Category: Health and wellbeing

Why Dental Plans Aren’t Worth Their Weight in Premium For Retirees

Why Dental Plans Aren’t Worth Their Weight in Premium For Retirees

If you’re coming off your employer plan and onto Medicare, you might have been surprised to find out that neither Medicare nor Medicare Supplements cover most routine dental services. So I understand why you might find it quite attractive to get on a dental plan in addition to Medicare.   After all, who else will insure your million-dollar smile?

 

But allow me to reason with you. Because I believe that—in most cases—a dental plan just isn’t worth it.  Don’t believe me?  Using the pictured plan as an example, give me a few minutes to explain.

 

Scaling Benefits, Depleting Value

Way back when, Dental Plans had much better benefits. Their maximum benefits started on day one and continued until you dropped the plan.  But people abused it.  They got on a plan when they found out they needed a major surgery, let the insurance company foot the bill, and then cancelled the plan, getting away with no more than $30-40 in out-of-pocket costs.

 

The insurance companies needed to get smart if they were going to make any money.  So what did they do?  They fought fire with fire, and introduced scaling benefits.  Now most plans do not grant you full benefits until much later, after you paid your dues in premiums.  In the example below, the full benefits aren’t granted until 2 years.  In other words, not until you spend $800 in premiums!  The only thing the plan pays in full on day one is preventative services such as cleanings and exams.

 

Maximum Benefits

Here’s where a dental plan can really get you: the maximum benefits per calendar year is $1000.  This means you will never squeeze anymore than one grand out of them per year, no matter how long you’ve paid into the plan.

 

So what do you pay in premiums per year for this plan?  Let’s crunch the numbers.  $33.71/ month X 12 months per year = $404.52.  So, for all intents and purposes,  you pay about $400.  Consider this:  if you put the money you would’ve paid in premiums into a savings account, you would cover the maximum benefits in 2.5 years.  So—as long as you don’t expect to spend well over $1000 in 2.5 years—why would you bother with a dental plan?  For most people, it is just not reasonable.

 

You might’ve notice that you can upgrade your maximum benefits to $2000 dollars for an extra $7.61 in monthly premium.  But did you notice the fine print?  Without squinting, you probably didn’t.  So let me help you out with the gist: despite the upgrade, major services will still not exceed $1000.  In other words, for the services that actually have a chance of exceeding $1000 like dentures and oral surgery, the benefit limit is the same.

 

What to Do Instead

If you are still concerned about paying for routine checks, I would recommend telling the dentist you don’t have insurance and asking about “network pricing.”  A lot of times they are willing to cut the price (as much as 50% for exams and cleanings).

 

And if you are still concerned about major services that are going to cost up to $1000 or more, I recommend saving up what you would’ve paid in premium to put into a savings account.  In 2.5 years, you will have a thousand dollars of self-insurance for that million- dollar smile.

 

Need help with your retirement transition? Seniormark is here to help! Call us at 937-492-8800 for a free consultation.

A Side-by-Side Comparison of Medicare Advantage and Medicare Supplements

A Side-by-Side Comparison of Medicare Advantage and Medicare Supplements

When it comes to Medicare, you only have two big options. That’s it.

The piles of mail you’ve been receiving from various agents as you approach 65 do not represent hundreds of choices. There are only 2 ways to get your Medicare coverage.

First, I hope you have already signed up for Medicare (If not, hop on over to our blog titled “What Is the Fastest Way to Sign Up For Medicare? to take care of that, then come back and read the rest of this!).

The first way is just to stick with original Medicare—Parts A and B. Then you need what is known as Medicare Supplement Insurance, named as such because it “supplements” Medicare, filling in the gaps of what Medicare doesn’t cover.

The other option, however, is to get a Medicare Advantage Plan. This is an alternative to Original Medicare provided through private insurance companies that have contracted with Medicare. Although you still have to sign up for Parts A and B to be eligible, this replaces Medicare as the primary payer of your claims.

Choosing one or the other comes down to what’s most important to you. You can’t have both! What I am going to do is hold both of these options up to the light, side-by-side, so you can see clearly the strengths and weaknesses of each.

Check it out:

Medicare Supplement

 

PROS  

  1. Minimal Out-of-Pocket Spending

You won’t have much coinsurance or copays with a Supplement. Most of it is covered.

 

  1. Predictability

They are also fairly consistent from year to year. They do creep up in premium (see our blog “Beat the Medicare Supplement Creep”, but they rarely leap! The benefits are guaranteed to stay the same.

 

  1. Out-of-State Coverage

Supplements cover you the same whether you are in your home state or out. Vacation homes? Extensive trips? No big deal. You’re covered.

 

  1. No Networks

You are free to use any doctor or hospital that accepts Medicare without sacrificing your coverage.

 

 

CONS

  1. Higher Premium

An in-the-ballpark average Supplement price is about $110 per month premium. This is higher than most Advantage Plans.

 

  1. No Drug Plan

Drug plans are not built in. You have to get a stand-alone drug plan, which cost an average of $34.10 per month in 2016.

 

Medicare Advantage

 

CONS

  1. High Out-of-Pocket Spending

Advantage plans have more of a pay-as-you-go approach. Higher copays, coinsurance, and unexpected costs are common.

 

  1. Unpredictability

Since Advantage plans are funded by government subsidy, benefits and premium costs tend to vary from year to year as a result.

 

 

 

 

  1. Out-of-State Coverage…Sometimes

Only in the case of emergency will you receive coverage out of your home state. Other than that, you’re on your own.

 

  1. Networks

They have them…networks of preferred hospitals and doctors. If you don’t use those preferred providers, you might have less coverage or—depending on the plan—no coverage at all.

 

PROS

  1. Low to No Premium

The average premium is somewhere around 60 dollars a month. Some are even free!

 

  1. Built-in Drug Plan

The vast majority of Advantage plans include a drug plan. No hassle or extra premium for you!

As you can see, the Medicare Supplement route is more costly, but there are a lot of benefits that give you more peace of mind and—all in all—less hassle.

On the other hand, the Medicare Advantage route is more economic, but it has fewer benefits, leading to unexpected costs and stress.

But both do their jobs. They both limit the potentially high out-of-pocket spending that is left by Medicare alone. Whatever you choose, don’t leave yourself vulnerable. Medicare alone is never a good idea!

Turning 65 soon and not sure what to do? Click here to sign up for our free Medicare workshop. No high-pressure sales pitches here, just in-depth discussion about the ins and outs of Medicare!

Workshops

10 Medicare Terms To Get You Started

10 Medicare Terms To Get You Started

If you’ve ever done research in your life, you know that knowledgeable people sometimes overdo it. They use words that only other life-long Medicare experts would know.

 

And when you ask them to explain, what do they do? Use even bigger and scarier words to describe the ones you didn’t understand in the first place. Our philosophy: Never use a big word, when a singularly un-loquacious and diminutive linguistic expression will do the trick.

 

Over our 19 years of helping retirees, it has served us well. Now we are here to pass our knowledge onto you in words you understand. To get started, here are 10 commonly used terms:

1. Medicare

At the top of the list, I like to kick-it-off with the basics. Medicare is a government-run health care program for those over 65. It is also for younger people with disabilities or kidney failure, but its primary concern is to serve the older generation.

2. Medicaid

This is often confused with Medicare, but they are completely different programs. Although they both serve the same purpose (to provide health insurance), Medicaid is for people with low income. There is a chance that you might be eligible for both programs at the same time.

3. Medicare Beneficiary

This is you. Or if you haven’t signed up yet, it will be you very soon. A Medicare beneficiary is a person enrolled in Medicare, receiving Medicare benefits.

4. Initial Enrollment Period (IEP)

The IEP is made up of 3 parts: the 3 months before you turn 65, your 65th birthday month, and the 3 months after. This 7-month window is the time that most people should sign up for Medicare. If you miss your IEP, it could lead to costly penalties. So pay attention. Like all time, those 7 months will fly by!

5. Part A

Medicare is divided up into 4 parts (A, B, C, and D). And Part A is your inpatient care. It includes nursing care, hospice, and some home health services. But—for the most part—it is coverage for when you are officially checked-in at a hospital.

6. Part B

Part B is exactly the opposite of Part A. It is your outpatient care, including lab tests, medically necessary supplies, and various screenings. To keep simple, Part B is care received while checked-out of the hospital.

7. Original (Traditional) Medicare

This one is simple. Whenever someone refers to original (or traditional) Medicare, they are referring to Parts A and B together.

8. Part C (Medicare Advantage)

Medicare Advantage is an alternative to original Medicare offered through private insurance companies that have contracted with Medicare. In other words, they replace Medicare as your health insurance provider. About 1 in 4 people choose Medicare Advantage, according to the Reader’s Digest. To find out the advantages and disadvantages of Part C, click here.

NOTE: You still have to sign up for Parts A and B to be eligible for Part C.

9. Part D

Part D is your drug plan. It covers your prescription medications. Also offered through private insurance companies, almost everyone signs up for Part D in addition to original Medicare (Parts A and B).

10. Medicare Supplement Insurance

A supplement is fondly nicknamed a “Medigap plan.” It is referred to this way because it “fills in the gaps” of what Medicare Parts A and B doesn’t cover on its own. Without it, you leave yourself quite vulnerable. There is no limit to what you could spend in uncovered health care costs!

That should be enough to get you started on this often-overwhelming journey of Medicare planning. As you continue to learn more and plan your retirement, we are committed to keeping you up-to date and informed…in words you can understand. How did we do? Leave us a comment below to pose any questions or concerns!

 

Turning 65 soon and confused about Medicare? Click here to sign up for our free Medicare workshop. No high-pressure sales pitches here, just in-depth discussion about the ins and outs of Medicare! We put it into words you can understand.

 

Workshops

4 Ways to Make Exercise Fun and Get Healthy in Retirement

4 Ways to Make Exercise Fun and Get Healthy in Retirement

If you are concerned about your health as you approach retirement, you are definitely not alone. According to a Merill Lynch Retirement Study, 81% of respondents reported that health is one of the most important ingredients for a happy retirement.

 

Sure, an excellent way to take charge of your health is to exercise, but sometimes the last thing you want to do is set foot on the treadmill or in the gym. Exercise doesn’t seem like much fun…

 

Which is why you need to make it fun! This is my recommendation: instead of grudgingly conjuring up the will power to do exercises you hate, instead of dragging your feet to the gym, muttering the adage “it’s good for me”, why not craft a regiment that you actually look forward to each and every day?

 

Don’t believe it’s possible? Here are 5 ideas that might change your mind!

1.  Tie Exercise to a Goal—and Not a Goal Weight Either

And for you older men out there, I am not referring to your blood pressure or cholesterol settling in on the magic numbers either. No, I’m talking about a life goal. Instead of making exercise merely about getting healthy, make it about accomplishing something you’ve always wanted to accomplish. For instance, have you ever wanted to…

  • Hike in all 59 National Parks?
  • Take a week to bike across your state?
  • Finally clean out that attic or shed?

You can even sign up for a Relay for Life or another exercise-related fundraiser to help a good cause reach their goals!

Whether it gives you a sense of personal satisfaction, curbs your appetite for adventure, or helps someone in need, don’t make your goal about how many calories you’re burning; make it about the life you’re leading!

2.  Join The Right Crowd…

Unlike most high school peer pressure, peer pressure as you age can be a wonderful encouragement. And it can certainly help you keep active. Think sports leagues. Think hiking groups. Think dance classes. Check online or at a fitness center near you. And if you can’t find one, take a lesson from Jake Chesson, and start one! Being a part of a group will help you stay consistent in your exercise routine, of course. But as you develop friendships and a community, I bet you’ll find yourself enjoying it as well!

3.  …Or Just The Right Person

Don’t like crowds? Then use your exercise time to reconnect with just one person you love. Take your spouse out for a long walk by the lake or—if you are lucky enough to live near one—the beach. Exercise with your sister or your brother or a friend you haven’t seen in ages. You can even choose to play a game with a grandkid like kickball, tag, or even old school hopscotch. The Lord knows it takes a lot of energy to keep up with them!

4.  Incorporate Exercise into a Hobby!

Do you have a knack for building things? Then stop by Lowe’s and get started! Have you ever tried golf? Why not try 9 holes without a golf cart? Want fresh fruits and vegetables to complement your healthy lifestyle of exercising? Work up a sweat while planting a garden.

 

The point is you shouldn’t make exercise about exercise. Instead, you should infuse physical activity into your lifestyle, your goals, your hobbies, and the people you love most. It may take a bit of thought and creativity to find physical activities that you are passionate about intrinsically, but once you find them, exercise will cease to be drudgery. Your exercise will make your heart thump in more ways than one.

 

Turning 65 soon and not sure what to do? Click here to sign up for our free Medicare workshop. No high-pressure sales pitches here, just in-depth discussion about the ins and outs of Medicare!

 

Photo:  http://newbridgespine.com/exercise-and-pain/