The Senior Insider

Am I eligible for a lung cancer screening?

Your first step should be to discuss your concerns about your smoking history with your doctor. You and your doctor will discuss the benefits and risks of lung cancer screening and decide whether lung cancer screening is right for you.

If screening is recommended, Medicare Part B covers Low Dose Computed Tomography (LDCT) once per year to detect lung cancer for people who currently smoke or were heavy smokers and have no symptoms of cancer.

To qualify for coverage of LDCT, Medicare Part B beneficiaries must meet all of the following conditions:
· You are age 55-77
· You do not have signs or symptoms of lung cancer
· You are a current smoker or have quit smoking within the last 15 years
· You have a history of smoking an average of one pack a day for 30 years
· You have an order from your physician or qualified non-physician practitioner

After the first scan, a written order for the scan can be provided during any visit with your health care provider. A separate counseling visit is not required. Your doctor or other health care provider will also provide information on smoking cessation services to current smokers.

If you have Original Medicare, there is no coinsurance or deductible for the lung cancer screening if you use providers who take assignment. If you have a Medicare Advantage Plan, your plan will not charge you deductibles, copays, or coinsurances as long as you see in-network providers.

Medicare covers the cost of many preventive services to help keep you healthy, including exams, immunizations, screenings and lab tests, as well as counseling services. You can learn more about Medicare’s preventive services by visiting Medicare.gov and enter preventive services or calling 1-800-MEDICARE (1-800-633-4227) and ask for your copy of Your Guide to Medicare’s Preventive Services.
Please contact me if you have questions concerning life, health, Medicare Supplement Insurance, Medicare Advantage plans or other insurance questions. I can be reached at 440-255-5700 or Lmutsko@mutskoinsurance.com.

Where to Keep Your Will

I was recently asked for my advice on where to store important documents. With so many of us relying on computers today, safe deposit boxes and in-home fire boxes may seem terribly out of date. However, each of these storage devices has a place in safe-keeping our records.

It is a good idea to keep hard copies of your will, power of attorney forms and any advance directives where they are safe, but easily accessible. Hospitals usually request a copy of your medical power of attorney and living will any time you are admitted for treatment. A trusted family member or the person you designate as your representative should know where to find these papers so your wishes will be followed in the event of an unexpected emergency.
Many people mistakenly keep their only copy of these documents in a bank safe deposit box. But storing them in a bank may prevent anyone from accessing them when they are needed. Banks usually require court papers before they allow anyone other than you to open your safe deposit box.

Bank safe deposit boxes remain your best choice for protecting jewelry, valuables and original documents you do not need often, including original birth certificates, property deeds, social security cards, paper bonds and securities.

As an added level of security, you can duplicate and store copies of important papers on a computer thumb drive kept with your valuables. Consider duplicating these:
– Insurance policies and agent contact information
– Original will and powers of attorney
– Passport
– Digital files of family photos
– Living wills and advance care directives

One last suggestion . . . keep a list of your access information and passwords for your digital files in a safe storage location or a secure website. Include access information for your computer, cellphone, bank records, google account and other social media accounts and let someone you trust know where to find this info. This step will save you time and frustration in case you are unable to access your accounts on your own.

Safeguarding your documents and valuables is a personal decision. You may want to discuss your situation and needs with a lawyer, financial advisor or other trusted professional.

How to Avoid Problems with a New Insurance Plan

Every year, many people like you take the opportunity during the Open Enrollment period to make changes in their insurance. If you made changes, there are a few things you can do now to avoid problems getting started with your new plan.

1. If you are dropping any insurance coverage including Medicare Supplements, Vision or Dental coverage, make sure you have cancelled you coverage with your insurer. Your insurance may not be automatically cancelled when you switch plans. Although some companies will cancel and make changes over the phone, others require a written request so give your insurer a call and ask what they require.

2. Cancel your automatic withdrawals for your old plan. I recommend you cancel your withdrawal with the insurance company and then follow up with a call to your financial institution to make sure the automatic withdrawal is stopped.

3. Tell your doctor that you have different insurance. If your doctor unknowingly files for reimbursement with the wrong insurance company, it will cause confusion and delays in payment. Let your doctors know about your new plan the first time you see them in 2018.

4. Check your Prescription Drug coverage to find out which pharmacies are the preferred pharmacies for your plan. If it is a different pharmacy than the one you have been using, arrange to transfer your prescriptions now so they have your information ahead of time. You should also present your new insurance cards to your pharmacy before you need your next prescription. Don’t wait until you need a refill or have an emergency before you make this change.

5. Determine whether your new plan has different requirements for your prescriptions. Some plans may require a pre-authorization before your prescription will be filled. Take steps ahead of time to let your physician know what is required by your new plan.

For your other questions on Life, Health, Dental, Vision, Annuities or Medicare Advantage Plans, please contact me at 440-255-5700 or email Lmutsko@mutskoinsurance.com.

Who is Responsible for Grandkids’ Health Care?

An increasing number of grandparents are taking on the responsibility of the care and upbringing of their grandchildren. In fact, more than 100,000 grandparents in Ohio are raising their grandchildren today. How to provide for their health care is a pressing concern for many.
Your options for health insurance for your grandchild will depend on a number of factors, including your legal status and whether you have employer provided health insurance.

What is your legal relationship? Is your arrangement to care for your grandchild informal or have you been established as his or her legal guardian or custodian? If you lack legal guardianship or custody of your grandchild, it is likely to be more difficult for you to seek medical insurance for him.

Will you claim your grandchild as a dependent on our federal income tax return? You need to be aware that a grandparent who claims a grandchild as a dependent on his or her federal income tax return is responsible for obtaining health insurance for that child. The penalty for not insuring your grandchild can be costly.

Do you have employer provided health insurance?  If you are working and have insurance through your employer, contact your human resource department and health insurance company to find out whether your grandchild can be covered under your policy. There is no clear cut rule concerning insuring grandchildren. You will likely have to prove that you have legal guardianship of your grandchild in order for your insurance provider to accept him/her as a dependent child.

Other insurance options.  Relative caregivers may apply for free or low-cost health and dental insurance for the children they are raising through the Children’s Health Insurance Program (CHIP). This program provides health coverage to eligible children through both Medicaid and separate CHIP programs. Check with your state insurance department to find out if your grandchild qualifies. If you have questions, you can contact me at 440-255-5700 or email your questions to me at Lmutsko@mutskoInsurance.com. I look forward to serving you.

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

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.