The Senior Insider

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.

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,  
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

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
Geauga Rescue Village

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

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.

My policy covers my daughter who will turn 26 in July.

When should he get his own health insurance?

The rules concerning health care coverage for adult children are complicated. This is why it is always best to discuss your specific situation with a qualified insurance professional who will give you all the different options.  

Your daughter’s under-26 insurance coverage will end on her 26th birthday. Because she is losing coverage on her birthday, she is qualified for a Special Enrollment Period that will allow her to enroll in a health plan outside the Open Enrollment Period.

The Special Enrollment Period ends 60 days after her 26th birthday.

If she enrolls in a new plan before her 26th birthday, coverage can begin as soon as the first day of her birthday month. If she postpones enrolling and enrolls during the 60 days after her birthday, coverage can start the first day of the month after she selects a plan. 

If your daughter does not enroll in health coverage within 60 days of her birthday, she may not be able to get coverage until the next Open Enrollment period and may be subject to penalties for being uninsured of up to $325 (per individual) or 2% of her income, whichever is more.

Many young people who are ‘aging’ off their parent’s plans qualify for premium tax credits and other savings based on their income. Whether she qualifies for these savings will be determined when she applies for an Affordable Care Plan or I can help her determine what she is qualified to receive.

Because your daughter is under age 30 she may choose to get coverage through a catastrophic health plan. These plans usually have lower monthly premiums but high deductibles. A catastrophic plan is an affordable way to be protected from worst-case scenarios, like serious accidents or illnesses.

For information, please visit our website at Or call us to make an appointment to discuss your situation. We will review all your options and help you select the plan that best suits your needs. Call me at 440-255-5700 or email 

Pregnancy and delivery are covered by Affordable Care Plans


All Health Insurance Marketplace plans cover pregnancy and childbirth. This is true even if your pregnancy begins before your coverage takes effect. 
Please pass this important information on to someone who is without insurance.
To learn more, contact me before open enrollment ends on February 15.  440-255-5700 or

Take this step to guard your medical identity

What do you do with the form you receive in the mail a few days after you see your physician or refill a prescription?  If you’re like so many others, you toss it aside after a glance, relieved to know that it’s an Explanation of Benefits and not a bill..

But, it’s important for you to check it out in detail to make sure the information it contains is correct.

Each insurance company and Medicare EOB usually contain the same information including your personal information, the doctor or facility visited, dates and description of your service, the fee billed to your insurance company and what you will be expected to pay once you receive your bill. It will also include any reason a service has been denied.

If any of the information on your EOB is incorrect, it could be a clerical error – or worse. Someone may have illegally used your medical identity. If you have any questions at all about your Explanation of Benefits call the phone number listed on the form and let them know your concerns.

Are you an in-patient or out-patient?

If you are in the hospital more than a few hours, always ask your doctor or the
hospital staff if you are an inpatient or an outpatient.
Your hospital status (whether the hospital considers you an “inpatient” or “outpatient”) affects how much you pay for hospital services, including X-rays, drugs and lab tests. It may also affect whether Medicare will cover the care you get in a skilled nursing facility (SNF).
You’re an inpatient starting the day you’re formally admitted to the hospital
with a doctor’s order. The day before you’re discharged is your last inpatient
day. If you have a Medicare Advantage Plan, costs and coverage may be different.
My clients can always call me if they have questions at 440-255-5700 about their



Some famous folks who are turning 65!

If you are turning 65 this year you are in good company. Here are just a few famous people you may run into at the Medicare office:

Bill Murray, comic
Little Stevie Van Zant, actor & musician
Jane Pauley, newswoman
Dr. Phil, tv psychologist
Jay Leno, comedian
Joe Perry, guitarist for Aerosmith
Cybill Shephard, actress
David Cassidy, pop star
Natalie Cole, singer
Stevie Wonder, musician
Steve Wozniak, cofounder of Apple
If these people are like the typical Boomer  he or she doesn’t even consider 65 to be old. According to a Pew Research study, the average Boomer believes that starts at 72. In fact, while only about half of all Americans say they feel younger than their years, 61 percent of Boomers feel that way – – – with the typical Boomer feeling about nine years younger than his or her chronological age.
As an FYI, you can enroll in Medicare up to 3 months before you turn 65. I strongly recommend you learn as much as possible about your Medicare options before you enroll. I teach a class called Getting Started with Medicare that explains all the basics. For a list of
class dates, times and locations click here: