Wednesday, July 22, 2015

Learn the basics on Medicare - August 5 at Mentor Library

Turning 65 this year? Then now is the time for you to learn all you can about Medicare.

Join me on August 15 for my class, Getting Started with Medicare, a 90 minute informational session presented by me, Laura Mutsko of Mutsko Insurance Services, LLC.
We'll cover all the basics, so you have a better understanding of how Medicare works and how to make the most of it. Sessions are educational only: no specific benefits, products or prices will be discussed

Getting Started with Medicare
Mentor Library
Wednesday, August 5, 2015
6:30 - 8:30 PM
8215 Mentor Ave, Room B

The class is free and open to the public, but space is limited so call to reserve your spot today. 440-255-5700.  

For a complete list of other class dates and times, visit www.mutskoinsurance.com/seminars or call Mutsko Insurance Services at 440-255-5700.


Saturday, July 11, 2015

How to choose a new doctor

Whether you are searching for a new doctor because of a recent move or you’re just ready for a change, finding the right physician is an important step in managing your health care. Your primary doctor is the point where all your care begins. Studies indicate that having access to good primary care is linked to lower mortality rates, fewer hospital visits and better health outcomes.

Here are five tips for finding the right doctor for you:

Start by determining which doctors are in your insurance network. Doctors in an insurer’s network contract with the insurance provider and agree to accept specified payment rates. If you choose someone outside your plan’s network, your costs may be higher. To find a list of “in-network” doctors and hospitals, call your health insurer and ask for a list of in-network providers.

If you have Original Medicare, search for doctors using Medicare’s Physician Compare at Medicare.gov. This tool provides information about primary care providers, specialists, hospitals and more. It will also help you find providers who accept Medicare.

Ask for recommendations from people you trust. Check with family members, co-workers and friends for doctors they rely on. You can also ask for a recommendation from other health care professionals including your pharmacist, specialist or dentist.

Consider logistics. Do you want a doctor located close to your home or office? Consider their office hours – what days and times does the doctor see patients? Find out who covers for your doctor when he or she is not in?  Many doctors now use email or an online portal to communicate with patients which may be important to you when selecting a physician. It’s also a good idea to find out what hospital your doctor refers to.

Research your doctor’s background. You can find sites that provide information on certification or educational background at websites like the American Medical Association Doctor Finder and American Board of Medical Specialties Certification Matters.  To learn about complaints filed against a doctor, check with your state medical board.

Whatever you do, please don’t wait until you get sick or hurt and try to find a new primary care physician. By having an established relationship, it will be so much easier for you and your family if or when you require care.

For answers to your life, health or Medicare plan questions please contact me at Mutsko Insurance Services, LLC.Call 440-255-5700 today.

 

Wednesday, July 8, 2015

Insurance to help cover out-of-pocket expenses


As you already know, a hospital stay or an accident that requires medical treatment can be very expensive. And, no matter how good your health insurance plan or Medicare Advantage Plan is, there are going to be gaps and out-of-pocket expenses that you will have to pay. These extras add up quickly and chip away at your hard-earned savings.

The good news is there are now plans to help fill these gaps. I can show you a plan that will help to cover the kind of costs that you mentioned.  It’s called an Indemnity Insurance Plan. When you’re sick or hurt and your major medical plan steps in to cover your doctors, hospitals and other health care providers, this kind of insurance plan pays you cash benefits to offset the cost of deductibles, co-pays, household expenses and out-of-pocket costs not covered by other insurance. The benefits are paid directly to you, unless you choose to assign them to a medical provider.

Plans are available for virtually all age groups, including those over age 65.

The Indemnity Plan I have in mind for you is not a Medicare supplement policy. It is not a major medical policy. It is affordable coverage that pays you cash to use however you want whenever you’re sick, hurt or require nursing care. The plan is offered through one of the nation’s leading diversified health care benefit companies . . . a company that you can trust to be there when you need them.

Call me to learn more about Indemnity Insurance and how it can reduce some of the worry that accompanies a health care emergency. Call me for all your life, health and Medicare insurance needs and I’ll help you find the best insurance for you and your family. There’s never a charge for my services. Call 440-255-5700 today.


Friday, July 3, 2015

Be wary of FREE medical devices

You’ve probably received an email or phone call offering you a free knee brace, diabetes test strips or a personal alarm system. The caller says it’s FREE. Medicare or your health insurance plan will cover 100% of the cost. You are assured there’s no obligation on your part and all they need is a little information to get started.

Sounds tempting, but my advice to you is WATCH OUT. It may be a scam designed to separate you from your hard earned money.

According to the Better Business Bureau, “In one version (of the scam) the recorded call claims that you can get an alarm system or medical supplies worth several hundred dollars for free. You are just responsible for a low monthly charge. In another variation, the call or email claims that “doctor-ordered” medicine or a medical device is already in the mail, and the call is confirming the shipment. In both cases, you will be asked to provide personal and/or insurance information. Just don’t expect your “free” products to ever arrive.” 

If you wish to follow up on a low-cost or free offer you’ve received, take the callers information and then contact your doctor or healthcare provider to help you determine whether the product or device is something you need. Medicare and insurance companies only cover durable medical equipment and other items that are medically necessary. You may want a scooter, but if you don’t need one, Medicare won’t pay for it.

Remember, it is illegal for medical device companies to make unsolicited calls to people on Medicare. The only three exceptions to this rule are:

1.    If you gave the company written permission to contact you

2.    If you received an item from the company in the past

3.    If the item you received was covered by your plan or the call is regarding that item.

While some of these low-cost/no-cost offers may be legitimate, you should always be careful. Under no circumstances should you provide personal medical information, banking information or Medicare identification information to anyone before you double check with your insurance company, your health care provider and the Better Business Bureau.

Always remember the old saying, “There’s no such thing as a free lunch.”

Got questions on insurance? Call me today at 440-255-5700 or email me at Lmutsko@mutskoinsurance.com.

Tuesday, June 30, 2015

Costly difference for you between being admitted or under outpatient observation care

Warning:  There is a really BIG difference between being classified as an admitted patient vs observation care when you're in the hospital. ‘Observation status’ changes what Medicare pays for as well as qualifying you for rehab care.

Over the past few years, some hospitals have increasingly classified the status of Medicare beneficiaries as out-patient observation instead of admitted patients. This classification dramatically reduces Medicare’s contribution to your cost of a hospital stay and any follow-up care in a skilled nursing facility.

Medicare considers hospital observation an outpatient service. Current Medicare law requires a patient to be admitted to the hospital as an inpatient for a minimum of three days in order to receive coverage for follow-up care in a skilled nursing facility. After that, Medicare pays for the first 20 days of skilled care at 100%. Should a patient be under observation for all or part of his hospital stay, he will be responsible for the entire cost of rehab.

Observation patients may also be charged co-payments for their doctors’ fees and other hospital services including X-rays, drugs and lab tests.

How to Avoid “Observation” Status

The problem is that you may not know whether you are receiving observation care or have been admitted as a patient unless you ask so it’s up to you to take the following steps:

1.     Ask about your status when you are admitted and each day that you are in the hospital. Your status can be changed from inpatient to observation or back again.

2.    Ask your doctor if observation status is justified for your medical condition. If not, ask your doctor to contact the hospital to request that you be admitted as an inpatient.


3.     After discharge, if you find out Medicare won't cover your stay in a skilled nursing facility, ask your doctor whether you qualify for similar care at home through Medicare's home health care benefit.

4.    If you have to pay for services at a skilled nursing facility, but you believe those services should have been billed as inpatient, you can try formally appealing Medicare's decision.

If you have a Medicare Advantage Plan, costs and coverage may be different. Always check with your agent or plan provider.  My clients can always call me if they have questions at 440-255-5700 about these or other issues concerning their insurance coverage.
            

Tuesday, June 23, 2015

Traveling outside the U.S. this summer?

Make sure your insurance travels with you.

You may be surprised to learn that Original Medicare does not pay for health care services or supplies you get outside the U.S. except in very limited situations. Medicare considers the 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa to be a part of the U.S. 

On your cruise for example, Original Medicare may cover medically necessary health care services you receive on board the ship within the territorial waters adjoining the land areas of the U.S. However, Medicare will NOT pay for health care services you get when a ship is more than 6 hours away from a U.S. port when you receive the services, regardless of whether it’s an emergency. 

Original Medicare will provide coverage for out of country travelers only if their situations meet very specific exceptions as outlined in your Medicare & You Handbook. If your circumstances do not match the allowable exceptions, you will be responsible to pay the full cost to the health care provider. If your situation matches one of the allowable exceptions, you still pay the coinsurance or copayments and deductibles you would normally pay if you received these services or supplies in the U.S.

Medicare drug plans (Part D) cannot cover prescription drugs you buy outside the U.S. so be sure to bring a sufficient supply of your prescription medications with you.

If you have a Medicare Advantage Plan or Medicare Supplement, you may be entitled to additional coverage for health care services you receive outside the U.S. Advantage Plan coverage may vary so it’s best to give your insurance agent a call and ask them about your coverage before you begin your trip.

While I make every effort to provide you with up to date, accurate information, these are general guidelines. Your situation or circumstances may be different. For answers to your life, health or Medicare plan questions please contact me at Mutsko Insurance Services, LLC, 440-255-5700.

Wednesday, June 17, 2015

Medicare coverage for diabetes management

Original Medicare and Medicare Advantage Plans provide a broad spectrum of support and services to help you manage your diabetes. It is in the best interest of your health as well as your wallet to become familiar with your benefits.

For example, if your doctor determines you are at risk, Medicare Part B will cover the cost of up to 2 diabetes screenings each year.

Part B will also cover outpatient training for people at risk for complications from diabetes or recently diagnosed with diabetes. Training will include tips for eating healthy, being active, monitoring blood sugar and taking medication. Your doctor or other health care provider must provide a written order to a certified diabetes self-management education program for this to be covered. You will be responsible for 20% of the Medicare approved amount as well as any Part B deductible.

Medicare Part D (Prescription Drug coverage) is the part of your Medicare Plan that covers medications prescribed to manage diabetes. Part D also covers certain medical supplies for administration of insulin, including syringes, needles, alcohol swabs, gauze, and inhaled insulin devices. As with other medications, when you purchase prescriptions or other supplies, you will be responsible for your coinsurance, copays and any Part D deductible.

Even if you don’t use insulin, Medicare Part B covers blood sugar self-testing equipment and supplies with a prescription from your doctor. Self-testing supplies include monitors, test strips, lancet devices, lancets and glucose control solutions. Check with your Medicare provider before ordering any supplies or durable medical equipment for the name of their recommended provider. Physicians and suppliers have to meet strict standards to be enrolled in Medicare. If your doctors or suppliers aren’t enrolled, Medicare won’t pay the claims submitted by them. If suppliers don't accept assignment, there’s no limit on the amount they can charge you.

If you have a Medicare Advantage Plan, it will provide you with the same coverage as Original Medicare, and often additional benefits.

The management of diabetes can be complicated, but help is available. The tips  presented here are general guidelines and you should always verify that your  providers accept Medicare assignments. For more specific benefit information, contact your insurance agent or consult your Medicare plan materials.


Got questions on health, life or Medicare Insurance? Contact me at 440-255-5700 or email me. I’ll answer your questions and help you find the right insurance plan for you.