HEALTH Focus

INSURANCE Laura Mutsko Agent and CSA

Q:Please share some information on how Telemedicine works. Can I use it if I have Original Medicare?

A:Simply put, Telemedicine is the practice of medicine electronically using your computer, mobile phone or pad for a two-way conversation with your health care provider. With telemedicine, you can safely receive medical advice without ever having to leave the comfort of your home. Telemedicine has been growing in popularity in the last few years. It has been used successfully for a variety of health issues including followup consultations with physicians, sore throats, counseling sessions, insect bites, rashes and other common ailments. It is not appropriate for emergency situations like heart attack or stroke, cuts or lacerations, or broken bones that require x-rays, splints, or casts. Anything that requires immediate, hands-on care should be handled in person.

A recent change now permits those on Original Medicare to use Telemedicine under specific circumstances. The policy change carries out a waiver of Medicare rules authorized by Congress under the Emergency Declaration authorized by the President and will remain in effect during the COVID19 outbreak. According to the CMS website at www.cms.gov/newsroom: “EXPANSION OF TELEHEALTH WITH 1135 WAIVER: Under this new waiver, Medicare can pay for office, hospital, and other visits furnished via telehealth across the country and including in patient’s places of residence starting March 6, 2020. A range of providers, such as doctors, nurse practitioners, clinical psychologists, and licensed clinical social workers, will be able to offer telehealth to their patients. Coinsurance and deductibles apply.”

At a press conference on March 17, CMS announced that Medicare will now cover telemedicine for routine follow-up visits as well during the COVID19 emergency — so if you need to check in with your doctor for a chronic condition such as high blood pressure or type 2 diabetes, for example, you’ll be able to do it via Skype or other technology instead of going in for an in-person visit. This option helps older people take care of many health concerns while they stay safely at home during the COVID19 outbreak.

For complete details, please visit: https://www.cms.gov/newsroom/factsheets/medicare-telemedicine-healthcare-provider-fact-sheet

The best way to know if—and to what extent—your current healthcare provider offers telemedicine services is to call and ask them directly. The practice administrator or manager should be able to explain what telemedicine services are offered, as well as the associated costs.

For your questions on insurance, including life, health, Medicare Advantage Plans and Medicare Supplements, call or email me at Lmutsko@ mutskoinsurance.com or call 440255-5700. Laura Mutsko Mutsko Insurance Services, LLC 6982 Spinach Drive, Mentor, OH 44060 440-255-5700 www.mutskoinsurance.com

PLASTIC SURGERY Paul Vanek, MD, FACS

Q: I need multiple procedures; is it better to do each surgery separately or all at once? A:

This is a decision that can only be made after our private consultation where we discuss your goals, and I have a better understanding about your physical health and lifestyle. But more often than not, patients wanting multiple procedures schedule several of them at the same time because there are many benefits to doing this.

One of the main benefits is cost savings. Surgical procedures are performed in a hospital or medical center, and require other medical professionals, including an Anesthesiologist. Combining procedures will cost less than scheduling facilities and professionals multiple times. Another benefit is your recovery time because your body can heal from multiple surgeries simultaneously. This is especially important if you are employed or have regular in-home responsibilities. With some people having concerns about taking pain medication, your overall intake of post-op medication will also likely be lessened when you combine surgeries.

There may also be an emotional benefit, which could even allow for a speedier recovery. Many patients approach their day of surgery and go through recovery with more optimism and energy when they know that they will see significant improvement in multiple areas after this one day and recovery period.

If you are curious about which procedures are most commonly combine, a breast augmentation or reduction is often combined with liposuction or a tummy tuck (abdominoplasty) as they are located on the same area of the body. A facelift and neck lift can easily be combined, along with most other facial cosmetic procedures.

Please call my office and I am happy to help you decide what is right for you. Dr. Paul Vanek M.D., F.A.C.S. Mentor Plastic Surgery 9485 Mentor Ave #100 Mentor, OH 44060 440-205-5750 www.MentorPlasticSurgery.com Accepting new patients for non-intrusive and surgical cosmetic and reconstructive solutions

DENTAL CARE Jeffrey Gross, DDS, FAGD

Q: Can We Talk About Something Else? A: We sure can. All that is on everyone’s mind is this pandemic of COVID-19, better known as Coronavirus. It is all over the news and the papers. Information and knowledge are useful, but there is also an overload. Therefore I decided to return and talk about dentistry. Let’s all take our mind off of the virus subject for a little bit. I would like to share with you how a toothache can be a good thing. No, that is not a typo. Often, a pain in our tooth brings a patient in for a visit. This visit allows me to do either a quick look around at the mouth. I also have an opportunity to do a more comprehensive exam at that time, depending on the case. A simple pain induced visit can lead me to head off something more devastating or even correct a problem which will affect the patient of many years to come.

I saw this type of patient recently. He came to me without a single filling or cavity in his mouth except for one tooth, which was broken down to the gum. The broken tooth had been that way for a while. Since it never caused him any pain, he never sought any help to rectify the situation. We know that a fractured tooth needs to be examined and ultimately fixed.

Unfortunately, the time for fixing that tooth in a manner that would afford him many years of function had passed. The treatment choices were twofold. The first approach involved a lot of procedures such as gum work and root canal, followed by a post and a crown. This treatment is a little older but still quite valid where it is indicated. Our second direction involved removing the tooth and replacing it with an implant. Both solutions could work. However, I had another dilemma. The tooth in question sat close to its neighbors. This tooth was jammed into position. Trying to create a new tooth would result in a misshapen tooth. If you make a tooth that is the wrong shape, it can lead to decay. This type of tooth may even feel funny to the patient.

I looked a little closer at the rest of his mouth and noted that tooth crowding was all over. Once I observed this, I thought of a different and unique approach. I proposed to the patient to remove the painful tooth. Doing that is in line with our implant direction. However, rather than replacing the tooth with an implant to fill the space, I decided to move his teeth. Through the use of clear aligners, I could close the gap and thus straighten all of his teeth.

I use Invisalign TM in my practice, as I believe that it is the best solution for this type of orthodontic tooth movement. Straight teeth are easy to keep clean and would prevent him from developing a lot of decay in future years. With crooked teeth, excessive cavities are a problem waiting to happen. Once the patient is out of pain, I allow him to heal before moving to the next step. He always wondered if he was a candidate for this type of treatment, and his broken tooth provided him with the answer. As I mentioned last week, our office is open to answer questions and help you treat your emergencies and pain. Don’t hesitate to call Megan at 440.951.7856. She is there to help and guide you, as is all of our staff in this stressful time. If you need to come in, we practice the highest level of disinfection and follow all guidelines for your safety. I wish all of you strength and health in this challenging time. 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, Ohio 44118 216-371-2333 www.jeffreygrossdds.com