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