Monthly Archives: September 2015

No Health Insurance? Penalties are going up for 2016

If you can afford health insurance but choose not to buy it and you do not have an exemption, you will likely be assessed tax penalties that will be collected with your federal tax return. 
 
According to Healthcare.gov, https://www.healthcare.gov/fees-exemptions/fee-for-not-being-covered/, the fees for not having coverage in 2016 are increasing and will be the higher of these two amounts:
 
·                  2.5% of your yearly household income
·               $695 per person ($347.50 per child under 18)
Open enrollment for Affordable Care coverage begins on November 1 and closes January 31, 2016. During this period, it is important for you to review your health care plan and make any changes or sign up for coverage for the coming year. To begin shopping for your Affordable Care plan go to www.mutskoinsurance.com and click on Online Quotes.

 

Don’t put off enrolling in a plan. If you have questions or need help finding the right coverage, call me at 440-255-5700 or email me today.  

Don’t get locked into a Medicare Advantage Plan that no longer works for you.

Whether this is your first Open Enrollment season or you’ve been through a few, it pays to take time now to study your Medicare and Medicare Advantage Plan options. Remember, plans can change their coverage, benefits and costs. You don’t want to find out too late that you’re locked into a plan for all of 2016 that doesn’t cover your doctors, your hospitals or your medications. You should receive updated information by October 1 on your plan.
 
I also recommend that you sit down with friends or family members who may have questions and aren’t sure what to do. Please set aside some time to go over their current Medicare or Medicare Advantage Plan coverage and figure out if they need to make any changes. If you need assistance, call me at 440-255-5700 or email me and I’ll look into your concerns and offer some options.
 
The dates to remember are:
 
October 1 – 15   Evaluate your current Medicare plan
October 15        Open Enrollment begins and you can make changes.
December 7      Open Enrollment ends. Last day to make changes for 2016
 
 
 
 

What Medicare doesn’t cover, a Medicare Advantage Plan may

Need hearing aids? Think you’re covered by Medicare?

Think again.

If you have Original Medicare, you will not be covered for the cost of routine hearing exams, hearing aids or fittings for hearing aids. Medicare Part B only covers diagnostic and balance exams if your doctor or other health care provider orders these test to see if you need medical treatment for balance issues, vertigo or a recent injury.  

Even if your exam is covered by Medicare Part B, you will still be responsible for the Part B deductible and 20% of the Medicare approved amount for the doctor’s services. If your test is done in a hospital setting, you may also be responsible to pay hospital co-pay costs.  

 

If you have a Medicare Advantage plan or Medicare Supplement, you may have coverage for a percentage of hearing exams and hearing aids. Your first step should be to review your Insurance Plan’s Summary of Benefits and Coverage or contact your agent to find out what your plan includes. Be sure to ask if your plan requires that you go through specific approved suppliers or if the plan has other guidelines you will need to follow.

Talk to your doctor or other health care provider to find out how much your test, hearing aids and other services will cost. The amount you’ll owe will depend on several things including how much your doctor charges, whether your doctor accepts assignments and where you get your test and hearing aid. Let your doctor know you’re concerned about costs in order to avoid being surprised with an unexpected big bill.

Now, during Medicare Open Enrollment, is a good time to look into a Medicare Advantage plan that offers coverage for hearing.  I can show you a number of plans with this option.

Other Options
In some cases, the U.S. Department of Veterans Affairs may offer financial assistance or reduced cost hearing aids for Veterans. Vets are eligible for hearing aids if their hearing loss is connected to their military service or linked to a medical condition treated at a VA hospital. Veterans can also get devices if their hearing loss is severe enough to interfere with activities of daily life. For details, contact your local Veterans Medical Center or visit http://www.cleveland.va.gov/.

Hearing loss is not just inconvenient; it’s a serious health condition. Better hearing may lead to a better life. 

If you would like to learn more about Medicare Advantage Plans that include coverage for hearing, dental and eye care, please contact me at 440-255-5700 or email me. I can show you a variety of plans that will provide the coverage you’re looking for.

Little known plan covers out-of-pocket costs.

If you’ve been confined to the hospital or had an accident that required medical treatment, you  know health care costs can be astronomical. And, no matter how good your insurance plan is, there’s going to be unexpected out-of-pocket expenses. Everything from co-pays to hospital parking fees can  add up quickly.

There’s now a plan to fill these gaps. It’s an Indemnity Insurance Plan designed to help protect you and your savings. When major medical plans step in to cover your doctors, hospitals and other health care providers, this 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.

This  is not a Medicare Supplement policy. It’s 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.

Don’t keep worrying about the ‘what ifs’ that go along with a health care emergency. Call me to learn more about Indemnity Insurance and how it can help you.

Divorced? Don’t rule out Social Security from your ex-spouse

Regardless of whether you stayed in touch with your ex . . . even if you never want to speak with him or her again . . . you may be eligible to collect Social Security spousal benefits based on your ex-spouse’s work record.
The rules are fairly straightforward. If you were married for at least 10 years, you are age 62 or older and your former spouse is 62 or older (or otherwise entitled to Social Security retirement or disability benefits,) you have been divorced for at least two years and are now single, you could qualify.
It does not matter if your ex has remarried. Your tapping into his or her Social Security benefits will not affect his or her benefits or what his or her current family receives from Social Security. In fact, if you’re concerned your ex will find out you are receiving these benefits, don’t worry. Social Security is not permitted to share this information so your ex-spouse won’t even know it’s happening.
If you remarried, you generally cannot collect benefits on your former spouse’s record unless your subsequent marriage ended by death, divorce or annulment. The benefits you are entitled to receive based on your ex’s work record must be more than what you are entitled to receive based on your own record.
If you think you may be eligible, contact Social Security to make a determination. They will take into account many variables including your current work status, your ex’s work record and whether your ex is living or deceased when you apply. To contact Social Security, call 800-772-1213.

Why Life Insurance is Important for Women

I talk to a lot of women about their need to purchase individual life insurance. Many still have the outmoded idea that life insurance is important for men but not necessary for women. I also find that when they do have life insurance, they generally have policies with far less dollar coverage than men, relying primarily on life insurance provided by their employee benefit plan for coverage.
 
Most married women with children see the need for their husbands to have life insurance. They understand that insurance may not make their family rich, but it can provide a financial cushion to give their family time to adjust to the changes they’ll have to make if their husband died. These including possibly down-sizing their home, finding quality child care and other services to compensate for not having a marriage partner. Life insurance benefits can mean the difference between the transition being manageable or desperate.
 
What many women don’t realize is that the same adjustments take place when a wife dies and leaves her husband and children alone. The fact is that if something was to happen to them, both parenting roles fall to their spouse. If he’s at work, how are things going to get accomplished at home? In addition to losing her contribution to their family income, their husband might have to change careers and take an income cut to spend more time with their kids. The bottom line is that when a mother dies, it is at least as expensive as when a father dies. And, a $50,000 policy from work won’t go a long way when a single parent faces years of raising children.
 
Women should also consider other life insurance benefits as well, including:
 
–  Insurance can provide a lump sum of money to help pay expenses and generate an income. Life insurance can’t replace a spouse, but it can help pay for your kids’ college education, a daughter’s wedding or help ensure your spouse’s retirement dreams are realized.
 
–  Insurance can be a lasting legacy. Life insurance can create a financial legacy for your kids, your spouse or even your favorite charity or alma mater.
 
Life insurance is important for both men and women. It provides a measure of security for you and your family and isn’t that what you want? I can help you determine the best options for you and your family. Give me a call at 440-255-5700 or email me at to set up an appointment. I look forward to working with you.

How do you get rid of your old medications?

If your household is like most others, you probably have a medicine cabinet filled with a variety of over the counter and prescription medications, including pet meds, cough and cold remedies and pain killers. Some have been sitting around in your cabinets for months or even years creating a potential hazard.

Sadly, I’m not aware of any programs that accept and recycle personal prescription or over-the-counter drugs. Flushing drugs down the drain or toilet is no longer a recommended method of disposal. Drugs disposed of in this manner are finding their way into our rivers, streams and ground water and are impacting our fish population. PLEASE DON’T FLUSH OLD MEDICATIONS.

Here are some safe approved disposal methods.

Medication Take-Back Programs
Many communities offer residents a place to drop off unused drugs for proper disposal. All private information should be removed or blacked out before disposing of prescriptions. Residents of Lake County can bring their unwanted and expired prescriptions, pet meds, creams, cough syrups, vitamins and pain killers to any of the following locations:

– Lake County Sheriff’s Office in Painesville
– Willoughby Hills Police Department
– Eastlake Police Department
– Madison Twp. Police Department
– Lakeland Community College Police Department
– Mentor Police Department
– Willoughby Police Department

No needles or syringes can be accepted. All drugs collected in these disposal bins will be destroyed by incineration.

For those outside of Lake County, please contact your city or county government’s household trash and recycling service to learn about medication disposal options and guidelines for your area.

Household Trash
If you don’t have access to a drug take-back program, you can safely dispose of drugs in your household trash. Mix tablets or pills with something inedible like kitty litter or used coffee grounds and wrap the mixture in a plastic bag before you throw it in the trash. This method prevents drugs from leaching into the soil or ending up in the wrong hands.

With the high price of medications, it may be difficult for you to throw away pills and prescriptions that cost you so much money. The hard fact is that it’s not safe to pass them on to others, their potency will change with age and their presence in your home is hazardous. So, please takes steps and clean out your medicine cabinet this week.

Questions? Contact me at 440-255-5700

Watch for Important Medicare Info in the Mail

Your Annual Notice of Change Booklet is Coming Soon.
 
By the end of September, everyone who has a Medicare Advantage plan or a Part D Prescription Drug plan will receive information in the mail called the “Annual Notice of Change” (ANOC). This booklet provides important information on changes you will see in your insurance coverage, cost and services for 2016.  
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:
 
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?
 
Provider Network 
Are your doctors still in the network? (You can confirm this with the insurance provider’s online directory.)
Is your plan still available in your county? Some plans may be discontinued for certain counties.

What to do if you find gaps in your coverage
If you find gaps in your coverage, you have an opportunity 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 there is plenty of time to shop and compare plans. 

 

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. If you have questions, call me at 440-255-5700 or email me and we’ll set up an appointment to do a Medicare review together.

When to use prescription discount programs and when not to use them

Many pharmacies, including many grocery store pharmacies, offer deeply discounted prescription drug prices to help you save money on your prescriptions. In some instances, the loyalty program drug prices are close to or less than the amount of your Medicare Part D copay. Purchasing through the loyalty program may be a good option for some people, but it isn’t always the best choice for everyone.

Here’s why. It all depends on whether you are likely to end up in the Medicare drug coverage gap, often called the donut hole. If you take a minimum number of prescriptions and getting your prescriptions filled through a discount loyalty program means that you will never reach the donut hole, it may be beneficial to use your pharmacy’s loyalty program.

However, if you are heading toward the donut hole, you may want to take a different approach.

Most Medicare drug plans include payment tiers or limits. The first tier is called Initial Coverage. In this tier, you and your plan pay up to $2960. This dollar amount is based on the total cost of your medications, including plan contributions and copays. Once the total of your plan contributions and your copays have reached the $2960 amount, you enter the Coverage Gap or Donut Hole. While in the coverage gap, you will pay a larger share of your prescription drug costs up to $4700. This $4700 is made up of your out-of-pocket expenses only. Once you get out of the donut hole and into the Catastrophic Coverage tier, you will only pay a small coinsurance amount or copayment for covered drugs for the rest of the year. In this case, as tempting as that $4 copay is, you should still use your Part D plan to pay for your prescriptions.

The coverage gap is set to close in 2020. Until then, filling prescriptions outside of your plan may count against you if you have large prescription drug bills and need to get out of the coverage gap and into catastrophic coverage.

Have questions about this? Contact me at Mutsko Insurance Services, LLC.
Email me or call 440-255-5700 today for an appointment.