Patients & Visitors

Right care, at the right time, in the right setting.

Your doctors try hard to give you high quality care, but it can be a challenge to juggle information. Working with Medicare, Hampton Roads Good Help ACO wants to make sure your doctors have the resources and information they need to coordinate your care. Your doctors, hospitals, and other health care providers have decided to participate in Hampton Roads Good Help ACO to give better, more coordinated health care to patients like you. You will benefit because they are working together to get you the right care, at the right time, in the right setting.

CMS Fact Sheets

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FREQUENTLY ASKED

Can I still choose the same doctor?

Answer: Your Medicare benefits won’t be limited because your doctor is part of an ACO. You still have the right to choose any hospital or doctor that accepts Medicare, at any time, even if that hospital or doctor isn’t a part of an ACO. Your doctor may make recommendations, but it’s always your choice on what doctors or hospitals you use. An ACO is NOT a Health Maintenance Organization (HMO), managed care or an insurance company An ACO is a group of doctors, hospitals, and other health care providers who communicate with you and with each other to make sure you get the care you need when you’re sick and the support you need to get and stay healthy. Unlike HMOs, managed care, and some insurance plans, an ACO can’t tell you which health care providers to see or hospital to visit, and can’t limit your Medicare benefits. Also, only people with Original Medicare can be assigned to an ACO. You can’t be assigned to an ACO if you have a Medicare Advantage Plan (like an HMO or a Preferred Provider Organization).

What to expect if your doctor is in an ACO?

Answer: When your health care providers participate in an ACO, you should see better, more coordinated care over time. With an ACO, you’re the center of care, and your satisfaction is one of the goals. Over time, you may notice that:

You don’t have to fill out as many medical forms that ask for the same information.
The health care providers that you see all know what’s going on with your health because they communicate with each other.
You don’t need to repeat medical tests because your results are shared among your health care team.
The providers participating in the ACO will work with you to make sure their health care decisions reflect your preferences.

How to know if your doctor participates in an ACO?

Answer: Doctors or health care providers who choose to participate in an ACO must display a poster that notifies you of your doctor’s participation in an ACO. It also informs you of your option to decline sharing your health care information by calling 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048. If you aren’t sure if your doctor or health care provider is participating in a Medicare ACO, ask him or her during your visit. For general information about ACOs, call 1-800-MEDICARE.

What rights do you have if your doctor is in an ACO?

Answer: You’ll continue to have the same rights all people with Medicare get. To help you to get the best-coordinated and highest quality care, Medicare will share certain information about your medical care with your doctor’s ACO, including medical conditions, prescriptions, and visits to the doctor unless you have called 1-800-MEDICARE to tell Medicare not to share your health care information with your doctor’s ACO or other ACOs. This information is important to help the ACO keep up with your medical needs and track how well the ACO is doing to keep you healthy. Also, you may get a follow-up survey to ask about your experiences as a patient of a doctor who’s participating in an ACO. You’ll get a letter to let you know the survey is genuine. The ACO will use your feedback to help make sure you get high quality care. ACOs are required to respect your privacy so you have the option to tell us not to share your health care information. You must call 1-800-MEDICARE (1-800-633-4227) to tell Medicare not to share information about your care with your doctor’s ACO or any other ACO. TTY users should call 1-877-486-2048. Unless you take this step, your medical information will be shared with your doctor’s ACO for purposes of care coordination and quality improvement. Your medical information will be protected. Federal law protects the privacy and security of your medical information. The group of doctors, hospitals, and other health care providers in the ACO working together on your behalf will be able to read your medical records, along with other office staff authorized to help coordinate your care. Each of your health care providers won’t only know about the health issues that they’ve treated, they’ll have a more complete picture of your health by sharing information with your other health care providers. Contact your doctor’s office for more information about how they protect your medical information, or call 1-800-MEDICARE to learn more about how Medicare protects your medical information. For more information about ACOs:

Visit CMS.gov/Medicare/Medicare-Fee-for-Service-Payment/ACO/.
Visit Medicare.gov/manage-your-health/coordinating-your-care/accountable-care-organizations.html.
Talk to your doctor.
Call 1-800-MEDICARE.

ANNUAL WELLNESS VISIT

Sign up for your Annual Wellness Visit with your primary care provider! If you have Medicare, every year you can talk with your health care provider about your health problems, review the medications you take, and make a plan for your health. If you are new to Medicare, you can schedule a one-time, Welcome to Medicare Preventive Visit. Or if you have Medicare for a year or more, you can schedule your Annual Medicare Wellness Visit. During these visits, you can talk with you health care provider about your health problems, review the medications you take, and make a plan for your health. That plan should include the shots and screenings that are right for you. If you have had Medicare Part B for longer than 12 months, you can get a yearly Medicare Wellness Visit to develop or update a personalized prevention plan based on your current health and risk factors. During the visit, your health care provider will:

Complete a comprehensive review of your medical and family health history.
Check your height, weight, and blood pressure.
Review your current medicines.
Schedule recommended shots and screenings.
Advise you on personal medical issues and treatment options.

How often is it covered? The Annual Medicare Wellness Visit is covered once every 12 months. "Welcome to Medicare Preventive Visit" Medicare covers a one-time preventive visit within the first 12 months that you have Medicare Part B. This visit is called the "Welcome to Medicare" Preventive Visit The visit is a great way to get up-to-date on important screenings and shots and to talk with you healht care provider about your family history and how to stay healthy. What happens during the visit? During the visit, your health care provider will:

Complete a comprehensive review of your medical and family health history.
Check your height, weight, and blood pressure.
Calculate your body mass index.
Do a simple vision test.
Give you advice to help you prevent disease, improve your health and stay well.
Make appropriate referrals where necessary.

How often is it covered? The "Welcome to Medicare" Preventative Visit is only covered one time, and you must have the visit within the first 12 months you are enrolled in Medicare Part B. Our providers stress the benefits of the Annual Wellness Visit in ensuring beneficiaries receive all evidence based prevention screening and treatments to prevent disease, early detection, and lifestyle modifications that support a healthier life. We strongly encourage patients to take advantage of this Medicare benefit as it will usually cost you absolutely nothing!

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