. Medicare  requires hospitals to screen  inpatients  and provide discharge p lanning for those who need it. But this  is only mandatory for hospital inpatients, if you are an  outpatient, possibly  on  observation status,   Medicare will not require screening or discharge planning. However, there are some states that provide outpatients with rights to discharge planning services. For more information on discharge planning in your state, please contact your  State Health Insurance Assistance Program (SHIP) . Your  discharge plan  should include information about where you will be discharged to, the types of care you need, and who will provi...
Mag-post ng isang Komento
Magbasa nang higit pa

Medicare & group health plan after you retire

Will my group health plan still work after I retire? It would depend on the terms of your specific plan. Other employers might not offer any health coverage after your retirement and even if you can get one, it might have different rules and might not work the same way with Medicare. When you have retiree coverage from an employer or union, they usually manage this coverage. Employers aren't required to provide retiree coverage, and if they would, they can change benefits or premiums, or even cancel coverage.  They may offer coverage that limits how much it will pay. It might only provide a stop-loss coverage that starts paying your out-of-pocket costs only when they reach of coverage that's covered. What happens to my retiree coverage when I'm eligible for Medicare? When you become eligible for Medicare, you will need to have both Medicare Part A and Medicare Part B to get full benefits from your retiree coverage. If your former employer offers retiree...
Mag-post ng isang Komento
Magbasa nang higit pa

Medicare Part D Costs for 2020

Before 2006, Medicare did not cover prescription medications. There was a limited number of medications that were offered under Medicare Part Band,  and otherwise, you had to pay for your medications out of pocket. In 2003, everything had changed when President George W. Bush passed the Medicare Prescription Drug, Improvement, and Modernization Act (MMA). This is what we now know of as  Medicare Part D , an optional part of Medicare that provides prescription drug coverage. Part D plans are run by private insurance companies and not by the government. However, the federal government sets guidelines on what basic medications are covered and how much you can be charged.  A deductible is the amount of money you spend out of pocket before your prescription drug benefits begin. Your plan may or may not have a deductible. The maximum deductible a plan can charge for 2020 is set at $435. It has increased by  $20 from 2019...
Mag-post ng isang Komento
Magbasa nang higit pa