Dental Insurance is available with Affordable Care Plans

In the Health Insurance Marketplace, you can get dental coverage 2 ways: 

1.  as part of a health plan, or 
2.  by itself through a separate, stand-alone dental plan

You can buy a dental plan through the Federal Marketplace
only when you enroll in a health plan.

As part of a Health Plan
In the Marketplace, dental coverage is included in some health plans. You can see which plans include dental coverage when you compare them. If a health plan includes dental coverage, you’ll pay one monthly premium for everything. The premium shown for the plan includes both health and dental coverage.

As a separate, stand-alone dental plan                                                                
In some cases separate, stand-alone plans are offered. You may want this if the health coverage you choose doesn’t include dental coverage, or if you want different dental coverage. If you choose a separate dental plan, you’ll pay a separate, additional premium.

For more information, go to www.mutskoinsurance.com and click on Get a Quote. I will get back to you with more information. 

The deadline to sign up for Affordable Care is February 15. Don't risk hefty fines for not having insurance. Contact me today.

Early retirees - Affordable Care is for you, too.

A major challenge for many early retirees used to be finding affordable health insurance to bridge the gap until they were age 65 and eligible for Medicare. 

In some cases, the retiring spouse could get coverage from their former employer but their spouse was not included. Others were denied coverage or charged higher premiums because of a preexisting condition.The Affordable Care Act changed all this. Insurance providers may no longer reject you or charge higher premium rates because of your health. 

If you are an early retiree and want more information on enrolling in a health insurance plan, give me a call today at 440-255-5700 or email me at lmutsko@mutskoinsurance.com.

Medical bills are the #1 cause of bankruptcy

Many American adults will struggle to pay medical bills this year. A sudden accident or frightening diagnosis can touch virtually anyone, unleashing mountains of bills. In fact, medical bills are the leading cause of personal bankruptcy.

For those with insurance, you can help keep your medical bills in line by taking the following steps:

• Compare your Explanation of Benefits against your medical bill to check for mistakes.
• Appeal any denied claims, 
• Ask your hospital or other health care provider if any financial aid is available

If you don't have insurance, don't put off enrolling in a plan any longer. Don't put your financial security at risk. Call me today and I'll help you find a health insurance plan to fit your needs. 

Steps to take now with your prescription drugs

The first seven to ten days of the new year are extremely busy for your local pharmacy. People have new insurance plans. Some have waited until the first of the year to get their prescription. And the pharmacy has to take extra time updating customers' information.

Don't get caught short.

Check now before the end of the year to make sure you have enough of your prescription drugs to last you through the first few days of the new year. 

Double check that your current pharmacy is still a part of your plan's preferred network. 

If you need to switch your prescriptions to a new pharmacy, talk to your pharmacist to find out what you can do right now to avoid any delays in getting your prescriptions filled during the first week of the new year.

Improve your health - Adopt a pet

I LOVE my three dogs and cannot imagine life without them. They are my best buddies and never fail to amp up the happiness level in our home. If you feel lonely or need a daily infusion of joy, I encourage you to consider adopting a dog, cat, fish or bird.

Bringing a new best friend into your home will help to alleviate loneliness and bring opportunities to meet new people and experience new things.Click on the links here to see who is waiting for you!

Lake County Humane Society  http://www.lakehumane.org/

Geauga Rescue Village  http://www.geaugahumane.org/

If you need more reasons, consider these: 

"According to The American Heart Association, owning a pet — particularly a dog — may help lower your risk of heart disease. There are two possible reasons for this. First, pets generally make people happy, providing the dog hasn’t recently ripped apart the couch cushions. Second, dog owners who walk their pets are more likely to get the level of daily physical activity needed for good health. There are other ways pet ownership may be beneficial to your health, such as:

• Going for a walk in the neighborhood or park helps keeps you physically active. It may also be good for your overall well-being. Going out with your pet may lead to more socializing, too.

• A furry friend provides emotional support, which may decrease stress and loneliness.*

*Taken from 

Pets and Good Health

Posted by Medicare Made Clear

Can my child get Marketplace Health Insurance if it's cheaper?

I was recently asked this question . . . 

If a child under age 26 is able to get coverage under a parent’s policy, can they get a lower cost plan with Marketplace insurance based on income if they apply themselves?

Answer:  It depends on whether the child is a dependent in the parent’s tax household.

If the under-26 child is claimed as a dependent in the parent’s tax household - and if they have access to a parent’s job-based coverage – they are not eligible for lower costs on a Marketplace plan. This is because they have access to job-based coverage.

If the child files taxes themselves, they may be eligible for lower costs on a Marketplace plan based on their income. This is true even if they have access to a parent’s job-based coverage.

But if the child is enrolled in a parent’s job-based coverage, they are not eligible for lower costs on a Marketplace plan.

My son is turning 26. What are his health insurance options?

Coverage for adult children ends on a child’s 26th birthday when they are required to secure their own health insurance. 

Regardless of whether their birthday occurs during Open Enrollment* or not, they will qualify for a Special Enrollment Period that allows them to sign up for a health plan outside of the Open Enrollment.The Special Enrollment Period will end 60 days after their birthday.

If they enroll before their 26th birthday, coverage can start as soon the first day of the month they lose coverage. If they enroll during the 60 days after their birthday, coverage will start the first day of the month after they pick a plan.

If they don’t enroll in health coverage within 60 days of their birthday, they will not have to wait to get coverage until the next Open Enrollment period and may have to pay the fee for being uninsured. For 2015, the fee is 2% of your income or $325 per adult, and $162.50 per child, whichever is more.

 

If they go without coverage for less than 3 months of the calendar year, they don’t have to pay the fee.

* Open Enrollment is going on now through February 15, 2015

Avoid these classic Medicare scams.

Medicare Open Enrollment always presents an opportunity for unscrupulous people to come out of the woodwork with financial scams designed to separate you from your hard earned money. Here are a few tips to help you avoid getting scammed:

- Never pay upfront fees. If someone asks for money to help you shop for insurance, it's a sure sign they're not legitimate.

-   Be wary of anyone calling you, claiming to be a Medicare representative or a representative of any other government agency. Official government agencies typically communicate by mail. If you’re concerned, ask the caller to send the information to you in writing through the mail.

- Do not fall for phone calls where someone pretends to be a representative from the government selling insurance or signing you up for Medicare. The government will not call you to sell you health insurance.

-  Do not provide personal information including your Social Security or banking info to anyone you do not know and trust. Your Medicare card has your social security number on it too, needs to be safeguarded. If you give out this information by mistake, immediately inform your banks and credit card providers.

-  If you are suspicious of a caller, simply hang up the phone.  Don't count on caller ID to prove who the caller is.The phone number and/or organization name on your caller ID can be faked to look like a legitimate organization.

- Never give your medical history or specific treatments you have received, to anyone who asks you for it.

One of the easiest ways to protect yourself from insurance scams is to seek out a knowledgeable insurance professional who has a well-established reputation in your community. By doing so, you’ll know that your insurance agent will be around when you have questions or a claim. Mutsko Insurance Services, LLC is this kind of insurance agency. We are conveniently located in Mentor, OH and have been serving customers throughout N.E. Ohio for nine years. You can count on us to be here for you now and in the future. 

Call us at 440-255-5700 for all your health insurance needs

Check out the latest online Senior Citizen's Resource Guide

The Fall/Winter edition of the Senior Citizens Guide is now available online. This is a great little resource guide for Seniors and Boomers with articles on a variety of topic In this edition, you can read about:

•          Reverse Mortgages. Common Misconceptions
•           What’s Your Plan When You Leave the Hospital?
•          Senior Real Estate Specialists
•          Charitable Gift Annuities Offer Steady Income, Attractive Rates
•          Managing Work/Life Imbalance for Caregiver

Plus, there's a handy list of phone numbers for local health, housing and community services.

Click here  http://www.seniorcitizensguide.com  to check out the latest online edition. 

Open Enrollment for Affordable Care Year 2 begins Nov.15

What do I need to know about Affordable Care Act 2015?

Here are four key points you need to know:

1.  Now is the time for you to look into getting health care insurance. The Open Enrollment Period for the Affordable Care Act begins this Saturday, Nov. 15 and continues through Feb. 15, 2015.

2.  Open Enrollment is the one time of year when you can enroll in a new plan or switch from one plan to another. You will not have another opportunity to enroll until the next Open Enrollment Period in the fall of 2015 unless you have a qualifying life-changing event such as the birth or adoption of a child, divorce, marriage or death of a spouse

3.  You must enroll in a plan by December 15, 2014, if you want your coverage to start on January 1, 2015.

4.  If you don’t have health coverage in 2015, you may have to pay a penalty equaling 2% of your taxable income or $325 per adult, and $162.50 per child, whichever is more.

A variety of plans are now available for individuals and families to suit your needs and budget. To find the best plan for you click her to Get a Quote. Complete the online application and we will be in touch with you within 24-48 hours to answer your questions and complete your enrollment.

For more information on Affordable Care Plans, please contact Laura Mutsko at Mutsko Insurance Services, LLC, 6966 Spinach Drive in Mentor, OH. Call 440-255-5700 or email lmutsko@mutskoinsurance.com. 

Here are three good reasons you should have health insurance.

Reason 1: 

1-day hospital stay                $1,910*

Physician, drugs and treatment costs not included

Reason 2:

5-day hospital stay                $9,550**

Physician, drugs and treatment costs not included

Reason 3:

Broken leg (with surgery)  $17,000-35,000***

Physician, drugs and treatment cost not included

According to the National Safety Council, one in eight people will need medical care for an accident. Will you be that one in eight?

Open enrollment for the Affordable Care Act begins November 15. If you don't have health insurance, please make it your business to get insured this fall. Don't risk the financial setbacks that one injury can cause.  

For a fast, no-obligation free quote, got to www.mutskoinsurance.com and click on 'free quote.'

*statehealthfacts.org, The Henry J. Kaiser Family Foundation.

**National Hospital Discharge Survey, Centers for Disease Control and Prevention.

***Costhelper: http://health.costhelper.com/broken-leg.html. 

Will Medicare cover my dental work?

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,  however, 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 at lmutsko@mutskoinsurance.com to make an appointment for a Medicare review.

Is a Medicare Advantage Plan the right choice for you?

Most people understand the basics about Medicare; that Medicare is a federal health insurance program managed by the Centers for Medicare & Medicaid Services (CMS) in which the government pays your Medicare benefits when you receive them. However, many people do not have a clear understand of Medicare Advantage Plans and how they work.

Basically, Medicare Advantage Plans are a different way for you to get your Medicare benefits. Advantage Plans, are offered by private insurance companies that have been approved by Medicare. Medicare pays these companies to cover your Medicare benefits and in turn, these companies must follow rules set by Medicare.
Medicare Advantage Plans provide the same coverage as Original Medicare.* In addition, many Medicare Advantage Plans offer extra coverage like vision, hearing, dental, and health and wellness programs. Many Plans include Medicare prescription drug coverage (Part D). All Medicare Advantage Plans cover you for emergency and urgent care services as well.

You must have Medicare Part A and Part B and live in the Medicare Advantage Plan’s service area to be eligible to join.

In addition to your Part B premium, you usually pay one monthly premium for the services included in a Medicare Advantage Plan. The total cost of the premiums, copayments and deductibles you pay under a Medicare Advantage Plan is often lower than those same total costs through Original Medicare.

A number of companies offer Plans with “zero premiums.” Although you pay no premiums to the Advantage Plan, you are still responsible for payment of your Medicare Part B premium.
Now, during Medicare’s Annual Open Enrollment Period, is the time for you to look into your Advantage Plan options. You’ll want to talk to a trusted insurance professional who can help you compare plans to determine which Plan is best for you. At Mutsko Insurance Services, we routinely provide our customers with comparisons to help them select the right Plan.

For more information on Medicare Advantage Plans, Medicare Supplements or Medicare Prescription Plans, please contact Laura Mutsko at Mutsko Insurance Services, LLC, 6966 Spinach Drive in Mentor, OH. Call 440-255-5700 or email lmutsko@mutskoinsurance.com.

*An exception is hospice care. Original Medicare covers hospice care for those in a Medicare Advantage Plan.

Is Open Enrollment the same if I get my coverage from my Union or former employer?

I heard that I should review my Medicare coverage during Fall Open Enrollment and I have until December 7 to make changes. Does that apply to me if I get my insurance through my former employer or a union?

 

Retirees who receive health insurance or a supplement from their former employer or union may not have the same open enrollment time-frame as people with Original Medicare or individually purchased Medicare Advantage or Prescription Part D Plans.Their "annual open enrollment" period is the time period established by their former employer or union. It is probably not the same as Medicare’s Open Enrollment period.

This is very confusing if their time-frame occurs within the Medicare Open Enrollment period. Many people have ignored an October mailing from their former employer or union, thinking they have until December 7 to act, only to find later that they needed to make changes much sooner.

I advise everyone with insurance from a former employer or union to open and read all mail regarding their insurance right away. Pay particular attention to the dates by which you need to respond. Don’t sign up for Medicare C, D or a Medicare Supplement without consulting your former employer or union insurance administrator. Signing up individually may end your retiree insurance and make it extremely difficult to get back if you make the wrong choice.

If however, you find that your employer or union provided plan no longer suits your needs, it may be time to look into other plans with better coverage. Call Mutsko Insurance Services, LLC to set up a Medicare health insurance review. We are conveniently located in Mentor at 6966 Spinach Drive. Call 440-255-5700 or email lmutsko@mutskoinsurance.com today.

How can you expect your older friends or relative to figure out Medicare?

If you find yourself confused by 
Medicare and all the choices available to you . . .

. . . . imagine how much more confusing it can be for your older friends or relatives who may not have access to all the information you have at your fingertips.

If you have elderly family members or friends, PLEASE see if they need help reviewing their Medicare Advantage and Medicare Rx plans. 

If after talking to them about their coverage you both still have questions, call me. We’ll set up an appointment to do a Medicare review together.  We have until December 7 to make changes.

Annual Notice of Change - Overlooking it can be costly!

What is it?
And Why is it important to me?

By the end of September or early October, everyone who has a Medicare Advantage plan or a Prescription Drug plan will receive information in the mail about their plan called the “Annual Notice of Change” (ANOC). This notice provides important information on changes you will see in your insurance coverage, cost and services for 2015. 

Please go over this information in detail. Don’t make a costly mistake and find out too late that your plan has made major changes that you will be locked into for the next year. 

Some key areas to review are:
Is your plan still available in your county? Some popular plans have been discontinued in counties for 2015.

Changes in benefits and cost: Do the changes affect the services you use? Has the amount of your co-pay changed? Have the premiums or out-of-pocket costs changed? 

Part D Prescription Drug Plan:  Are your prescription medications covered? Are they in a different tier? Can you continue to use the same pharmacies? Has the premium, deductible or tier costs changed?

Providers Network: Are your doctors still in the network? (You can confirm this with the online directory.)

You have the opportunity NOW during the Medicare Open Enrollment Period to switch to more suitable coverage. This year, open enrollment begins October 15 and continues through December 7 so you have plenty of time to shop and compare plans. 

This is where I can help you.

As an independent agent, I represent many of the most respected insurance companies in Ohio and I will help you find the most suitable plan for you based on your personal needs. Best of all, you never pay a dime for my services. The big difference is that with me as your agent, you have the advantage of having your own personal local insurance expert to call whenever questions arise. 

When it comes in the mail, please review your Annual Notice of Change carefully. If you have elderly family members or friends, please help them review their plans, too. Don’t wait until it’s too late. Call me if you have questions and we’ll set up an appointment to do a Medicare review together.

1 out of 5 surveyed describe Medicare as confusing.

So, if Medicare has you stumped, you're not alone!

According to a 2013 survey of 1000 older adults, 1 in 5 Medicare beneficiaries could not correctly identify what Medicare Parts A, B, C and D covered. And, that's just the beginning when it comes to Medicare!

A health care crisis or hospital confinement is no time for you to begin trying to figure out how to make the most of your Medicare benefits. You owe it to yourself and your family to learn as much as you can NOW, so you have the coverage best suited for you before a need arises.

I invite you to invest two hours of your time learning the 'ins and outs' of Medicare at one of my upcoming classes called Getting Started with Medicare.  I will be presenting the class throughout the fall at locations in Lake, Geauga, Lorain and Cuyahoga Counties including:

09/23  Willoughby Library

09/24  Kenston 

09/25  Peninsula Library

09/29  Lorain County Community College

09/30  Chagrin Falls

10/01  Concord

10/02  Mentor Senior Center

10/06  Lakeland Community College

10/07  Hudson

10/08  Euclid Public Library

For more dates, times and registration information, please visit, www.mutskoinsurance.com/seminars.  

This is your opportunity to begin learning about the options and services you have as a Medicare beneficiary.

What to do if you're not happy with Medicare or your Advantage Plan

Your chance to switch to a new plan is coming soon!

Medicare Open Enrollment begins on October 15 and is the time of year when you can make changes in your Medicare health plan or prescription drug coverage for the coming year. While many people are happy with their current coverage, it's always smart to check to see what changes will be made in your plan and take a look at other options that are available.

Start by looking for these four C's:

1.  Cost:  Will your out-of-pocket costs change? Will there be increases in your premiums, deductibles and co-payments in 2015?

2.  Coverage:  Does your plan cover all the medications you're taking? Are your preferred doctors, health care providers and hospitals covered by your plan?

3.  Convenience:  Do you need prior authorizations or referrals? Are you restricted to using specific pharmacies? Can you get your prescriptions through the mail if you wish?

4.  Customer Service:  Do you have someone who provides personal service when you run into problems? Is your plan responsive when you have a question?

If you find your plan falls short of your expectations, give me a call. We will set up a time to review your options and help you find the coverage that best suits your needs at an affordable price. I can be reached at 440-255-5700 or via email at lmutsko@gmail.com.

Do you need help with utilities? health care costs? other basic needs?

There are more than 2,000 federal, state and private benefit programs to help people in need. Unfortunately, many people do not know where to look or who to trust to help them find the benefits they qualify for. 

The National Council on Aging offers a confidential, online program to help identify benefits that can save you money and help cover everyday expenses. It's called BenefitsCheckUp and it's available online at http://www.benefitscheckup.org.

BenefitsCheckUp asks a series of questions. After answering the questions, you will get a report created just for you that describes the programs you may get help from. 

Here are the types of expenses the program may be able to help with:

• Medications
• Food
• Utilities
• Legal
• Health care
• Housing
• In-home services
• Taxes

About the NCOA

"The National Council on Aging (NCOA) is the nation’s leading nonprofit service and advocacy organization representing older adults and the community organizations that serve them. Our goal is to improve the health and economic security of 10 million older adults by 2020. For more than 60 years, NCOA has been a trusted voice and innovative problem-solver helping seniors navigate the challenges of aging in America. We work with local and national partners to give older adults tools and information to stay healthy and secure, and we advocate for programs and policies to improve the lives of all seniors, especially the most vulnerable. For more information, please visit www.ncoa.org." 

- taken from NCOA website, September 16, 2014

When will Medicare send me my card?

If you’re sitting back, waiting for Medicare to send you your Medicare card because you turned 65, you’re in for a disappointment. Only a limited number of people will receive their Medicare card without taking action first. Specifically, those who are already receiving Social Security benefits will receive their card without applying.

But, if you want your Medicare card, you must take steps to enroll. Here are three ways to get the ball rolling:

1. A phone appointment. Call Social Security at 1-800-772-1213 between 7:00 AM and 7:00 PM Monday through Friday and begin the enrollment process.

2. Go to your local Social Security office for an in-person session. To locate an office near you, visit Social Security Office Locator, SSA Office Locator Social Security Office Locator, Social Security and enter your zip code.

3. Online. Enroll online at http://www.socialsecurity.gov/medicareonly/. Social Security promotes online enrollment as the easiest and quickest way to enroll.

Because 10,000 people turn 65 EVERY DAY, the Social Security offices are very busy places. It can take up to six weeks to get your Medicare card after you enroll.

To find out more about Medicare, please join me for Getting Started with Medicare, an informational session to help those turning 65 become familiar with Medicare and how it works. For more information on Getting Started with Medicare, please visit http://Mutskoinsurance.com/seminars.

Medicare or Medicare Advantage Plan?

Which one is right for YOU!

You'll be better prepared to make the right choices once you attend Getting Started with Medicare, a 90 minute interactive class that covers all the basics on Medicare. It is especially helpful for people turning 65, those going on Medicare for the first time or anyone who want to brush up on the most current Medicare information. 

Plan now to attend one of these upcoming classes:

Thursday, September 18, 2014 

SELREC-YMCA – Brush High School

7:00 pm – 8:30 pm

Brush High School, 4875 Glenlyn Road, Lyndhurst OH 44124

216-382-4300

Tuesday, September 23, 2014

Willoughby Library

7:00 pm – 8:30 pm

30 Public Square, Willoughby, OH 44094

440-942-3200

Wednesday, September 24, 2014 

Kenston Community Education-Middle School

6:30 pm – 8:00 pm

17425 Snyder Rd., Chagrin Falls, OH 44023

440-543-2552 x 2566

Thursday, September 25, 2014 

Peninsula Library

6:00 pm – 7:30 pm

6105 Riverview Road, Peninsula, OH 44264

330-657-2291

Monday, September 29, 2014 

Lorain County Community College, Elyria Campus

6:30 pm – 8:00 pm

1005 N. Abbe Rd., Room 219, Elyria OH 44035

440-366-4148

 

Tuesday, September 30, 2014 

Chagrin Falls Community Education

7:00 pm – 8:30 pm

342 E. Washington St., Chagrin Falls, OH 44022

440-247-5375

Wednesday, October 1, 2014 

Concord Community Center

6:30 pm - 8:00 pm

7671 Auburn Rd., Concord, OH 44077

440-639-4650

Thursday, October 2, 2014

Mentor Senior Center

10:00 am – 12:00 pm

8484 Munson Rd., Mentor OH 44060

440-255-5700

Monday, October 6, 2014

Lakeland Community College

6:30 pm – 8:30 pm

7700 Clock Tower Drive, Kirtland, OH 44094

440-525-7116 

Tuesday, October 7, 2014 

Hudson Community Education & Recreation – Hudson High School

6:30 pm - 8:00 pm

2500 Hudson-Aurora Rd., Hudson, OH 44236

330-653-1210

Wednesday, October 8, 2014 

Euclid Library

7:00 pm - 8:30 pm

631 E. 222 St., Euclid, OH 44123

216-261-5300

Thursday, October 9, 2014 

Lorain County Community College, Brunswick Campus

6:00 pm – 8:00 pm

50 Pearl Road, Brunswick, OH 44212

440-366-4148

Tuesday, October 21, 2014

Mandel Jewish Community Center

6:00 pm – 7:30 pm

26001 South Woodland Rd., Beachwood, OH 44122

216-831-0700

Monday, November 3, 2014

Willoughby Library

7:00 pm – 8:30 pm

30 Public Square, Willoughby, OH 44094

440-942-3200

For a complete list of upcoming seminars, please visit our website at www.mutskoinsurance.com.   

Preregistration is required. Please register by calling the phone number listed for the class you wish to attend. These events are only for educational purposes and no plan specific benefits or details will be shared. Some venues charge a nominal fee

Alcohol, Food and Drug Interactions

What you eat and drink may affect the way your medicines work. Some foods interfere with the body's ability to absorb medications into the blood stream. On the other hand, some prescription medications should be taken with food to prevent stomach irritation.  Some combinations may create new symptoms.

Be sure to ask your doctor about the effects of food on your prescribed medication, especially whenever you are given a new prescription.

Mind Your Meds: How do you track your Rx usage?

It     It is estimated that more than 90 percent of people 65 or older use at least 1 medication per week. More than 40 percent of people in this age range use 5 or more different prescriptions per week. That's a lot of medications to keep track of!  To ensure their safe use, here's a couple of tips to stay organized:

1    Create a chart that outlines your medications, including when and how much to take. You should also include any non-prescription vitamins, supplements and prescription creams that you are using. Bring this chart with you whenever you see your doctor, visit an emergency room or are admitted to the hospital.

      You can create your own chart or you can pick up a complimentary wallet-size medication record/ID card at Mutsko Insurance Services, LLC,  6966 Spinach Drive, Mentor, Ohio 44060.

2.  Check into using e-tools and apps offered for free on your iPad or smart phone to help you track your medication usage. Two free apps that have good reviews are:

Med Helper  –  Pill Reminder and Medication Tracker, and

Pill Alert  –  Medication, Prescription Reminder and Tracker, and Tracker.

Are you paying too much for your prescriptions?

You probably already know that drug prices can vary widely. In fact, the cost of a prescription may differ by more than $100 between two pharmacies across the street from each other!

But, there's a very easy way to compare prices for all FDA-approved prescription drugs. 

It's a website called GoodRx.   

GoodRx will show you prices, coupons, discounts and saving tips for your prescriptions at pharmacies near you.  Simple visit www.goodrx.com and start saving.

Do you know all you should about Medicare?

It's one of the most important decisions you will make affecting your health care. You want to get this one RIGHT.

You'll be better prepared to make the right choices once you attend Getting Started with Medicare, a 90 minute interactive class that covers all the basics on Medicare. It is especially helpful for people turning 65, those going on Medicare for the first time or anyone who want to brush up on the most current Medicare information. 

Plan now to attend. For a complete list of upcoming seminars, please visit our website at www.mutskoinsurance.com.   

Preregistration is required. Please register by calling the phone number listed for the class you wish to attend. These events are only for educational purposes and no plan specific benefits or details will be shared. Some venues charge a nominal fee. 

Tuesday, August 5, 2014
Lakeland Community College
6:30 pm – 8:30 pm
7700 Clock Tower Drive, Kirtland, OH 44094
440-525-7116

Thursday, August 7, 2014
Mentor Library
6:30 pm – 8:00 pm
8215 Mentor Ave., Mentor, OH 44060
440-255-8811

Monday, August 18, 2014
Morley Library
6:30 pm – 8:00 pm
184 Phelps St., Painesville, OH 44077,  Meeting Room B
440-255-5700

How to Get the Rehab Therapy You Need

Have you been denied rehabilitation therapy because your medical condition was no longer improving?  

In the past, in order for Medicare to pay for occupational therapy (OT), physical therapy (PT) and speech-language therapy (SLP) services, Medicare required that these services help you to improve or regain your ability to perform these functions. If your progress slowed down too much or stopped, then Medicare would no longer cover its share of the cost. If you simply wanted to continue therapy for maintenance of your condition, you would be responsible for the full cost of therapy.

The problem with this is that the law did not require a person’s condition to improve in order for Medicare to pay for rehabilitation therapy. People were being denied the coverage that they were entitled to receive.

A legal agreement, Jimmo v Sebelius, settled this and determined that Medicare is required to cover the costs of rehabilitation therapy for qualified individuals who receive therapy for maintenance of their condition. The agreement applies to skilled maintenance services provided in all three care settings including Medicare home health, outpatient therapy and skilled nursing facility benefits and applies equally to Medicare Advantage as to the traditional Medicare program.

Specific language in the agreement states that “Nothing in this Settlement Agreement modifies, contracts, or expands the existing eligibility requirements for receiving Medicare coverage.” The agreement is intended to clarify that when skilled services are required to provide care that is reasonable and necessary to prevent or slow further deterioration; coverage cannot be denied based on the absence of potential for improvement or restoration.

Medicare has not expanded coverage. They are providing coverage in situations where they should have been provided in the first place.

Patients must still meet certain requirements for any treatment to be covered, including:
- Medically necessary
- Appropriate and effective in treating the condition
- Provided by a skilled professional
- Reasonable in terms of frequency and duration.

The payment limits, called “therapy caps,” are still in effect as well.

The bottom line is that not all medical providers are aware of these Medicare coverage changes and you may still be denied coverage for rehabilitation therapy you need. You need to be aware of these changes and bring them to the attention of your provider. If you’re still being denied the rehab therapy you are entitled to, you or your doctor will need to contact Medicare to correct the claim.

Who will shoulder your retirement health care costs?

If you’re planning on your employer picking up the cost of your healthcare once you retire, you may want to rethink your plans. The number of employers who provide health benefits has declined from 40% to 28% between 1988 and 2013. Today, less than one in five people work for a company that offers health benefits for their retirees.

The problem boils down to cost. Healthcare costs continue to grow and retirees are living longer. We are seeing more and more companies taking steps to contain costs by capping their contributions, tightening eligibility standards and eliminating new employees from this benefit.
The picture has improved for early retirees. They are enjoying the benefits of the Affordable Care Act and the availability of insurance on the healthcare marketplace. In the past, retirees who were too young to qualify for Medicare struggled to fill the gap in coverage until they turned 65. They were often denied coverage for pre-existing conditions or had to bear the burden of expensive premiums.

For retirees over age 65, the gap in covered medical costs is widening. Medicare alone does not cover 100% of medical costs and excludes long-term healthcare and dental care. In place of employee provided retiree health benefits, Medicare beneficiaries are increasingly relying on supplemental Medicare coverage such Medigap or Medicare Advantage Plans.

As employers move away from retiree health coverage, it's important for workers today to prepare themselves for future healthcare expenses and consider supplemental insurance plans. It is estimated that a 65-year-old couple who retired in 2013 will spend $220,000 on healthcare over the course of retirement.

And more than 70% of seniors will eventually need some sort of long-term healthcare, which is not covered by Medicare. Pre-retirees might want to consider long-term care insurance before they leave the workforce. The average policy costs about $3,000 a year — not cheap but certainly less expensive than the average of more than $83,000 a year that you’d shell out for a private nursing home stay without insurance.

If you are concerned about who will shoulder your health care costs, call me and we'll work together to put together a plan for you.

Fun Facts to brighten your day

Did you know . . .

• On average, women say 7,000 words per day. Men speak just over 2,000

• Americans eat 18% more vegetables today than they did in 1970.

• The width of your arm span stretched out is equal to the length of your whole body.

• Research shows that people will walk 30% longer if they listen to music when they walk.

• Laughing lowers levels of stress hormones and strengthens the immune system.

Do Marketplace Insurance Plans cover mental health and substance abuse services?

Yes.

All Marketplace insurance plans cover mental health and substance abuse services as an essential health benefit.

Health insurance plans available in the Marketplace must cover ten categories of essential health benefits. One of these categories is mental health and substance abuse services, also known as substance use disorder.

These services include behavioral health treatment, such as psychotherapy and counseling. They also include mental and behavioral health inpatient services and substance use disorder treatment.

Mental and behavioral health and pre-existing conditions

Marketplace plans can’t deny you coverage or charge you more just because you have a pre-existing condition. This includes mental health and substance use disorder conditions.
Coverage for treatment of pre-existing conditions begins as soon as your Marketplace coverage is in effect. There’s no waiting period for coverage of these services.

There are also no lifetime or yearly dollar limits for mental health services. Marketplace plans can’t apply yearly or lifetime dollar limits on coverage of essential health benefits which includes benefits for mental health and substance use disorder services.

Parity protections for mental health services

Marketplace plans must provide certain “parity” protections between mental health and substance abuse benefits on the one hand, and medical and surgical benefits on the other.This means that in general, limits applied to mental health and substance abuse services can’t be more restrictive than limits applied to medical and surgical services. The kinds of limits covered by the parity protections include:
· Financial, like deductibles, copayments, coinsurance, and out-of-pocket limits
· Treatment, like limits to the number of days or visits covered
· Care management, like being required to get authorization of treatment before getting it

(taken from HealthCare.gov)

Ohio Celtic Fest is this weekend

If you're looking for something fun to do this weekend, visit 
The Ohio Celtic Fest at the Lake County Fairgrounds, on Mentor Avenue in Painesville Township.  There'll be six stages of non-stop musical entertainment - from Celtic rock to ballads and everything in between. Bagpipe band. Irish dancers from four local schools of dance. Lots of food. Shopping. And a kid's area with magicians, storytellers, petting zoo and bouncy things.

Stop by the Coffee House, sponsored by Mutsko Insurance Services, if you get a chance.

For more information, go to ohiocelticfest.com

Four ways to save big on prescription costs

1. Shop Around.
Prices at different pharmacies can vary dramatically, as much as from $4 to $250 or more within your neighborhood for the same prescription. Visit www.goodrx.com to compare prices and find coupons.  It pays to check.

Be sure to ask for the pharmacy’s lowest price because additional discounts may be available when you’re a member of a store’s loyalty plan. And don’t overlook your insurer’s “preferred” retail or mail order pharmacy when comparing costs. Some insurers and Medicare Part D Plans have negotiated deep-discounts to help you save.

2. Be wary of coupons.
Makers of brand-name drugs often flood the market with discount coupons in order to keep you as a customer. Even if a coupon cuts the cost you pay at the counter, your employer and insurance company are often paying the full price which will cost you in higher premiums down the road.

3. Cut the quantity 
Ask for a 14-day supply to get you started and see whether it help you without side effects. Once you're sure it works for you, you can refill a larger quantity.

4. Ask about OTC drugs, samples or a two week supply
Your physician may write prescriptions for drugs even after they are available over-the-counter. But, over the counter drugs are often cheaper so be sure to ask your doctor if your drug is available over the counter. 

What your doctor calls your visit can cost you.

Annual Wellness or Preventive Care Visit?

How your visit is coded by your physician’s office may mean the difference between your claim being covered or denied.

 

If you have Medicare Part B for longer than 12 months, you can get an annual wellness visit or update a personalized prevention plan on your current health and risk factors. 

This visit is covered once every 12 months.

 

Be sure your doctor codes it as an Annual Wellness Visit not a preventive visit to avoid any mix-ups or your claim being denied.

 

Getting Started with Medicare

Get the facts on Medicare. Attend one of our upcoming Getting Started with Medicare seminars. 

This class covers all the basics and is especially helpful for people turning 65, those going on Medicare for the first time or anyone who want to brush up on the most current Medicare information.

Preregistration is required. Please register by calling the phone number listed for the class you wish to attend. These events are only for educational purposes and no plan specific benefits or details will be shared. Some venues charge a nominal fee.

Tuesday, August 5, 2014
Lakeland Community College
6:30 pm – 8:30 pm
7700 Clock Tower Drive, Kirtland, OH 44094
440-525-7116

Thursday, August 7, 2014
Mentor Library
6:30 pm – 8:00 pm
8215 Mentor Ave., Mentor, OH 44060
440-255-8811

Monday, August 18, 2014
Morley Library
6:30 pm – 8:00 pm
184 Phelps St., Painesville, OH 44077,  Meeting Room B
440-255-5700

Still Need Health Coverage?

Did you recently graduated from college?  

Have you aged off of your parent’s health plan? 

Are there events that left you without health insurance? 

Even though open enrollment is over, you may still have options to get health coverage this year. You may be qualified to sign up for private health insurance in the Marketplace right now, outside the Annual Open Enrollment Period.  

Anyone who experiences a qualifying life event is eligible to purchase private insurance in the Marketplace. Here are some examples of qualifying life events:

·         No longer covered by your parents’ plan

·         Get married

·         Get divorced

·         Death of a spouse

·         Have a baby or adopt a child

·         Move to a new area

·         Lost other health insurance including student health plans

Employment-Related Qualifying Events

You may also qualify for the Special Enrollment Period if your employment is terminated, your hours are cut back or your COBRA benefits expire. You will need to provide a letter from your employer on company stationary that verifies your termination or reduction in hours in order to qualify. For expiration of COBRA benefits, you will need a letter of documentation with your termination date.

Time Limits

You have sixty days from the date of any qualifying event to apply for health insurance coverage. In all cases you will be asked to provide documentation of the qualifying life event in the form of a birth or adoption certificate, marriage license, divorce decree or other legal documents.

Medicaid or CHIP coverage                                                                                 Enrollment to Medicaid or CHIP is open all year round. If you qualify, you (or a family member) can enroll immediately.

Call me to discuss your options.

If you or someone you know has questions on whether their circumstances qualify as an eligible life changing event, please contact me. I’ll do the checking and provide the best insurance choices for you and your budget.

There’s never a charge for my services.