Health Focus Q: I have Medicare. I also have coverage through a difference health insurance plan. Does Medicare coordinate benefits with other insurers?

OPHTHALMOLOGY Gregory Eippert, MD Q: What are the general requirements for someone to be considered a candidate for LASIK surgery?

A:

Determining if you are a LASIK candidate involves several factors. First, have a complete, dilated eye exam. Your eye doctor can give you a good idea if you are a potential candidate. Final candidacy will require a consultation at a LASIK Center where you will be evaluated with precision optical equipment and examined by the clinical director. General requirements for LASIK include the following.

One, your eyes must be healthy. If there is any condition that will affect how your eyes respond to surgery or heal afterwards, you must wait until that condition is resolved, i.e., severe dry eye, conjunctivitis, infection, and eye injuries. Other eye conditions that may preclude you from LASIK are glaucoma, cataracts, thin corneas, and keratoconus, among others.

Two, your prescription must be within certain limits. If it is too high, whether due to nearsightedness, farsightedness, or astigmatism, your eye surgeon may advise against LASIK and recommend another refractive procedure.

Three, you must be at least 18 years of age and your vision must have been stable for at least a year. And four, you must be in good health. Conditions that are contraindications for LASIK may include uncontrolled degenerative conditions or autoimmune diseases. It is very important to tell your surgeon all pertinent information relating to your health and medical history to determine your candidacy and ensure you achieve the best possible results. If you are pregnant or nursing, LASIK surgery should be delayed until your hormones and vision have returned to normal.

While the vast majority of LASIK and surgery results are excellent, you should be fully aware of the possible side effects, risks, and potential LASIK complications before having LASIK. Choose an experienced LASIK surgeon who can advise you about the best refractive surgery option for your vision needs.

Gregory Eippert, MD 8140 Norton Parkway Mentor, OH 44060

440-255-1115 www.opivision.com

DENTAL CARE Jeffrey Gross, DDS, FAGD Q: 6 Signs You Need to See a Dentist 1. You are in constant pain –

A:

pain in your mouth, face, or neck is abnormal and can mean several things, including infection or TMJ disorder. The pain may be limited to one tooth or be more widespread. The location, duration, and severity are all important things to note. In fact, I encourage my patients to keep a log, as this is always better than recalling what and when things happened after the fact. These details are all instrumental in making a proper diagnosis.

2. Your gums are bleeding – Bleeding gums = infection. That simple. Usually, bleeding gums are easy to correct and return you to a state of health. You would not expect it to bleed if you touched the skin on the back of your hand. If it does, you probably would run to your physician. The same applies to the mouth. Healthy gums do not spontaneously bleed while eating or during brushing.

3. You don’t smile – If you’re self-conscious about missing a tooth or the color of your teeth that can be fixed, whether one tooth or multiple teeth, the fixes available today are truly amazing. Whether you are wearing an old denture or your natural teeth have taken a beating through decades of life, there are good options for you. New treatments and variations of existing ones are always appearing in the professional literature.

4. You’ve had work done – Many people think that they are good to go once they’ve had work done in their mouths. These thoughts are incorrect. We need to see you routinely to ensure that nothing breaks down over time and that no bacteria are getting in and causing infections. Regular cleanings and checkups are keys to maintaining optimal health. 5. You are having trouble eating – Difficulty chewing or swallowing is not normal, so don’t brush it off (sorry for the pun). I saw a patient yesterday who no longer chews on her left side. Whenever she eats anything slightly cold or hot, she must shift the food to a different area of her mouth in her tooth. A painful tooth can be a major game changer when trying to enjoy life. If you feel this applies to you, please see a professional as soon as possible. These unpleasant sensations can be the start of a much more serious problem

6. You use tobacco – Tobacco is harmful to your mouth as well as your overall health. Gum disease is directly related to gum disease and oral cancer. We can also recommend smoking cessation if you are ready for the next step in your journey to excellent health.

Oral health and good-looking teeth greatly benefit general demeanor and interaction with family members and friends. In the 21st century, there is no good reason for someone not to have a functional and attractive dentition. If you have put off a professional visit for whatever reason, now is the time to turn that thinking around and do something for yourself. Please call Nikki at 440.951.7856, and schedule a free appointment. As always, I look forward to meeting you.

Jeffrey Gross, DDS, FAGD, is an Ohio-licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

The Healthy Smile 34586 Lakeshore Boulevard (¼ mile west of Route 91 on Lakeshore Blvd) Eastlake, Ohio 44095

440-951-7856 Severance Medical Arts, Suite 603

5 Severance Center Cleveland Heights, OH 44118

216-371-2333 www.jeffreygrossdds.com

INSURANCE Laura Mutsko Agent and CSA

A:Medicare does coordinate benefits for those people who have Medicare and other health insurance coverage. Medicare Part D Prescription plans will also coordinate benefits with other prescription drug coverage. Coordination of benefits rules will determine how benefits are coordinated and who pays first.

The “primary payer” is first in line to pay what it owes on your bills. Any remaining costs are then sent to the secondary payer who determines what portion they are responsible to cover. The secondary payer may or may not pay 100% of the uncovered costs, depending on the type of plan you have. If your employer insurance is the secondary payer, you may need to enroll in Medicare Part B before your insurance will pay.

If Medicare is not the primary payer and the other insurance company does not pay your claim promptly (usually within 120 days), your doctor or other provider may bill Medicare. Medicare may make a conditional payment to pay the bill, and then later recover any payments the primary payer should have made.

Whether Medicare pays first depends on the specific type of coverage you have. If you have other questions about who should pay first, check your insurance policy or call the Benefits Coordination & Recovery Center (BCRC) at 1-855798-2627. You can also find a table outlining who pays first at www. Medicare.gov/supplements-otherinsurance/how-medicare-workswith-other-insurance/which-insurance-pays-first.

Whether Medicare Part D coverage pays first or second for covered prescription drugs depends upon your circumstances and the source of the other prescription drug coverage.

Your responsibility

If you have Medicare and additional health insurance coverage, be sure to tell your doctor, hospital, and all other health care providers about all your coverage. By providing all details to them, it will help to make sure your bills are sent to the right payers, in the right order avoiding any delays in payment.

Do you have questions on life, health, Medicare Advantage Plans, or Medicare Supplements? Call or email me to set up an appointment. I will help you find a plan that works for you. Email me at Lmutsko@mutskoinsurance.com or call 440-255-5700.

Laura Mutsko Mutsko Insurance

Services, LLC 6982 Spinach Drive Mentor, OH 44060 440-255-5700 www.mutskoinsurance.com

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare. gov or 1-800-MEDICARE to get information on all of your options.