Arlington’s Virginia Insurance Counseling and Assistance Program (VICAP) is introducing a fresh look and style for our newsletter to make it easier for customers to find the information they need quickly and efficiently. We are confident this tool will serve as a resource to keep you informed about programs, services, and Medicare updates that impact the VICAP community.
Take a look around and Let us know what you think!
Arlington County’s Virginia Insurance Counseling and Assistance Program
(VICAP) provides free, in-depth, one-on-one insurance counseling to Arlington
County Medicare Beneficiaries, their families, friends and caregivers.
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You're invited to join VICAP in collaboration with Virginia Hospital Center and Arlington County’s Police Department for a virtual program on Friday, March 25th from 11:00 AM - 12:00 PM to learn about ways to protect yourself against fraud.
Discussion Topics:
- Medicare Scams & Fraudulent Requests to Include Prescription Drug Fraud
- How to Prevent, Detect, and Report Fraud and
- Top Tips, Red Flags, & Resources to Enhance the Security of Older Adults
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Colorectal Cancer Awareness Month
Did you know that according to the American Cancer Society, 1 in 23 men and 1 in 25 women are likely to be diagnosed with colorectal cancer in their lifetime? Among diverse groups of individuals in the U.S, Colorectal Cancer and mortality rates are highest in African Americans. This is due to both risk factors and access to healthcare among other various reasons.
Medicare covers screening colonoscopies once every 24 months if you’re at high risk for colorectal cancer. If you aren’t at high risk for colorectal cancer, Medicare covers the test once every 120 months, or 48 months after a previous flexible sigmoidoscopy. There is no minimum age requirement.
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Outpatient mental health care can be an important benefit to a beneficiary. Medicare covers outpatient mental health services in settings such as a doctor’s office or other health care provider’s office, a hospital outpatient department, or a community mental health center. Medicare only covers visits when they are provided by a health care provider who accepts assignment, which means that they agree to accept the Medicare-approved amount as full payment for any covered service provided.
Report potential outpatient mental health care fraud, errors, or abuse if:
- You are picked up by a bus or van along with other beneficiaries and taken out for a meal and Medicare was billed for a psychiatric evaluation
- You spend all day watching TV or playing games at a facility and Medicare was billed for group psychotherapy
- You see on your Medicare Summary Notice (MSN) or Explanation of Benefits (EOB) charges for:
- Mental health services or time spent in excess of what was received
- Mental health services that were not received
- Mental health services that were not provided by a psychiatrist or other doctor, clinical psychologist, clinical social worker, clinical nurse specialist, nurse practitioner, or physician assistant
To learn how to read your Medicare Summary Notice (MSN) and Explanation of Benefits (EOB), click here.
Report Suspected Fraud
To report suspected fraud, click here.
Dear VICAP Team,
I'm covered by my husband's employer health insurance because he is still working, but I'm turning 65 in a few months and wonder if I should enroll in Medicare?
Dear Medicare Beneficiary,
Great job looking into this ahead of time! Having employer health coverage can allow you to delay your Medicare enrollment. Be sure to ask yourself these two questions when you consider delaying enrollment:
- Will I have a chance to enroll in Medicare Part B later on without having to face a penalty?
- Will my employer based insurance, or my spouse's employer based insurance, pay primary for my health care?
If you become eligible for Medicare because of your age, (meaning you'll be 65+), and are covered by your employer health insurance or your spouse's employer health insurance, then you will have a Special Enrollment Period (SEP) to enroll in Part B. Your Special Enrollment Period (SEP) is an 8 month window that begins after your employer/ or your spouse's employer health insurance ends or you or your spouse stops working (whichever happens first).
If your employer health insurance, or your spouse's employer health insurance, is from an employer with 20+ employees, than that employer based insurance pays primary on your health care claims, and Medicare is secondary. In this case, some people choose not to enroll in Part B so that they don't have to pay the additional $170.10 monthly premium for Part B.
If your employer health insurance, or your spouse's employer health insurance, is from an employer with less than 20 employees, than Medicare pays primary, and the employer based insurance may provide little to no payment towards your health care claims. In this case, you should not delay Medicare Part B enrollment and should enroll when you first become eligible.
Contact your employer or your spouse's employer human resources department to find out if your employer health insurance would pay as primary or secondary. Keep in mind, if you have insurance from your employer or spouse's employer that is not because of current work, such as COBRA or retiree insurance, the rules for a Special Enrollment Period (SEP) will differ.
 Contact the Arlington County VICAP team one of two ways:
By Phone: (703) 228-1725
By Email: MedicareHelp@arlingtonva.us
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