Saturday, October 10, 2015

PayClose Attention to Your Medicare Part D Coverage

Don’t make a costly mistake and get locked into a Medicare Part D Prescription Drug Plan that’s not right for you. Take a look at the changes being made in your coverage and what it will cost you in 2016. You have an opportunity now, during open enrollment to change plans if you need to do so.
Some plans are making significant changes. Look at what tier your prescriptions will be in. What are the costs of each tier?  Have they changed from last year? Also look at your deductible and co-pay. All of this will determine whether your out-of-pocket costs are going up or going down next year.
Call me if you would like to look at other Medicare Part D Prescription Drug Plans. We’ll sit down and do a review and help you determine which plan is the best fit for your needs.

Thursday, October 8, 2015

Do Medicare or Medicare Advantage Plans cover eye exams? What about glasses?

Unfortunately, routine eye exams (sometimes called "eye refractions") that test for eyeglasses or contact lenses are normally not covered under Original Medicare. (Coverage is available through a number of Medicare Advantage Plans, but more about that later.)

Most major vision care procedures are covered, including cataract surgery, treatment of eye diseases and medical emergencies. Original Medicare will also pay for exams to test for other problems like macular degeneration, dry eye syndrome and eye infections.

Original Medicare provides coverage for eyeglasses following cataract surgery and contact lenses if the lens were inserted during cataract surgery. Medicare will not pick up the extra cost if you choose a specialized lens that restores full range of vision in order to reduce your need for glasses after cataract surgery. 

If you have diabetes or are at high risk for glaucoma you will be covered for an annual exam. People at high risk include diabetics, those with a family history of glaucoma and older Hispanics and African-Americans.

So are there other options? There are a number of Medicare Advantage plans that include vision coverage as part of their plan. If you know you are going to want to visit your eye doctor every year, it’s a good idea to consider one of these plans instead of Original Medicare. In addition to covering a percentage of the cost of exams and eyeglasses, many of these plans include dental, hearing and prescription drugs coverage.  

Another option is to purchase a Medicare Supplement, sometimes referred to as Medigap Insurance. A Medicare Supplement will cover your out-of-pocket costs for approved Medicare vision procedures. Remember, Original Medicare does not consider routine eye exams and prescription glasses to be approved expenses.

Military veterans who are visually impaired may be eligible for the VA’s vision health benefits. These range from primary care services to intermediate and advance clinical vision care. If you qualify for veterans benefits, check with your local VA Medical Center for more details.

If you would like to learn more about insurance plans that cover vision care, hearing or dental costs, please contact me at 440-255-5700. Open enrollment begins October 15 and is a good time to take a look at your options for 2016 to find a plan that fits your needs.

Tuesday, October 6, 2015

What are some affordable dental care options with Medicare?

If you plan to stay with Original Medicare, your dental options will be very limited. Original Medicare DOES NOT pay for routine dental care, including the cost of exams, teeth cleaning, tooth extractions, x-rays and dentures. This means that you can expect to pay 100% of the costs for all these services if you want to keep your healthy smile.

Original Medicare will only cover the cost of dental procedures related to covered medical procedures. For example, Medicare will cover extractions before cancer radiation therapy or jaw reconstruction after an injury. Procedures such as these are covered because they are necessary to treat a non-dental condition. They must be treated at the same time and by the same doctor as the covered condition.

There are other affordable options for dental coverage available to you. 

At Mutsko Insurance Services, LLC we offer a number of Medicare Advantage Plans that include coverage for routine dental care as well as vision, hearing and prescriptions. 

Coverage and costs will vary from plan to plan, and some plans may charge additional for dental coverage. There are plans that cover a percentage of your costs for cleanings, x-rays and exams while other are more comprehensive and will cover major dental services like crowns, bridges, root canals and denture, in addition to your routine care. It all depends on which plan you choose.

Before you sign up for any Medicare Advantage Plan, compare the dental coverage and costs and the find out whether your dentist is in the provider network. At Mutsko Insurance Services, we’ll do the work for you. We’ll show you your coverage options and determine whether your dentist is in the network. Our job is to help you find the plan that works best for you.

For more information on Medicare Advantage Plans, Medicare Supplements, dental, vision and other coverage options, please contact Mutsko Insurance Services, 6966 Spinach Drive in Mentor, OH or call 440-255-5700 or email me to make an appointment for a Medicare review.

Monday, October 5, 2015

Questions that help you evaluate your Medicare Plan

Medicare Open Enrollment begins October 15 and ends December 7. During this window, you have the chance to evaluate your current coverage to make sure you're getting the most out of your plan.

Start by asking . . .

Does your current Medicare plan still fit your budget?

Do you have access to the doctors, hospitals and other health care providers that are important to you?

Does your plan include routine dental, vision or hearing coverage?

Are you covered when you're traveling?

What will your prescription coverage cost you this year? And, are your prescriptions covered?

Do you have a fitness membership or other fitness benefit?

If your plan falls short on any of these points, call me. We'll take a look at other options.  440-255-5700. 

Tuesday, September 29, 2015

No Health Insurance? Penalties are going up for 2016

If you can afford health insurance but choose not to buy it and you do not have an exemption, you will likely be assessed tax penalties that will be collected with your federal tax return. 

According to,, the fees for not having coverage in 2016 are increasing and will be the higher of these two amounts:

·                  2.5% of your yearly household income
·               $695 per person ($347.50 per child under 18)
Open enrollment for Affordable Care coverage begins on November 1 and closes January 31, 2016. During this period, it is important for you to review your health care plan and make any changes or sign up for coverage for the coming year. To begin shopping for your Affordable Care plan go to and click on Online Quotes.

Don’t put off enrolling in a plan. If you have questions or need help finding the right coverage, call me at 440-255-5700 or email me today.  

Saturday, September 26, 2015

Don't get locked into a Medicare Advantage Plan that no longer works for you.

Whether this is your first Open Enrollment season or you’ve been through a few, it pays to take time now to study your Medicare and Medicare Advantage Plan options. Remember, plans can change their coverage, benefits and costs. You don't want to find out too late that you're locked into a plan for all of 2016 that doesn't cover your doctors, your hospitals or your medications. You should receive updated information by October 1 on your plan.

I also recommend that you sit down with friends or family members who may have questions and aren't sure what to do. Please set aside some time to go over their current Medicare or Medicare Advantage Plan coverage and figure out if they need to make any changes. If you need assistance, call me at 440-255-5700 or email me and I'll look into your concerns and offer some options.

The dates to remember are:

October 1 – 15   Evaluate your current Medicare plan
October 15        Open Enrollment begins and you can make changes.
December 7      Open Enrollment ends. Last day to make changes for 2016

Friday, September 25, 2015

What Medicare doesn't cover, a Medicare Advantage Plan may

Need hearing aids? Think you're covered by Medicare?

Think again.

If you have Original Medicare, you will not be covered for the cost of routine hearing exams, hearing aids or fittings for hearing aids. Medicare Part B only covers diagnostic and balance exams if your doctor or other health care provider orders these test to see if you need medical treatment for balance issues, vertigo or a recent injury.  

Even if your exam is covered by Medicare Part B, you will still be responsible for the Part B deductible and 20% of the Medicare approved amount for the doctor’s services. If your test is done in a hospital setting, you may also be responsible to pay hospital co-pay costs.  

If you have a Medicare Advantage plan or Medicare Supplement, you may have coverage for a percentage of hearing exams and hearing aids. Your first step should be to review your Insurance Plan’s Summary of Benefits and Coverage or contact your agent to find out what your plan includes. Be sure to ask if your plan requires that you go through specific approved suppliers or if the plan has other guidelines you will need to follow.

Talk to your doctor or other health care provider to find out how much your test, hearing aids and other services will cost. The amount you’ll owe will depend on several things including how much your doctor charges, whether your doctor accepts assignments and where you get your test and hearing aid. Let your doctor know you’re concerned about costs in order to avoid being surprised with an unexpected big bill.

Now, during Medicare Open Enrollment, is a good time to look into a Medicare Advantage plan that offers coverage for hearing.  I can show you a number of plans with this option.

Other Options
In some cases, the U.S. Department of Veterans Affairs may offer financial assistance or reduced cost hearing aids for Veterans. Vets are eligible for hearing aids if their hearing loss is connected to their military service or linked to a medical condition treated at a VA hospital. Veterans can also get devices if their hearing loss is severe enough to interfere with activities of daily life. For details, contact your local Veterans Medical Center or visit

Hearing loss is not just inconvenient; it’s a serious health condition. Better hearing may lead to a better life. 

If you would like to learn more about Medicare Advantage Plans that include coverage for hearing, dental and eye care, please contact me at 440-255-5700 or email me. I can show you a variety of plans that will provide the coverage you’re looking for.