Monthly Archives: October 2015

Do Medicare or Medicare Advantage Plans cover eye exams? What about glasses?

Unfortunately, routine eye exams (sometimes called “eye refractions”) that test for eyeglasses or contact lenses are normally not covered under Original Medicare. (Coverage is available through a number of Medicare Advantage Plans, but more about that later.)
 
Most major vision care procedures are covered, including cataract surgery, treatment of eye diseases and medical emergencies. Original Medicare will also pay for exams to test for other problems like macular degeneration, dry eye syndrome and eye infections.
Original Medicare provides coverage for eyeglasses following cataract surgery and contact lenses if the lens were inserted during cataract surgery. Medicare will not pick up the extra cost if you choose a specialized lens that restores full range of vision in order to reduce your need for glasses after cataract surgery. 
If you have diabetes or are at high risk for glaucoma you will be covered for an annual exam. People at high risk include diabetics, those with a family history of glaucoma and older Hispanics and African-Americans.
So are there other options? There are a number of Medicare Advantage plans that include vision coverage as part of their plan. If you know you are going to want to visit your eye doctor every year, it’s a good idea to consider one of these plans instead of Original Medicare. In addition to covering a percentage of the cost of exams and eyeglasses, many of these plans include dental, hearing and prescription drugs coverage.  
Another option is to purchase a Medicare Supplement, sometimes referred to as Medigap Insurance. A Medicare Supplement will cover your out-of-pocket costs for approved Medicare vision procedures. Remember, Original Medicare does not consider routine eye exams and prescription glasses to be approved expenses.
Military veterans who are visually impaired may be eligible for the VA’s vision health benefits. These range from primary care services to intermediate and advance clinical vision care. If you qualify for veterans benefits, check with your local VA Medical Center for more details.
If you would like to learn more about insurance plans that cover vision care, hearing or dental costs, please contact me at 440-255-5700. Open enrollment begins October 15 and is a good time to take a look at your options for 2016 to find a plan that fits your needs.

What are some affordable dental care options with Medicare?

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 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 email me to make an appointment for a Medicare review.

 

Questions that help you evaluate your Medicare Plan

Medicare Open Enrollment begins October 15 and ends December 7. During this window, you have the chance to evaluate your current coverage to make sure you’re getting the most out of your plan.

Start by asking . . .

Does your current Medicare plan still fit your budget?

Do you have access to the doctors, hospitals and other health care providers that are important to you?

Does your plan include routine dental, vision or hearing coverage?

Are you covered when you’re traveling?

What will your prescription coverage cost you this year? And, are your prescriptions covered?

Do you have a fitness membership or other fitness benefit?

If your plan falls short on any of these points, call me. We’ll take a look at other options.  440-255-5700. 

PayClose Attention to Your Medicare Part D Coverage

Don’t make a costly mistake and get locked into a Medicare Part D Prescription Drug Plan that’s not right for you. Take a look at the changes being made in your coverage and what it will cost you in 2016. You have an opportunity now, during open enrollment to change plans if you need to do so.
Some plans are making significant changes. Look at what tier your prescriptions will be in. What are the costs of each tier?  Have they changed from last year? Also look at your deductible and co-pay. All of this will determine whether your out-of-pocket costs are going up or going down next year.
Call me if you would like to look at other Medicare Part D Prescription Drug Plans. We’ll sit down and do a review and help you determine which plan is the best fit for your needs.

Medicare Open Enrollment does not Apply to Medicare Supplements

Medicare Supplement Plans, sometimes referred to as Medigap Insurance, are not the same as Medicare or Medicare Advantage plans. You are permitted to purchase or make changes to your Medicare Supplement at any throughout the year. The Open Enrollment Period does not apply to this type of insurance.

 

The best time to contact me concerning Medicare Supplements will be after January 1 when information on new rates should be available.

Affordable Care Open Enrollment begins 11-1-15.

While there may be a lot of other things competing for your attention at this time of the year, it’s a good idea to brush up on your Affordable Care options for 2016. Open enrollment occurs this year between November 1 and January 31, 2016.
 
I’m often asked by some people why they need to buy health insurance.They reason that they are young and healthy so why not just go without insurance. 
 
Consider these facts:
 
Fact:  All marketplace plans cover you for the kind of health care that most young people and their families need most including immunizations and preventive services, mammograms, flu shots, childhood immunizations, cholesterol screenings and more. These services are provided with no co-pay or coinsurance even if you haven’t met your yearly deductible.They also include ten essential health care benefits including doctor visits, mental health services, emergency care, hospitalization, prescription drugs, maternity and newborn care.
 
Fact:  Unless you have an exemption, you are required by law to have health insurance for yourself and your family. Your coverage may be through your job, your parent’s plan, Medicaid, the Children’s Health Insurance Program (CHIP), or another source that provides qualifying coverage, but you must have coverage or an exemption.
Fact: The fees for not having health insurance are going up. If you don’t have coverage or an exemption in 2016, you’ll pay the higher of these two amounts:  2.5% of your yearly household income, or $695 per person ($347.50 per child under 18.) You’ll pay the fee with your federal income tax return you file for the year you don’t have coverage. If you don’t pay the fees, the IRS will hold back the amount of the fee from any future tax refunds.
A variety of plans will be available for individuals and families to fit your needs and budget. Financial help may be available to pay for part, or in some cases, all your health insurance premiums, but you need to apply in order to find out what this means for you. To look at your options, visit www.mutskoinsurance.comwww.mutskoinsurance.com  after November 1 and click on Get a Quote. Complete the online application and we will be in touch within 24-48 hours to answer your questions and complete your enrollment.

 

For more information on Affordable Care Plans and other insurance matters, please contact me Laura Mutsko at Mutsko Insurance Services, LLC at 440-255-5700 or email Lmutsko@mutskoinsurance.com.