Dental Insurance Info

I recently met with Shirley, a prospective client for Medicare Supplement Insurance. She was shocked to find out that Medicare did not cover any dental costs. She said, “I don’t understand, good dental health and overall health go hand in hand”. I agreed, research shows oral health is linked to diabetes, heart disease, cancer and more. Unfortunately, that was not widely known at that time Medicare was implemented in 1965. Now, Medicare can not afford to pay out more benefits. Medicare beneficiaries need to purchase a separate policy if they want that coverage.

As it turns out, I can help. If you think insurance is hard to understand, dental Insurance is even more complicated and there are lots of choices. I begin by asking questions such as do you presently have a dentist and if so, are you willing to change? I ask that because a lot of available plans offer benefits only if you use their network providers. How often do you get your teeth cleaned? Do you routinely use services other that just preventative ones?

Consumers usually see the most savings when using a network type plan. This is because the insurance company has negotiated a significant discount. These savings get passed on to you. But, a lot of dentists do not work with any dental insurance plans or limit the ones they participate with. In that case, I recommend an “indemnity” type plan. With this type of plan, you can go to any dentist and get reimbursed for a portion of the expenses. Usually, the longer you keep your plan, the better the benefits.

I explain that either type of dental insurance can save significant money but it is not going to cover all the expenses. There are waiting periods, deductibles, co-insurance costs and usually a limited amount of coverage to consider. Occasionally, self-insuring may be the best choice.

Personally, I have a combination dental, vision and hearing plan that lets me go to whatever dentist I want. I get my prescription glasses at the warehouse-type stores where I really save. I love it because it really helps me budget my expenses and encourages me to take care of myself on a regular basis.

In case you are wondering, Shirley chose a dental plan that also included a membership to her local YMCA. The cost of the plan was lower than a regular membership fee. The dental coverage was like a free added benefit.

Don’t Miss Medicare Annual Enrollment Period

Beginning October 1, 2018, Medicare-eligible beneficiaries can start “shopping” for new Medicare Advantage and Medicare Part D Prescription Drug Plans (PDP).   Those who are in Medicare Supplement plans should be okay unless you have seen major rate increases and want to see if you can get a better premium price.

I highly recommend at least looking at the options available to you.  I have seen clients save up to $2000 per year by just changing to the best prescription plan for them.  The Part D plans are annual contracts and can change significantly from year to year.  In this area, there were 24 different plans available in 2017.  All of them vary in premium, deductible, formulary, tier levels and prices, and pharmacies that they prefer you use.

Yes, unfortunately, the “donut hole”, (also known as the gap in coverage) will still be in place for 2018.  It will not be until 2020 that you should expect not to pay more than 25% of the retail price for any medicine.  If you have a difficult time paying for your medicines, there is “extra help” available. I can connect you to someone who will see if you are eligible income-wise and will help you complete the necessary paperwork.

As in past years, all Medicare Advantage Plans (also known as Medicare Part C) will change also.  There are insurance companies that are “exiting the market” and a few new ones coming in.  The premiums, co-pays, and co-insurance will likely go up. Be sure to check if your doctors are “in Network”. It does not cost anything but a little time, to be certain that you are in the best plan.

If you qualify for Medicare but are still covered under a work health plan, you may very well want to look at your options.  You should be able to get better coverage at a lower cost by utilizing Medicare and dropping your work insurance.  That can be a scary thing to do, but as long as you have a competent advisor, it may well save you money!

I consult for free.  Only if I put you in a new plan, am I paid a commission by the insurance companies. You do not have to pay anything extra to get the benefit of my years of knowledge and experience. Please don’t wait. This election period ends December 7th.

How Do I Get Paid?

I recently had a  prospective client ask how much my services cost. She had checked out my website, yet that question was not clear. It is not a secret, and I want all my clients to feel comfortable using me and my knowledge. I am an independent insurance agent/broker. I do not work for just one insurance company. I do not get a paycheck or any benefits. I do, however, contract to represent many reputable insurance companies. If and when I place a policy with them, they reward me with a commission. In all honesty, these commissions can vary significantly. However, it is my practice to place my clients in the best policy for them; not the one that will pay me the most. There is also a misconception that using an agent will cost more than dealing with a company directly. That is not true. The Virginia Department of Insurance approves all the insurance rates. They are published in black and white, no matter what course you take to obtain your policy, the rates are the same. Why not use your local, experienced agent instead of trying to talk to someone on the phone, or figure it all out on the internet? I am not a high-pressure sales person. Also, not only do insurance companies pay me for explaining the policy and doing the paperwork, many continue to pay me a trail of commissions for a certain time. That means every year that you renew, I get a small payment again. This is a good deal for you and for me. The insurance company wants you to be happy with their product. They know an approachable agent is of value to them and their clients. I tell my clients that they may contact me at any time for any reason. They are not “bothering” me, I get paid to help them and it is an important part of my work. Even if you choose not to buy a policy for from me, that is okay. I trust that I will have done a good enough job for you that you might refer me to someone else who will buy. I trust God that if I do the right things for my clients, God will make sure that my needs are provided for. It has worked well.

Recognition from United Health

It is an honor indeed, to have United Healthcare recognize me as a level 2, “Authorized to Offer” agent.  Every “A2O” agent is required to meet rigorous criteria to become “Authorized to Offer” status.  Even though I pride myself on being a professional to all my clients and the insurance companies that I represent, it is this particular company who recognizes that professionalism.  In order to qualify for this I had to meet certain standards and ethics.  Some of these include:

  • Demonstrated competency and experience requirements
  • Commitment to community service
  • Required agent training on product, ethics and needs analysis, as well as regulatory training requirements
  • State licensure
  • Annual disciplinary history and background check review, including third-party credit and criminal checks

I must:

  • Requalify every year
  • Sign a code of Ethics
  • Protect consumers through required Errors and Omissions insurance
  • Not engage in door-to-door marketing or cold calling
  • Meet with you in the place of your choice
  • Place you with the best product for you.  I am commission “neutral” meaning I don’t push you to a product that pays me the most.
  • Give you a clear explanation of who you are doing business with
  • Clarify all consumer disclosures and provide you with the limitations and exclusions of product

It is important to you because an “Authorized to Offer” agent:

  1. Can provide you with personalized service and can assist in finding solutions to fit your needs.
  2. Can address the complexity of many of the insurance and financial products you may need in order to have protection and a sense of security.
  3. Can meet with you in-person to address your specific questions and concerns and can lead to a more thorough understanding of how the solution addresses your unique needs.

You can expect me to be a trusted professional and practice four core principles:

  1. Approach every interaction with integrity
  2. Put client needs first
  3. Be an expert and stay informed
  4. Display a commitment to the community.

For further information, please refer to the official Introducing “Authorized to Offer” Local Agents brochure (You will need Adobe Reader installed on your computer to view this document. Adobe Reader is available for free here.)

Two Words Can Cause Medicare Patients Thousands of Dollars!

You could get caught owing many thousands of dollars even though I have sold you the best coverage available.  This is due to two little words in your hospital medical chart – “Under observation”.  Make sure that if you go to the hospital and stay there, that you are actually “admitted.”  NBC News explains it in this two words can cause medicare patients thousands of dollars video.

Here is another video created by Ronald Hirsch that explains the details of these rules. Ask to be admitted as an inpatient- The real rules.

Update 2018:  This is still a major problem today.  The laws now require hospitals to give formal notification of status change.  However, it is a form and it is seldom read or understood.  A nurse will just ask you to sign that you have received the paper. Your nurse may not even know the implications of moving you to observation status.