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Does Medicare Cover Dental - YouTube
Channel: MedigapSeminars.org
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does Medicare cover dental one of the
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most common questions we receive is does
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Medicare cover for dental procedures or
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eye exams the short answer
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is that Medicare does not cover
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most dental care this
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includes fillings cleanings dentures
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extractions and so on it
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also does not cover eye exams for
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eyeglasses or contact lenses
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however the Medicare Part A
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you're inpatient coverage may
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cover up certain dental services that are
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related to your inpatient
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hospital stay for
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example it's not uncommon for your
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doctor to require an oral
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exam and treatment before an organ
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transplant or heart surgery this may
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also include emergency or
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complex dental procedures related to
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facial care , reconstructive
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surgery and so on
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that is covered by Medicare
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regarding vision keep in mind that
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Medicare will cover eye diseases or
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conditions like cataracts and
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glaucoma but it does not
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cover corrective vision because
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Medicare does not cover basic dental
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care standalone dental
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vision and hearing insurance coverage is
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very popular among those on
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Medicare but also very
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misunderstood in this video I
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will review how you can get dental insurance
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coverage and how you can compare
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one plan versus another
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you'll want to be able to sort through the plans that
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are available to you and identify the best
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value so grab a pen and
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paper and join me as we guide you through
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the dental plans that improve upon
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your Medicare
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hi I'm Matthew Claassen with
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MedigapSeminars.org my company is an
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independent insurance broker specializing
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in Medicare and retirement needs
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we help people with their Medicare
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decisions in virtually every state of the
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country we work with all Medicare
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supplement plans we also work
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with Medicare Part D. through are very
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popular
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PartDShopper.com
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website and of course we work with
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Medicare advantage plans as well
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our services are free to use the consumer
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you don't pay us we're paid by the
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insurance company when we help you
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with your application so does
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Medicare cover dental or vision and
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hearing unfortunately in
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most cases the answer is no
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unfortunately because many studies have
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shown that dental health is linked to
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overall health in fact according
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to the Mayo Clinic dental health can be
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directly linked to conditions like
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cardiovascular disease
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endocarditis and
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pneumonia a study by the national
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association of dental plans found that
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people with dental benefits are more
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likely to visit the dentist and
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have better overall health I
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believe it can be recently argued that if Medicare
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wants to save money covering
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basic dental care can reduce other
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more expensive and life
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threatening conditions but alas
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that is not to be
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thankfully there are many dozens of
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standalone dental and dental vision
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hearing plans available for
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reasonable monthly premium that's the
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good news the bad news is
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that the benefits are different from plan to
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plan plus because
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many new plans have increased their benefits
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in the past few years you can't
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simply compare premiums without also
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comparing benefits
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dental insurance plans are so different
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from other types of insurance policies
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that most people have no idea
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how to compare plan benefits to
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find the right plan for themselves
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to what I'm going to do in this video
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is go over how I evaluate these
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policies and how you can too
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this will help you understand the value of dental
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coverage and determine which dental
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is best for you let's start by
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looking at the features and benefits of dental
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plans no we're going to touch on the vision
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and hearing components if you're going
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to compare the value of different dental
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plans you must have some understanding of
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these planned characteristics
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there are dozens of dental plans and
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all have different benefits they do
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not offer the same benefits
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so I've created a cheat sheet for
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you to use when comparing plans to please
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print out from the link
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above and in the description below if
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you're watching this on YouTube or in the
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article if you're watching it on my website
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it may even help to have that handy
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as I walk through each dental plan feature
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so you can pause here and print
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that out I'll wait
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okay the features is that we're going to
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review in this video clip are the
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deductible the annual
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benefit cap the
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percent paid per procedure which
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is one I believe most important
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benefit tiers and grading benefits which
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is like a waiting period before
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procedures are are covered to a certain
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degree and then the coverage of the
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actual charges versus
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usual and customary then your
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network and of course we're gonna start
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with the all important monthly
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premium so let's take a closer look at
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each of these characteristics of dental plans that you
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can add to your Medicare
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before I do please click on
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the black button below
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when you click on the like button or comment
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or share this video it helps indicate to
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you to that this video is worth
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watching that way but you help
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others that are either on or
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going on Medicare who are also
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looking for this information
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so thank you for doing so so let's start
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with the premium most dental plans
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are guaranteed renewable plans
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that are priced much like an issue age
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plan L. on a Medicare supplement
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your premium is based on your age when
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you purchase the policy the price
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of the policy can increase but does
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not do so regularly
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dental policies typically operate on
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a benefit year basis not a
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calendar year basis when you
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enroll in a dental plan your
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deductible your benefit cap
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and then so on renew and
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reset on your policy
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anniversary not on a calendar
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year for example if your plan
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starts in September then your
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deductible another annual features of
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your plan reset every
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September not on the calendar year
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basis I'll shed more light on
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this as we go through the other features
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to be clear that the vast majority of
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dental plans renew on a benefit
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year based on your policy
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anniversary so is the
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deductible what is a
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deductible the
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deductible is an amount of
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money that you before your insurance
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benefits can start most dental
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plans have that leased a small deductible
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like twenty five dollars or fifty
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dollars some have a larger
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deductible like a hundred dollars or
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more in many plans the
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deductible does not apply to
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preventive care like your twice a
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year cleaning the annual
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deductible typically resets
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once a year on your policy
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anniversary the deductible is not
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complicated but if you're
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comparing plans it's certainly an important
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factor in determining value
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your deductible resets on your
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policy anniversary
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and that's important if you are
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trying to plan out procedures of
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for example and you have a
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plan this renews in
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September if you're having
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you know some services before September
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and after September you're
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gonna end up paying your deductible against so
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obviously you want to move everything
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ahead of your next deductible so the
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benefit cap now
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unlike Medicare all dental plans
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have a maximum benefit that the insurance
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company will pay during the twelve month
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benefit period in the distant
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past insurance plans with a maximum
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benefit of a thousand dollars or a
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thousand five hundred dollars were most common
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in recent years we've seen that maximum
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increase to two thousand dollars or even three
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thousand dollars with the option of
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choosing a lower amount to fit your
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budget most dental plans allow
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you to choose from a range of annual
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maximum coverage limits
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that way you can design a
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plan for your needs and your
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budget of course the higher
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the maximum annual cap on your
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benefits the more your plan will
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likely cost like the deductible
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the maximum benefit would typically we
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sat on every policy
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anniversary again this
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is important to know if your
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planning multiple procedures
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I consider the benefit cap the
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second or third most important
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feature of a quality dental plan
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so next feature is the per
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procedure maximum just as
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there's a cap on the maximum total benefits
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paid there's also a cap on the
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percent paid per procedure
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that is the maximum percentage of each
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procedure that the insurance company will
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pay for example let's say you
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have a maximum annual benefit cap of a
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thousand five hundred dollars on your dental
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policy and a maximum
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percent procedure payout of
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fifty percent so if you have
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a procedure like a crown or root
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canal the cost a thousand
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dollars are you going to get the full
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one thousand dollars benefit
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paid by your insurance kapala sleep
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not likely with a fifty percent
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maximum pay out per procedure
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your benefit will be fifty percent
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of the cost of the procedure for five hundred
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dollars and that leaves you with a
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balance of a thousand dollars in annual
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benefits yet to spend
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the percent per procedure
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maximum pay out is often based on
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the tier of the procedure we're
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going to go into that part next just
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understand that often preventive care is
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covered at a hundred percent or to
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put it another way preventive care may be
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exempt from your percent per
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procedure limitations
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also when you're comparing plans the
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plan with the highest payout
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per procedure will provide the
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most benefit on a regular
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basis this is a more
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important measure of value than the annual
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maximum benefit cap let's
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look at a quick example here to see
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why let's say you have a dental plan
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with a two thousand dollar annual
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benefit cap but fifty
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percent per procedure at
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the same time your best friend has a dental plan
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with only a thousand five hundred dollars of
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benefit but it pays eighty
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percent per procedure
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so both of you go hand in hand to the same
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procedure for Dennis charging
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two thousand dollars for some major
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dental procedure your benefit
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would be a thousand dollars fifty
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percent of the total procedure cost
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your friends benefit would be eighty
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percent of the two thousand dollars or a
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thousand six hundred dollars
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however because of the one thousand
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five hundred dollar maximum annual
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benefit your friend received the
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benefit of a thousand five hundred
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dollars put another way you
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pay a thousand dollars out of your
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pocket fifty percent of two thousand
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dollars your friend pays
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just five hundred dollars even though your
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friend had a lower annual maximum
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benefit because your policy had
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a lower percentage per procedure
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benefit you have less insurance
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coverage the percent per
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procedure has the greatest impact
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on how much of a benefit that your will
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you will receive from your
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policy and in my
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opinion this is the most important
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feature of dental insurance
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plans sold next we're gonna look at
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benefit tiers and grated
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benefits when you examine the
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benefit of a dental plan you'll notice the
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entrance company has placed the benefits
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into categories also called
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tears typically those tiers include
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preventive care basic services
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major services
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and many will now have
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specialty procedures take
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a close look at the grated benefit per
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tier in other words with all
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the preventive care you're not likely to have a
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hundred percent coverage right away
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insurance companies usually start at a
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low level of insurance coverage and then
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increase that percent per
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procedure coverage over time
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on your policy anniversary
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for example the policy may say that
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basic services are covered at sixty
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percent the first year then
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eighty percent starting in the second year
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this grated coverage is simply a way of
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discouraging people from putting off
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acquiring insurance coverage until
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they need major services
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preventive care is
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typically dental exams cleanings
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and basic X. rays to
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cleanings and exams per year is
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pretty standard most plans will
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cover this tier of service at a hundred
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percent meaning it's at no cost to
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you so next is basic services
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basic services include procedures that are
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not preventative but
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not major in character procedures like
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fillings basic
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Donal care surgical
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services basic services
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typically have a grating where you get
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some coverage immediately but the
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coverage increases by the
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second or third here for example you
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might see fifty percent coverage your
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first year increasing to seventy or
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eighty percent starting the second year
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every insurance company defines basic
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services a little differently so
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please look over those services
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carefully and look over the grading
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carefully because that two changes from plan
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to plan so the next is major
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services major services typically
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include crowns endodontic
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services restorations and so on
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most dental insurance policies do not
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pay any benefits for major
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services during the first year
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and then pay a percentage the starting
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in the second year however
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recently some insurance companies have
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started to pay twenty percent
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coverage starting from day one of the
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policy and then increasing to fifty
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percent after the first year so
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last but not least many companies have
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introduced a specialty coverage
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so in recent years some insurance
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companies have now included limited
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coverage for implants
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and orthodontic
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and on the vision portion even
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for eye care these services may
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have a separate limited lifetime
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maximum benefits you want to take a close look
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at that so next is reasonable and
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customary charges most dental insurance
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policies will pay benefits based on a
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reasonable and customary charges
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for your region not
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necessarily the actual charge but you're gonna
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want to know before you go into your
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dentist what your dentist charges
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and will that charge or
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is that charge within the customary and
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reasonable charges for that service
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for your area so next we're gonna cover
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networks so the the next
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feature that you want to
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examine is the network most
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insurance companies will have a network of
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doctors that have contracted with the
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company through this network contract
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you will get the best prices on the
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services that you use you can
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often save twenty percent or more
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by using some of the network providers
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I've seen up to fifty percent some
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insurance companies that you only get
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services through in network medical
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providers other insurance companies allow
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for out of network services but at a
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higher rate in general there are two
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major dental providing networks
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there's a Carrington network and the
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Ameritas network both our
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national networks with
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thousands of medical
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providers there are many
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other networks as well but those are the two
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largest that we've come across if
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you have a specific dentist that you
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want to use make sure they're in network
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or ask them to accept your
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insurance so I mentioned that we'd also be
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looking at the vision and hearing
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for most dental vision and hearing plans
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the vision and hearing portion is
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minimal in some cases it's just
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a small annual allotment like a two hundred
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fifty dollars for eyewear or hearing
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test there's only one dental vision and
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hearing plan I know of with vision
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and hearing benefits that are
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almost as robust as their dental
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coverage a vision and hearing benefits are
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important to you please reach out to us
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we can compare the dental plans the dental
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vision and hearing plans that are available
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to you if you are comparing multiple
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dental vision and hearing policies
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using the cheat sheet that I've
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created will make identifying the better
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policy much easier for you
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so this is important please keep in mind
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the insurance policy that has a greater
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insurance coverage for the
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expensive procedures and or
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a higher percentage per procedure
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pale will likely be your
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best value used to cheat
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sheet to help compare plans
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and identify which
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of those benefits are most
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important to you so does Medicare cover
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dental no but that's
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okay there are many standalone dental
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vision and hearing policies with a
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variety of benefits and monthly
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premiums that will fit your budget and your
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needs I hope the information we covered in
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this video will help you to compare plans
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and find the best value for your
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needs if you're on the fence about
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dental plans please research has
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shown that dental health is linked to
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overall health and those who have
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dental insurance coverage tend to have
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better dental health so please do not
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neglect your dental health at least take a
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look at the dental policies that we have available
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for you call us or contact us through
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our website for personalized help if you
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found this information useful please help
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share this information with other people
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in the same situation as you
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press the like button below and write a
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brief comment let me know if you've learned
[1119]
something today share this video so
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others can see this information
[1124]
as well I. Matthew Clawson that
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Medigap seminars dot org thank
[1128]
you for watching them if you have
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a procedure like a crown or root
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canal that
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so if you have a procedure like a
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canal or a
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I need a drink we're also building
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