Monthly Archives: August 2015

Tips for keeping hospital costs down

 
Outstanding medical bills make up the largest single category of consumer debt in collection today. You’re smart to take steps now to manage your costs. One place to start is by keeping a close eye on what you’re being charged. Billing errors are more common than most people realize.
 
I recommend that you do your best to keep an accurate record of your hospital stay, noting the dates, times and places of your admission, release, procedures performed, doctors who saw you and medications provided. Ask your spouse, a companion or friend to help you with this task.
 
Once you’re discharged, request an itemized statement from the hospital with every individual charge listed. Although you are entitled to receive an itemized bill, many hospitals send a summary bill unless requested otherwise. Check through the itemized list to make sure everything you’re being charged for is correct.
 
Check the following information for errors: 
Verify your insurance policy number and all personal information. Errors may result in delayed or denied payments from your insurance provider.
Correct date and time for your admission and release
Correct list of the procedures and tests performed
Duplicate charges for any services or procedures
Charges for tests or procedures that were canceled
 
If you find a questionable charge, contact your health care provider right away. Track all calls, noting the names, phone numbers and call reference numbers every time you talk to someone about your medical bills. This goes for your insurance providers, your physicians and their staff as well as the hospital customer service department.
 
If you believe you have been overcharged and you’re unable to get any satisfaction, seek assistance from a medical or patient advocate. My clients can always call me if they have questions on medical bills or other issues concerning their insurance coverage. It’s one of the benefits of having a personal insurance agent.
 
 There are other ways you can reduce your out-of-pocket costs for co-pays, deductibles and other medical expenses, including indemnity insurance plans and Medicare supplement plans. Contact me to go over your options and come up with a plan that works for you. Email me or call 440-255-5700 today.

Medicare terms: How many do you know?

Ever get confused by different terms used by Medicare or your Medicare Advantage Plan. Here are a few of the more common ones that you need to be familiar with.  Test yourself and see how many you get right.

Accepts Assignment: An agreement that your health care provider will accept the Medicare-approved amount for services as full payment limiting your share of the cost to your coinsurance and deductible.

Benefit Period: A benefit period begins the day you are admitted as an inpatient to a hospital or skilled nursing facility and ends when you haven’t received any inpatient hospital care (or skilled care) for 60 days in a row. You may be in the hospital more than once during a benefit period. There’s no limit on the number of benefit periods Medicare will cover. Part A charges a deductible for each benefit period.

Coinsurance: The percent of the cost of a service which you pay. For example, Medicare pays 80% and you would pay 20% as coinsurance.

Deductible: A fixed amount that you pay for your medical care first, before insurance or Medicare starts to pay.

Lifetime Reserve Days: For Medicare Part A, there are a set number of hospital days you can draw on if your stay lasts longer than 90 days in a benefit period. You have 60 lifetime reserve days. A lifetime reserve day cannot be replaced.

Medicare-approved amount: In Original Medicare, this is the amount health care providers who accepts assignment can be paid. It may be less than the actual amount a doctor or supplier charges. Medicare pays part of this amount and you’re responsible for the difference. Providers who accept Medicare but not assignment can charge up to 15% above this amount.

Out of pocket limit: A limit that Medicare Advantage plans set on what you will have to personally spend in a plan year. For Medicare Part D plans, this is the maximum amount of money you will have to spend out of your own pocket before catastrophic coverage kicks in for the year.  

If you have more questions, please join me for my class, Getting Started with Medicare. It will help you gain a basic understanding of Medicare, Medicare Advantage Plans and many other terms you’ll need to know. For a list of all my upcoming classes, visit my website at www.mutskoinsurance.com/seminars. (Pre-registration is required. These events are only for educational purposes and no plan specific benefits or details will be discussed.)

Are changes in store for health care insurance for same-sex spouses?

The Supreme Court ruling legalizing marriage in all 50 states for same-sex couples is bound to have far-reaching repercussions. In the coming months, you are sure to hear more about how the ruling is affecting income taxes, social security, retirement accounts, inheritances and, of course, health insurance.
Many issues surrounding same-sex spouses and health care have already been addressed. HealthCare.gov, the official website for the Affordable Care Act, already states, “For coverage starting in 2015, an insurance company that offers health coverage to opposite-sex spouses must do the same for same-sex spouses.”
This means that as long as a couple is legally married an insurance company is not permitted to discriminate against them when offering coverage. The company must offer to same-sex spouses the same coverage it offers to opposite-sex spouses.
The Affordable Care Marketplace treats married same-sex couples the same as married opposite-sex couples when they apply for premium tax credits and lower out-of-pocket costs on private insurance plans. This is true in all states.
Legal questions remain about whether employers who provide health insurance benefits for spouses will be required to provide the same benefit to same sex couples. While the issue is not yet settled it is likely that many employers who offer health coverage to an employee’s spouse will simply offer that coverage to all spouses in the future. It simplifies administration of the plans and also avoids any discrimination issues that could result if the employer limited coverage to opposite-sex spouses.
The Supreme Court’s ruling also means that same-sex married couples have the same rights under Medicare as other married couple. If a spouse has not earned 40 credits to qualify for premium-free Medicare Part A they now can qualify for it based on the work record of their spouse, if he or she has achieved the required credits and is age 62 or older. 
Same-sex spouses will now be treated as family, so that if one spouse requires hospitalization, the other will have access to medical information regarding the hospitalized spouse’s condition, as well as to visitation rights — without having to worry about whether the specific state recognizes their marriage.
If you have any questions concerning your health or life insurance coverage, please let me know. As an independent agent, I represent many of the nation’s most respected insurance companies and will help you find the right insurance plan for you Contact me at 440-255-5700 or email me and we’ll set up a time to talk.