The Senior Insider

2018 Dates for Getting Started with Medicare Seminars

Get the facts on Medicare. Join me for one of these upcoming

Getting Started with Medicare Seminars

Wednesday, January 24, 2018

Mentor Library-Main Branch

6:00 pm – 8:00 pm

8215 Mentor Ave., Mentor, OH 44060

440-255-8811 x216

 

Tuesday, January 23, 2018

Kenston Community Education

6:30 pm – 8:30 pm

Gardiner Center C7, 9421 Bainbridge Rd., Chagrin Falls, OH 44023

440-543-2552

 

Thursday, February 15, 2018

Chagrin Falls Community Education

7:00 pm – 8:30 pm

400 E. Washington St., Chagrin Falls, OH 44022

440-247-5375

 

Monday, March 12, 2018

Eastlake Library

6:00 pm – 8:00 pm

36706 Lake Shore Blvd., Eastlake, OH 44069

440-942-7880

 

Monday, April 9, 2018

Willoughby Hills Library

6:00 pm – 7:30 pm

35400 Chardon Rd., Willoughby, Hills, OH 44094

440-942-3780

 

 

The Ins and Outs of Travel Insurance

Travel Insurance means many things to different people. Some people are looking for protection against trip cancellation. Others are more concerned about emergencies, such as evacuations, rental car losses or terrorism. Some are looking for plans that cover just about anything and everything that could go wrong during a trip.

Unfortunately, many people overlook the kind of emergency they are most likely to encounter which is an accident or health care emergency. Don’t take risks. Contact your health insurance agent or provider and make sure your health plan covers you during your travels

If you’re not on Medicare, your health insurance policy may cover you anywhere in this country and sometimes abroad. If you are on Original Medicare, you will not be covered while you are in Europe, Asia or on some cruises.

Government health insurance, including Original Medicare and many other health insurance plans do not pay for medical care, evacuations, prescriptions or supplies you receive outside the U.S. except in very limited situations. For example, on a cruise Original Medicare may cover medically necessary health care services you receive on board the ship within the territorial waters adjoining the land areas of the U.S. However, Medicare will NOT pay for health care services you get when a ship is more than 6 hours away from a U.S. port, regardless of whether or not it’s an emergency.

Because of these limitations, it is a good idea to consider travel medical insurance, especially if you have a preexisting or chronic condition. Travel medical insurance policies are designed to pick up where your primary health plan leaves off and offer a choice of varying limits and coverage. If you do not have health coverage, some plans act as primary insurance while you are out of the country.

Please keep in mind that this is general information and your circumstances or insurance coverage may be different. You need to talk to your insurance company or agent to verify your coverage.

If you would like to learn more about travel medical insurance, call me at 440-255-5700 or email me at Lmutsko@mutskoinsurance.com. A travel medical insurance plan can be the difference between a trip ruined by unexpected illness or injury, versus a trip with access to quality care and financial help should an emergency arise.

E.R., Urgent Care Center or Other Choices.

Imagine. Your doctor’s office is closed for the weekend and you are hit with a sudden illness or a painful injury. The conventional choice has been to head for the hospital emergency room and plan on a long wait for treatment.

But, today, there is a shift away from using hospital emergency rooms for non-life threatening emergencies. Hospital costs are skyrocketing and insurers are passing a bigger portion of these costs on to the patients.

There are a growing number of good alternatives to the ER for those times when you need immediate attention, including:

Urgent Care Centers: Most urgent care are equipped to handle a wide array of non-life threatening health needs, including fevers, coughs, sprains and stitches. Some give you the option of checking in online so you can avoid long delays in crowded waiting rooms. Most urgent care clinics offer extended hours and are open seven days a week, including holidays.

Video visits with a physician: You can skip the waiting room completely by doing a video visit. Video visits provide access to board-certified doctors 24 hours a day, 7 days a week, all from the comfort of your home, office or anywhere you have an internet connection. Video visits are most often used for common complaints, such as upper respiratory infections, allergies, flu symptoms and coughs. The physician you chat with online is able to assess your condition and send prescriptions to your pharmacy, with some insurance plans covering 100% of the cost.

24/7 nurse line:  Many health insurance plans now have a 24/7 nurse line that you can call for help determining the severity of your symptoms and advice on where to go for care.

In non-emergency situations, it is best to call your doctor’s office first. They may want to see you or suggest their preferred alternatives to the emergency room.  Your insurance provider can also help you find a conveniently located, licensed and accredited care setting and determine whether your plan covers the alternative facility’s services.

I want to stress that you should always call 911 or go to the nearest emergency room in any life threatening situation including:

  • Chest pains, shortness of breath and signs of heart attacks
  • Signs of stroke
  • Poisoning
  • Severe cuts or limb threatening injuries
  • Suicidal or homicidal feelings

 

What is meant by ‘advance care planning’ and ‘advance directives?’

Advance care planning is the process of making decisions about the kind of care you would want to receive if you were unable to speak for yourself.  It is your wishes based on your personal values, preferences and thoughtful consideration of those closest to you.

Your wishes are then put into written legal documents called advance directives. It is up to you to share these documents with your family, your medical team and those who will be entrusted to carry out your directives.

In most cases, advance directives include the following types of documents:

  • A health care proxy,which may also be called a “Health Care or Medical Power of Attorney” or a “Durable Power of Attorney for Health Care.” This document names a specific person who will make the health care decisions for you if you are unable to make them yourself. A physician must conclude that the person is unable to make their own decisions and a second doctor must agree before the medical power of attorney goes into effect.
  • A living will.Living wills give directions about the kind of health care you want when you are not able to make a decision for yourself. Living wills state which medical treatments you would accept or refuse if your life was threatened and you were not able to express these wishes.
  • After-death wishes.These may include decisions such as organ and tissue donation.

Advanced care planning is important for people of all ages because anything can happen to anyone at any time and having a plan in place will help ensure that your healthcare wishes are known and honored in any situation. In fact, today most hospitals will ask if you have advance directives any time you are admitted to the hospital.

If you have Medicare, Part B covers voluntary Advance Care Planning as part of the Medicare Yearly Wellness Visit. You can talk about an advance directive with your health care professional, and he or she can help you fill out the forms.You can also download advance directive forms online or contact your local office on aging, your state health department or an attorney to learn more about advance directives.

What if I don’t enroll in Medicare

Delaying your enrollment in Medicare can have a lasting impact on your future health-care costs. Before you put off enrolling, be aware of the consequences.

Let’s begin with Medicare Part A. Part A is premium-free if you or your spouse worked and paid taxes for ten years or more. If you are not eligible for premium-free Part A and you delay enrolling, you will be assessed a 10% penalty. You will be charged the penalty for twice the number of years you could have had Part A, but didn’t sign up.

Not enrolling in Medicare Part B when you first become eligible will result in a penalty of 10% of the Part B premium for every 12 months you put off signing up. In most case, you will pay the penalty as long as you have Part B coverage.

There is an exception. You are not required to take Part B if you or your spouse is still working and you have coverage as a result of that employment. Once this qualifying insurance ends, you and your spouse would be able to enroll without penalties.

The late enrollment penalty for Medicare Part D depends on how long you go without Part D or other creditable prescription drug coverage. Medicare calculates the penalty by multiplying 1% of the ‘national base beneficiary premium’ ($35.63 in 2017; $35.02 in 2018) times the number of full, uncovered months you did not have Part D or creditable coverage. You will pay this penalty for as long as you are enrolled in a Medicare Part D plan.

It is important to understand the period when you first become eligible for Medicare so you can avoid these penalties. If you qualify for Medicare by age, it starts three months before you turn 65 and lasts for a total of seven months.

Giving Up the Car Keys

I am thinking about giving up my car keys. Although my family and neighbors will help me get around, I really don’t want to give up my independence.  What are your thoughts on this?

Before we look at your options for getting around without a car, let’s look at what your car is costing you. According to Nerd Wallet (www.nerdwallet.com), the average owner of a medium size sedan who drives 15,000 miles each year can expect to pay an average of $286 a month for insurance, maintenance, taxes, licenses and tags. This figure does not include purchase cost of a car, financing or depreciation. Giving up your car will free up a portion of your budget so you afford to hire transportation whenever you need it.

One of the first options to look into is LakeTran. LakeTran offers a number of specialty transportation services for older Lake County residents. For anyone with a Medicare Card or Golden Buckeye Card, fares are discounted and begin at 75 cents for Local Routes.

LakeTran also offers Dial-a-Ride at discounts for Medicare and Golden Buckeye Card holders. With Dial-a-Ride, you reserve your trip in advance for door-to-door, assisted transportation to any destination throughout Lake County or to limited medical facilities in Cleveland. Fares are reasonable, beginning with $2.50 for a ride within Lake County, and $5.00 a ride to a limited number of Cuyahoga County Medical facilities.

All veterans of the United States Armed Forces may ride Laketran free of charge to the VA office in Painesville, Veteran’s Administration Hospital in University Circle, Veteran’s Clinic in Painesville and any other medical appointment.

Other LakeTran fare discounts are offered through a number of city programs and can be found on their website at www.LakeTran.com

Another option for independent transportation is Uber. An increasing number of seniors are relying on Uber to get where they want to go when they want to go without having to rely on family members or friends. Uber generally costs less than a taxi. Because rides are paid in advance through an account on your IPAD or smart phone app, you have no need to carry cash to pay for your ride.

For those who require a little help to get into and out of the car or need assistance with a wheelchair or other device, there’s Uber ASSIST. With Uber ASSIST you get a specially trained driver who can help with transfers and is trained to handle your medical device.

Giving up your car does not necessarily mean you have to give up your independence. In fact, you may find that you prefer leaving the driving to someone else once you give it a try.

 

Does Medicare Open Enrollment apply to Medicare Supplements?

The Open Enrollment Period does not apply to Medicare Supplements. You are permitted to purchase this type of insurance or make changes to your Medicare Supplement at any time throughout the year.

To be clear, a Medicare Supplement, sometimes referred to as Medigap Insurance, is not the same as a Medicare Advantage plan. Advantage plans are plans that provide Medicare benefits while a Medigap policy only supplements your Original Medicare benefits. It helps pay some of the health care costs not covered by Original Medicare such as copayments, coinsurance and deductibles. Medicare Supplements generally do not cover long-term care, vision or dental care, hearing aids, eyeglasses, or private-duty nursing.

You will pay a separate premium in addition to your Medicare premiums and you will also need to purchase a separate Prescription Part D plan as this coverage is not usually included with these plans.

The best time to buy a Supplement policy is during your 6-month Medicare Supplement open enrollment period. During that time you can buy any policy sold in your state, even if you have health problems. This period automatically starts the month you turn 65 and are enrolled in Medicare Part B (Medical Insurance). After this enrollment period, if you are able to buy one, it may cost more.

You cannot have a Medicare Advantage Plan and a Medicare Supplement. In fact, it is  illegal for anyone to sell you a Medicare Supplement policy unless you’re switching back to Original Medicare.

If you are interested in learning more about Medicare Supplements, please contact me after January 1 when information on new rates should be available.

 

Are Grandparents Responsible for Health Insurance?

My wife and I recently took in our eight year old grandson. What should we do about health insurance for him?

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 grandson 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 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.

You can also look into purchasing a “child-only” policy on the Affordable Care Marketplace. Open Enrollment for Affordable Care is going on now through December 15 for coverage beginning January 1, 2018.

Dental Coverage is available as Affordable Care Option

In the Health Insurance Marketplace, you can get dental coverage 2 ways: 
 
1.  as part of a health plan, or 
2.  by itself through a separate, stand-alone dental plan
You can buy a dental plan through the Federal Marketplace only when you enroll in a health plan.
As part of a Health Plan
In the Marketplace, dental coverage is included in some health plans. You can see which plans include dental coverage when you compare them. If a health plan includes dental coverage, you’ll pay one monthly premium for everything. The premium shown for the plan includes both health and dental coverage.
As a separate, stand-alone dental plan                                                                
In some cases separate, stand-alone plans are offered. You may want this if the health coverage you choose doesn’t include dental coverage, or if you want different dental coverage. If you choose a separate dental plan, you’ll pay a separate, additional premium.

An Agent or an 800 Number?

It is as predictable as the season’s changing. Your mailbox will soon be overflowing with letters and brochures on all the different Medicare Advantage Plans. You will see television ad after ad, each claiming their Advantage plan provides the most comprehensive coverage. Most will ask you to go online or call an 800 phone number to sign up. The question is, how do you know which plan to choose?
There is a better way. Before you decide, talk to an independent insurance representative who can sit down face-to-face with you and help you find the right plan for you. Independent brokers represent a number of companies and can explain how coverage differs. They will look for a plan that suits your needs and budget.
Best of all, you will not pay any more for your insurance if you purchase your Advantage Plan or Part D Prescription Drug Plan through an independent broker instead of an 800 number. Brokers and agents are compensated by the insurance company, not the customer.
As an independent agent and broker, I provide my clients with many other services as well, including:
Unbiased Advice: I help my clients choose a plan covering their preferred doctors, hospitals and prescription drugs. I also have a good idea of which companies have the best track record when it comes to pleasing their customers.
Help with questions: My customers have me to turn to when they have questions. That’s a lot better than an 800 number where you may reach a different customer service representative every time you call.
Help with claims: I help my clients navigate the rules and regulations and provide assistance if they need help filing a claim or an appeal. It is personal service that sets the independent representative apart from an 800 number.
No charge for service: There is never a charge for any of these services. They are all a part of the ‘package’ you get when you choose Mutsko Insurance Services. Call me, Laura Mutsko at Mutsko Insurance Services at 440-255-5700 before you decide on a Medicare Advantage Plan for 2017. Information on new plans will be available after October 15 when Open Enrollment begins.