Medicare – S. Cadena

6 Things to Look for Regarding Dental Insurance and Medicare

One of the most surprising things I learned about my teeth when I was already in my 40s was that losing my teeth is not preordained. I always thought that everyone loses their teeth and someday I would have to wear dentures. Not so said my dentist. Instead, it can come down to good dental hygiene to help me prevent developing a gum disease or wearing out of my teeth before I wear out. Since then I have strived to see a dentist twice a year to help me remove plaque and tartar (leading causes of teeth decay) as well as identify cavities via x-rays. I’ve been fortunate, I’ve had health insurance throughout the years that has helped pay for my dentist visits. However, now that I’m older and can see the Medicare train down the road I’ve learned that generally Medicare does not have dental service coverage (medicare.gov)!

So, what can be done now that we know something to plan for?

Since you can receive Medicare through the Original Medicare plan or through a Medicare Advantage plan then we need to consider how dental coverage can be received through either plan.

If you have Original Medicare, then the best way to get dental coverage is to pay for a separate individual dental plan.

If you have a Medicare Advantage plan, then you want to verify that your plan does indeed have dental coverage. Advantage plans come at a price of flexibility, you have to use those doctors in that particular plan, pay those particular deductibles and be ready to change if your plan changes and leaves you behind.

Either way you go you’ll want to verify these features in your dental plan:

What do they cover? (Preventative, oral surgery, etc.,)
What will be the deductible amounts?
When will your coverage begin?
What is the maximum amount they will cover?
Is your dentist on their list of approved dentists?
Do you have upcoming dental high costs needs that you need to consider?

My preferred method is to apply for Original Medicare, this is not always the best way but is my preferred way. And while you are still working and if you are eligible, save money in a Health Savings Account so that you can afford to pay for an individual dental plan during your Medicare Years. This takes early planning so start working on it as soon as possible. Overall, this method should give you the most flexibility.

Health Saving Accounts & Medicare

What is a Health Savings Account and how can you use as you get ready to enter your Medicare years?

A Health Savings Account (HSA) was created as part of the Medicare Modernization Act of 2003.

According to IRS, the key benefits of an HSA are:

You can claim a tax deduction for contributions you, or someone other than your employer, make to your HSA even if you don’t itemize your deductions on Schedule A (Form 1040).
Contributions to your HSA made by your employer (including contributions made through a cafeteria plan) may be excluded from your gross income.
The contributions remain in your account until you use them.
The interest or other earnings on the assets in the account are tax free.
Distributions may be tax free if you pay qualified medical expenses. See Qualified medical expenses.
An HSA is “portable.” It stays with you if you change employers or leave the work force.

And the criteria for eligibility for a HSA

You are covered under a high deductible health plan (HDHP)
You have no other health coverage except what is permitted under Other health coverage.
You aren’t enrolled in Medicare.
You can’t be claimed as a dependent on someone else’s 2022 tax return.

A key point to be aware of is that contributions to an HSA are not allowed if you are a participant in Medicare. Pre-planning, years ahead, is essential.

Second key point is that HSA accounts go hand-in-hand with High Deducible Health Insurance Policies. If your employer has this type of medical insurance plan then you are allowed to open an HSA. Contributions are tax deductible, and 2003 limits are $3,850, additional $1,000 allowed if you are 55 or older.

Your balance rolls over year to year, you don’t lose it if you don’t use it. Similar to a Retirment account you can designate a beneficiary and generally can be used to cover spousal medical expenses too. Also, in some cases your spouse can have his/her own HSA account doubling the opportunity.

You can use the monies in the HSA to take care of current medical needs or save for future expenses. Many people are surprised to learn that Medicare has it owns deductibles, generally doesn’t cover vision, dental and hearing aids. Setting aside money before the Medicare years will be advantageous.

A Health Savings Account can be a very smart move as you prepare for future medical needs. Definitely worth looking at and seeking wise counsel on the best way to open an account and allocate monies for this type of savings plan.

When should I sign-up for Medicare?

Individuals are generally able to sign up for Medicare at age 65. If you are already receiving Social Security benefits, you’ll automatically be enrolled in Medicare. Otherwise, you’ll be eligible to sign up 3 months before your 65th birthday. You could sign up earlier if you have a disability, End-Stage Renal Disease, or Lou Gehrig’s disease.

However, if you plan to continue working and will be taking advantage of your employer’s health insurance then you might want to consider only signing up for Medicare Part A. Most individuals that have been working for more than 10 years (have earned 40 credits) already paid into Medicare so there should be no extra charge for Part A. Part A is considered “Hospital Insurance” and helps cover inpatient care in hospitals and a few other items.

As for Part B, “Medical Insurance” and Part D, “Drug Coverage” these areas would be generally covered by your employer health insurance if you are still working.

Part C, “Medicare Advantage” is an alternative to “Original Medicare” plan above. This will be covered in more detail in a different post.

These decisions can be daunting especially if you have lots of other things going on. Seek qualified help in working through these issues, especially since missing some of the deadlines can cause life-long financial penalties.

Be aware that these are general guidelines.

Have I mentioned you should seek qualified help in making these decisions?

A good resource to use medicare.gov – lots of great information.