Archive for the ‘Medicare News’ Category

In most cases, Medicare does not cover dental services like routine cleanings, fillings, tooth extractions, or items like dentures. In addition, Medicare Advantage may not provide enough coverage when you need it.

Some Dental Services Medicare May Cover:

  • Certain dental services you get when you’re admitted as a hospital inpatient for your dental procedure, either because of your underlying medical condition or the severity of the procedure. 
  • Specific inpatient or outpatient dental services directly related to certain covered medical treatments. In these cases, you must get the dental service because it’s linked to the success of the medical treatment you need, like:
    • An oral exam and dental treatment before you get a heart valve replacement or a bone marrow, organ, or kidney transplant. 
    • A procedure (like a tooth extraction) to treat a mouth infection before you get cancer treatment services like chemotherapy.
    • Treatment for a complication you experience while getting head and neck cancer treatment services.

Regarding your primary and overall dental care needs, consider shopping for a dental insurance plan that better fits your dental needs. Having good dental healthcare helps maintain good overall health. You can contact our member service line at 310-534-3444, where our team of experts will help you understand each plan’s different options and benefits. They will guide you in selecting the best plan to provide your family with the necessary coverage at a price that fits your budget.

As a person with diabetes, it’s essential to keep an eye on your eye health. High blood sugar levels can damage the tiny blood vessels in the retina, leading to diabetic retinopathy. This condition can cause vision loss or even blindness if left untreated. Therefore, regular eye exams are crucial to catch any issues early on and prevent further damage. So, it’s highly recommended to have more frequent eye exams if you have diabetes.

Medicare Part B (Medical Insurance) covers annual eye exams for diabetic retinopathy if you have diabetes. The exam must be conducted by an eye doctor legally authorized to perform the test in your state.

It is important to note that your healthcare provider may suggest that you receive services more frequently than what Medicare covers. Additionally, they may recommend services that are not covered by Medicare, which means you may have to pay some or all of the costs. To better understand why your doctor recommends certain services, you should ask questions and determine how much Medicare will pay for them.

If you are a Medicare beneficiary, it is important to know that Medicare does not cover routine eye exams for eyeglasses or contact lenses. However, some Medicare Advantage Plans may offer additional benefits that Original Medicare does not cover, such as vision, hearing, or dental services. If you are interested in these plans, you should contact the plan provider for more information on their benefits.

Alternatively, consider purchasing a separate vision insurance plan, such as VSP Vision. With VSP Vision, you can enjoy a routine eye exam for just $15.00 co-pay. Moreover, the plan offers benefits for frames with prescription lenses or contacts and extra savings on glasses/sunglasses. What’s more, the plan has no waiting periods for services and a broad range of providers in their network. Call our member services at 310-534-3444 M-F, 8 am-4 pm, if you have questions about the VSP vision insurance we offer.

So, if you need vision care services, you have several options. Whether you prefer a Medicare Advantage Plan or a separate vision insurance plan, it is essential to research and choose a plan that meets your specific needs and budget.

In short, Medicare does not cover routine eye exams for eyeglasses or contact lenses. Medicare also does not cover the cost of glasses or contacts unless you’ve just had cataract surgery.

However, our office offers a vision insurance plan by VSP that provides benefits for eye exams and eyeglasses or contact lenses. VSP Vision Insurance is a comprehensive insurance plan that provides benefits for eye exams, eyeglasses, and contact lenses. The plan covers eye exams with a low copay and includes eyeglasses or contact lenses allowances. VSP has an extensive network of eye doctors and retailers, so finding a provider or a retail location for eyewear is easy. Additionally, VSP offers additional savings on lens enhancements and other vision-related needs. VSP Vision insurance could be an excellent option for those who want to maintain their eye health and save money on vision-related expenses.

I live in California and am looking for dental insurance. What are some excellent dental insurance companies to get dental insurance with?

Answer: There are several excellent dental insurance companies to consider, depending on your needs and budget. Some of the top dental insurance providers are Delta Dental, Cigna, Humana, MetLife, and UnitedHealthcare. Each of these companies offers a range of plans with varying coverage levels and premiums, so it’s important to compare their options to find the best fit for you. You can research their plans and benefits online or speak with a representative to learn more about their offerings. If you have any questions about our dental insurance plan options, please call our member services line at 310-534-3444

We offer over 30 dental insurance plans from several different insurance companies. Out of our dental insurance plan options, more than half are dental PPO insurance plans. We are giving you a broad range to review and choose from. Our member services at 310-534-3444 are here to help you if you have any questions about our dental insurance plan options. We strive to offer as many dental insurance options as possible so that you can pick the best dental insurance that fits your and your family’s dental care needs.

Medicare is a government-funded health insurance program for people over 65 with specific disabilities or end-stage renal disease. It is divided into parts – A, B, C, and D – each covering different aspects of healthcare services. While Medicare Part A covers hospital insurance, Part B covers medical insurance, which includes doctor visits, outpatient care, and some preventive services. However, it’s important to note that Medicare Part B does not cover some services.

Some of the services not covered by Medicare Part B include:

  • Drug coverage is covered by Medicare Part D. 
  • Hearing aids, 
  • Dental and vision services are not covered by Medicare Part B, but rather by Medicare Part C or Medicare Advantage plans. 
  • Additionally, Medicare Part B does not cover long-term care.

Medicare Advantage plans, as mentioned earlier, bundle Parts A, B, and D and often include additional dental, eye, and hearing services and fitness programs. If you’re looking for more comprehensive coverage than what Medicare Part B offers, you may want to consider a Medicare Advantage plan.

Question: What is affordable dental insurance? 

Dental insurance is a type of insurance coverage that helps to cover the cost of dental services. It’s an essential component of overall health coverage, as good oral health is critical for overall health and well-being. Affordable dental insurance in California is a popular topic of discussion for many people. Affordability depends on the person. If you are looking for a lower-cost dental insurance option, start your search for dental insurance by reviewing dental HMO insurance plan options. HMO dental insurance plans are usually more affordable than PPO and Indemnity dental insurance plans. 

Remember that with HMO dental insurance, you will need to choose a dental office that is a part of the plan network of providers, and unlike a PPO plan, there are no plan benefits if you go to a dentist who is not a provider of the plan.

Question: Costco sells a Delta Dental plan, Delta Care, but you have to be a member of Costco, which I am not. I know about it because my friend told me. Can I get this plan or one like it for myself? 

Answer: We offer Delta Care HMO plans for individuals to buy directly. I can’t say it is the same as Costco’s offering, but it is an HMO dental insurance plan offered through Delta Dental. Call our member services at 310-534-3444. We will gladly assist you with these options if you have questions about our dental insurance plans.

Medicare Part B provides coverage for many routine and preventative services – some of which may be surprising, like bariatric surgery. However, strict medical criteria must be met before being approved for gastric bypass surgery and laparoscopic banding surgery.

Check out the numerous services covered through Medicare Part B:

Medical services covered:

  • Acupuncture.
  • Advance care planning, such as advance directives.
  • Ambulance services.
  • Ambulatory surgical centers.
  • Behavioral health integration services (like depression, anxiety, or other mental health conditions).
  • Chemotherapy.
  • Chiropractic services.
  • Chronic care management services (if you have two or more serious, chronic conditions).
  • Clinical research studies.
  • Cognitive assessment and care plan services.
  • CPAP devices and therapy.
  • COVID-19 vaccines.
  • Defibrillators.
  • Diabetes equipment, supplies, and therapeutic shoes.
  • Durable medical equipment like hospital beds, oxygen, walkers, wheelchairs, etc.
  • Electrocardiogram (EKG) screenings.
  • Emergency department services.
  • E-visits allow you to talk to your doctor virtually.
  • Eyeglasses (if you have cataract surgery).
  • Foot care.
  • Hearing and balance exams.
  • Home health services.
  • Home infusion therapy and supplies.
  • Kidney dialysis and supplies.
  • Kidney disease education.
  • Laboratory tests.
  • Mental health outpatient care.
  • Nutrition therapy services.
  • Occupational therapy.
  • Opioid use treatment services.
  • Oral anti-cancer drugs.
  • Outpatient hospital services.
  • Outpatient medical and surgical services.
  • Outpatient rehabilitation services.
  • Physician’s services – primary care and specialty.
  • Physical therapy services.
  • Prostate cancer screenings.
  • Prosthetic-orthotic items.
  • Pulmonary rehabilitation programs.
  • Rural health clinic services.
  • Second surgical opinions.
  • Telehealth.
  • Transplants and immunosuppressive drugs.
  • Travel care: There are certain exceptions when traveling outside the US.
  • Virtual check-ins.
  • Annual wellness checks.

Tooth decay is a common dental problem that affects people of all ages. However, children are more susceptible to it, and as the study done by Delta Dental suggests, a significant number of children are at a higher risk of tooth decay. According to a study done by Delta Dental, a third of children ages 6-18 are at higher risk for tooth decay, and of those children. 

* More than 70 percent are not receiving two fluoride treatments a year

* More than 60 percent of ages 6-9 did not receive sealants on their first molars

* More than 80 percent of ages 11-15 did not receive sealants on their second molars

While having dental insurance can help save money on dental care expenses, it is equally important to use it effectively. Many people with dental insurance do not understand their plan’s benefits and miss out on treatments that could prevent future dental problems. 

You should review your dental insurance plan’s coverage, including preventive care services like fluoride treatments and dental sealants, which can significantly reduce the risk of tooth decay. By taking advantage of your dental insurance benefits, you can help ensure that you and your family receive the proper dental care you need to maintain a healthy smile.

Question: I have health insurance through my employer, and although it offers dental benefits, it is limited in coverage of dental care services. Can I buy another individual dental plan and use that instead? 

Answer: If you have health insurance through your employer that includes dental benefits but is limited in coverage for dental care services, consider purchasing an individual dental plan. You also may be able to coordinate benefits. It will depend on what you have currently and if you are going to a dentist who will coordinate dual plans. It is, however, worth asking about at your dental office. 

If you are considering purchasing an individual dental plan, it is essential to review your options carefully. We currently offer 46 different dental insurance and plan options for your review. Our member services at 310-534-3444 will gladly assist you with these options if you have any questions about our dental insurance plans.

Question: What is the best dental insurance in California? I know very little about dental insurance, but I want to spend less time looking into getting a plan. I only need something for essential check-ups and cleanings anyway. 

Answer: We often get asked this question, but the best depends on your dental needs. What dental care do you feel you will need, and what dental provider you may want to go to? You state that you only currently need preventive dental care, which most plans provide benefits for preventive care at a low to free cost. It would help if you spent time reviewing your dental insurance options to ensure you get what suits you. 

However, our member services at (310-534-3444) can review our dental insurance plan options with you and help you choose a plan that fits your current dental needs. 

We have posted several posts about how oral health can affect overall health care. Many studies show a high correlation between heart attack, stroke, diabetes, bone loss, lung disease, and oral health. Take your oral health seriously. Here are some tips to help you keep your teeth and gums healthy:

  1. Brush your teeth twice a day with fluoride toothpaste.
  2. Floss daily to remove food particles and plaque between teeth.
  3. Limit sugary and acidic foods and drinks that damage your teeth.
  4. Drink plenty of water to keep your mouth hydrated and wash away food particles.
  5. Visit your dentist regularly for check-ups and professional cleanings.
  6. Quit smoking or using tobacco products, as they can cause oral cancer and other health problems.
  7. Use mouthwash to freshen your breath and kill bacteria.

By following these simple tips, you can maintain good oral and dental health and reduce your risk of developing tooth decay, gum disease, and other oral health problems. People with dental insurance are more likely to make and keep dental appointments.

Maintaining good oral health is crucial for overall health. Poor oral hygiene can lead to dental problems such as gum disease, tooth decay, and bad breath, which can cause significant discomfort and pain. Moreover, research has shown that poor oral health is linked to other health problems such as heart disease, stroke, respiratory infections, and diabetes. Therefore, it is important to maintain good oral hygiene by brushing and flossing regularly, having periodic dental checkups, and following a healthy diet. If you have dental insurance under most plans, this type of service falls under preventive care and is inexpensive.

Question: Can I get a Dental discount plan for only my six-year-old son?

Reply: Yes, many dental discount plans offer coverage for children only. You can check with various dental insurance providers to see what options are available for your six-year-old son. It’s essential to compare the plans and see which offers the best discounts for your needs. Additionally, consider whether you want a plan with savings for preventative care, such as regular check-ups and cleanings, or one that discounts major procedures like braces or oral surgery.

Overall, a dental discount plan can be an affordable and effective way to ensure that your child has access to the dental care they need by comparing plans and finding the right fit for your family.

Another option is looking into an HMO dental insurance plan. Some will let you have only a minor as an individual plan. Others may require you to buy a couple of plans for you and your son. However, HMO dental insurance plans are the more affordable option, and it may be well worth buying an insurance plan for you and your son.

It is important to start flossing your child’s teeth when they touch each other around two and a half years old. Flossing makes a big difference in the prevention of cavities. Generally, when your child starts a kinder garden, they should be able to begin flossing their teeth. Though they may not yet have the skills to do a good job, you should supervise and give tips and pointers now and then to encourage good oral health care. Just like adults, a child should floss their teeth every day. A good time is right before they go to bed, but that is important as long as they floss each day

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