It's Time to Review Your Medicare Plan

Open Enrollment for Medicare begins on October 15. You have until December 7 to review your current coverage and compare it to other options to determine if there is a better plan for you.

Here are some tips on what to look for in a plan.

1. Compare Original Medicare coverage to the most current Medicare Advantage plans being offered for 2018. Does your plan fit your budget? As you look at your share of costs, it is important to remember Original Medicare does not cover 100% of medical costs. And, unlike Medicare Advantage Plans which have a yearly limit or cap on your share of medical costs, Original Medicare has no limit on your share of medical costs each year.

2. A plan’s provider network can change from year to year. Make sure your physicians, specialist and hospitals are included in your plan’s network.

3. Prescription costs will vary depending on the plan you choose, the drugs you use, whether your prescriptions are included in the plan’s formulary and whether you use a pharmacy in your plan’s network. Check all of these to estimate your share of prescription costs.

4. Are you likely to need routine vision care, preventive dental treatment or hearing exam in the coming year? Are your dentists, vision and hearing specialists covered or will you be responsible for 100% of the cost of treatment?

5. Does your plan offer wellness programs, gym memberships, coverage when you travel or access to a nurse on call service? 

   Finally, know the difference between a Medicare Advantage HMO and a Medicare Advantage PPO.

   HMO is short for Health Maintenance Organization. Generally Medicare Advantage HMOs tend to be more affordable choices. They usually have zero or a low monthly premium and low deductible. Except for emergencies, HMOs do not cover care you receive outside their network. Make sure your preferred providers are in the network of any HMO you are considering.  

   PPO is short for Preferred Provider Organization. Medicare Advantage PPO plans offer greater flexibility than HMOs, usually having a larger network of physicians, hospitals and other health care providers. With a PPO you can see providers outside the network for any service at any time, as long as they accept Medicare and you’re willing to pay more out-of-pocket. Premiums tend to be higher for a PPO and it is common to have a deductible.

   If this sounds like a lot of information to wade through, give me a call to help you find the plan that’s right for you. I will provide a level of personalized service you won’t get when you go through an 800 telephone number or do all the legwork yourself. There is never a charge for any of the services I provide now or in the future.

   For more information please call Mutsko Insurance Services, LLC today at 440-255-5700 or email me at We are conveniently located in Mentor at 6982 Spinach Drive. Set up an appointment today.

Laura Mutsko

Laura Mutsko is a licensed insurance agent offering a complete line of health and life insurance products, including Individual, Group and Family Health, Medicare Advantage Plans, Medicare Supplement Plans, Medicare Part D Prescription Coverage, Vision, Dental and Life Insurance. Mutsko Insurance Services, LLC is located at 6982 Spinach Drive in Mentor, Ohio.

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Volume 8, Issue 10, Posted 3:26 PM, 10.08.2017