What is the Medicare Annual Election Period

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Before you sign up for Medicare, you have to consider what type of services you need before committing to a plan. The choice often boils down to choosing Part A and Part B or Part C (also called Medicare Advantage) and Part D (Medicare prescription drugs). However, this does not mean that you are bound to the policy that you chose forever.

There are circumstances that will make you want to change your Medicare coverage. Fortunately, the federal government offers a yearly window of opportunity for those who want to make the switch to do so easily. This is called the Medicare Annual Election Period (AEP). During this time, you can dis-enroll from, change, or sign up for a plan.

The Medicare Annual Election Period happens only from October 15 to December 7 each year.

*Take note that AEP is different from the Open Enrollment Period, which applies only to Medicare Supplement Plans (Medigap).

What Can You Do During the AEP?

You cannot just make changes to your Medicare coverage anytime you want. This is why it is important that you know the right schedules when you are able to do so. Here’s what you can do during the AEP.

– Switch from Original Medicare Parts A and B to Medicare Advantage

– Switch from Medicare Advantage to Original Medicare Part A and B

– Switch from one Medicare Advantage policy to another (regardless whether they offer drug coverage)

– Sign up for a stand-alone Medicare Part D prescription drug plan

– Switch from one stand-alone Medicare Part D prescription drug plan to another one, and

– Dis-enroll from Medicare prescription drug coverage completely

When you avail of these changes during the October 15 to December 7 AEP, expect the changes to take effect beginning January 1 of the next year.

What to Do During AEP: A Checklist

Because the conditions of Medicare are ever-changing, it is advised that you consider the benefits on a per-year basis. After all, the AEP happens yearly. While you certainly wouldn’t want to keep switching every year, because that would be troublesome and stressful, getting advice from your doctor or qualified Medicare advisors will help you make an informed decision so that you don’t have any issues when the AEP approaches. Here’s a checklist that can help.

  1. Discuss your current Medicare plan with your doctor.

If you have Original Medigap with a Medigap add-on policy, ask your physician if he or she will continue to take Original Medicare next year. If the answer is yes, then you may continue your current plan, unless you have a major reason to switch.

If you are currently signed up in Medicare Advantage, where the fees can change yearly, there are several things you should consider. Is your doctor still part of the Medicare network and is he or she happy with the service? Is there a possibility of your doctor leaving the network in the next year?

  1. Pay attention to the Annual Notice of Change, which is sent out yearly.

If you are enrolled in Medicare Advantage or the Part D drug plan, you will receive an Annual Notice of Change in the mail before September 30 of each year. This packet contains information about changes that will be happening to your policy in the coming year. This package will be big, and people often neglect looking at its contents or put it off, until they do and they realize it’s too late to make any changes.

When you receive this envelope, just skim through what’s inside, take note of what is changing and decide if these are minor enough to stay with your current plan, or major enough to want to make a change. If it is the latter, it’s best to contact your Medicare agent right away to discuss your options.

  1. Know if the AEP dates are still valid.

The October 15 to December 7 AEP window changes from time to time. It certainly was not the same a few years ago, so be sure to always be updated yearly so you don’t miss any schedules. This window is short so be sure to verify if the same is happening this year and mark it on your calendar.

  1. Review you Prescription Drugs annually.

Have your prescription drugs changed in the past year? If so, you might want to re-evaluate your Part D prescription drug plan and see if it is still the best and most cost-efficient option for you. List them all down along with the frequency and dosage and have them ready for your agent to look over before October.

  1. Talk to your Medicare agent.

While it’s protocol for your Medicare agent to touch base with you at least once a year, it’s best to make a call in September to make sure that you have everything prepared and all choices are laid out before AEP arrives. Even if it’s just the start of the year, just drop in or make a friendly call. Better yet, remind him or her that you would like to set an appointment when the Annual Notice of Change arrives in September. Just make sure your agent is reminded of you so that you stay in his or her radar.

Finding the Best Package for Your Needs

When you consider making changes during AEP, the most important thing to do is get a thorough assessment of your current and projected healthcare expenses. Although you might already be satisfied with your current plan, it wouldn’t hurt to check out the prices offered by other providers to see if you’re getting the most bang out of your buck. Take note that Medicare Advantage plan fees vary depending on the provider.

If you’re still unsure if you should be concerned that AEP is approaching and what you should be doing to prepare, it’s best to consult with a qualified agent so everything is laid out clearly and no stone is left unturned. After all, it’s your health we are talking about here and that reason alone should be good enough for you to be extra mindful and vigilant about Medicare.

Medicare and Dental Coverage for Seniors

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Does a Medicare supplement plan include dental care? It does not. While Original Medicare Part A and Part B do shoulder some dental procedures that are necessary when you are in the hospital as an in-patient, it does not cover any procedure or consultation outside of a hospital stay. Seniors who would like to expand their insurance coverage to include dental care will have to purchase private dental insurance.

The types of procedures that Medicare will cover when you are in the hospital are those that are necessary to protect your overall health, or are prerequisites to another procedure that Medicare actually shoulders. Here are some instances where Medicare does provide dental coverage.

When Medicare DOES Cover Dental

There are specific instances when you will need to undergo a dental procedure so the doctors can proceed to another treatment that is covered by Medicare. For example, it may shoulder:

– Dental services necessary for certain jaw-related ailments prior to radiation treatment, such as oral cancer

– Oral exams prior to a kidney transplant

– Surgical procedures to rectify fractures on the face or the jaw

– Oral exams in a Federally Qualified Health Center or rural clinic before a heart valve replacement surgery

– Dental wirings and splints necessary post jaw surgery

– Surgeries that involve ridge reconstruction during a facial tumor removal procedure

– Dental-related hospitalizations where you require observation due to a health-threatening situation

In the case of hospitalizations that are dental-related, Medicare may cover the likes of x-rays, anesthesia, and even room and board, depending on the condition. However, it will not shoulder the expenses related to dentist fees and the charges for other attending physicians, such as anesthesiologists and radiologists.

Options for Senior Citizens to Acquire Dental Coverage

If you need a dental care plan in your senior years, you will need to be prepared to have it as an out-of-pocket expense because it will not be covered by Medicare. While there are specific inclusions, mostly related to hospitalization, it’s better to count it as an additional coverage that you must pay for.

So how can a senior citizen obtain a dental plan? There are several options.

  1. Enrol in a Medicare Advantage (Part C) plan

Medicare Advantage plans are another way to access Medicare benefits and may include dental care. While Medicare is administered by the U.S. government, Medicare Advantage is offered via private insurance agencies that are working under the rules set by the CMS (Centers for Medicare and Medicaid Services). Medicare Advantage are required to offer the minimum benefits under Original Medicare Part A and Part B, they have greater leeway when it comes to what more they can offer because they are private agencies. Typically, the extra benefits included are vision and dental care, as well as hearing care.

Generally, Medicare Advantage plans that offer dental benefits will cover preventive and diagnostic procedures such as x-rays, cleanings, and annual exams. Many Medicare Advantage providers can also include fillings, extractions, root canals, crowns, dentures, bridges, and treatment of gum diseases. Take note, however, that these plans might require to seek dental care only from a pre-selected list of dental clinics. You can also expect to pay a certain set amount for these services regardless of how much they really cost, while some might put a cap on the dental benefits that you can avail in a year.

  1. Check if your spouse has an existing dental plan and if you can enroll in it

If your spouse is currently employed and is enjoying a group plan that includes dental coverage, you might also qualify for this coverage. Ask your partner to inquire with his company on extended coverage for family members.

  1. Join a club that offers discounts on routine dental procedures

There are organizations where you pay a fee to become a member and then be entitled to a range of services on discount. Look for those clubs that offer special rates for dental procedures or are partnered with clinics that offer cheaper rates, in addition to other healthcare and lifestyle perks.

  1. Sign up for a stand-alone dental insurance policy

Most private insurance agencies offer dental coverage as an independent plan and you can certainly subscribe to a dental only policy. You will be asked to pay a monthly or quarterly premium, but the cost will generally be offset by lower out-of-pocket expenses. Many of the dental plans will require that you work only within a pre-listed network of clinics and healthcare professionals—and this list will vary depending on the private insurer you sign up with. Some plans will allow you to go outside of their network, although be prepared to pay a little more for their consultation fees and services.

What We Offer

At SecureCare65, we offer four types of dental care plans with features that range from routine checkups to the more advanced orthodontic care procedures. The maximum benefit of each also varies depending on the type of plan you sign up for and every package will have varying degrees of coverage for Preventive, Basic, Major, and Orthodontia procedures.

Plans   (For Year 1 only*)
Preventive
Basic
Major
Orthodontia
Spirit Choice 3500
100%
65%
25%
10%
Spirit Choice 1200/2500/5000
100%
50%
10%
10%
Spirit Choice 1200
100%
50%
25%
10%
Spirit Choice 750/1000/1250
100%
50%
10%
none

*The percentage of coverage increases as your subscription extends from year 1 to year 2 and to year 3.

For Spirit Choice 1200/2500/5000 and Spirit Choice 750/1000/1250, here is the distribution of benefits.

Spirit Choice 1200/2500/5000
Preventive
Basic
Major
Orthodontia
Year 1 (max. benefit $1,200)
100%
50%
10%
10%
Year 2 (max. benefit $2,500)
100%
60%
30%
25%
Year 3 (max. benefit $5,000)
100%
80%
50%
50%
Spirit Choice 750/1000/1250
Preventive
Basic
Major
Orthodontia
Year 1 (max. benefit $750)
100%
50%
10%
n/a
Year 2 (max. benefit $1,000)
100%
60%
30%
n/a
Year 3 (max. benefit $1,250)
100%
80%
50%
n/a

Preventive: 3 cleanings and 2 exams per calendar year

Basic: Sealants for 16 years old and below, 1 topical fluoride annually for 16 years old and below, basic fillings, 1 series of bitewing x-rays annually, and space maintainers

Major: Includes implants, simple extractions, oral surgery and restoration services, endodontic and periodontics’ treatments, 1 diagnostic x-ray in panoramic or full in any 3-year period, and prosthetic services such as dentures and bridges

Orthodontia: orthodontic care of proper teeth alignment for dependents under the age of 19 years; has a $1,200 lifetime maximum per child

Note: These rates are guaranteed for your first 12 months and may change in the succeeding years.

Some Reminders About Senior Dental Care

Dental coverage acquired as a stand-alone policy gives you the freedom to avail of any service you want at a price that it lower than the usual market rates. While you are paying a premium for these services, you will find that the healthcare providers included in the private company’s network will be more affordable, if not free. Should you want to obtain services of a dentists who is not part of the network, you will have to be ready to pay larger out-of-pocket fees.

To further illustrate the difference, let’s say you are having a crown installed. This is considered a Major procedure. Here is a sample of your possible fees.

Network
Usual Dentist’s Fee
Reduced Network Fee
Your Plan’s 50% coverage
Your out-of-pocket expense
Within the network
$985
$685
$342.50
$342.50
Outside the network
$985
$750
$375
$610

Before deciding on any dental care policy, talk to your preferred insurance agency about their inclusions and exclusions. For example, you might think that you can get veneers for aesthetic purposes and be able to get it for free because you have a dental plan, and then find out later that your policy does not cover it.

Be upfront with your queries and plans when it comes your oral healthcare, whether it’s for practical healthcare or aesthetic reasons. Better yet, talk to our team of healthcare plan experts so we can help you find the best and most cost effective policy that matches your and your family’s needs and budget.

Let us help you get an accurate quote before enrolling in any dental insurance plan by visiting us at https://securecare65.com/. You can also give us a call at 1-800-354-1078 so our customer service team can assist you immediately and answer any questions you might have

What Does Medicare Pay for Chiropractic Care?

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A huge part of ageing and entering the senior years is the increasing need for chiropractic care. While not everybody will likely need any major spine alignment procedures, there are certain chiropractic procedures that will help senior citizens enhance flexibility, balance, coordination, and mobility. These procedures are also often necessary when a person starts to feel some discomfort and pain. Thus, the question of whether Medicare includes chiropractic care to its coverage is often asked.

Why Is Chiropractic Care Needed for Older Adults?

It is a fact of nature that bones do start to exhibit signs of wear as we get older and this amount can vary from person to person. Those who already are feeling the strain on their bones and joints are more likely to see the problem escalate to bigger mobility and posture issues, which when experienced with intense pain can indicate a pinched nerve. While this part of ageing is expected, it shouldn’t be a hindrance to enjoying one’s golden years. This is where chiropractic care steps in.

The common misconception is that chiropractic care is physically stressful because the manipulation techniques could place the elderly’s frail bones at risk. However, as chiropractors are also medical practitioners, it should be known that there are varying degrees of manipulation, depending on the patient’s needs and condition. This can be in the form of gentle massages and mobilization techniques, as well acupuncture or dry needling. All that said, chiropractic care is an essential part of the ageing process — so everyone can transition gracefully and as pain-free as possible.

What Medicare Pays for Chiropractic Care

The only chiropractic procedure that is covered under Medicare, Part B (medical insurance) specifically, is manipulation of the spine to correct a subluxation, which happens when one or more bones on the spine are out of their normal position. No X-ray is needed to prove this condition. It is also covered under Part B when it is medically necessary and if it is performed by a qualified chiropractic care provider or a licensed chiropractor. This includes both inpatient and outpatient care, such as lab testing, doctor visits, equipment, necessary surgical procedures, home health care and other directly related situations.

Medicare Part B covers 80% of this type of chiropractic care while the patient takes care of a small annual deductible. You may purchase supplement insurance or Medicare Supplement plans to help pay for such expenses. Take note that X-rays are not covered unless it was specifically ordered by the doctor to determine whether a subluxation does exist. The initial exam by the chiropractor to find out is a misalignment is present is also not part this. The coverage refers only to the adjustments that need to be made.

Chiropractic Care and Medicare Advantage

A popular way to obtain additional coverage for chiropractic services is to get a Medicare Advantage plan. Note that they may cover such services, though what they include and how much of a copayment the patient must pay are not standardized. Providers of Medicare Advantage plans have the liberty to set their own packages of benefits, and pricing so it’s best to shop around and compare offerings before signing up for anything.

Medicare Advantage plans typically offer the same services as Medicare Part A and Part B, but the difference is that they are limited by their network of healthcare professionals. This means that you should seek medical consultations and assistance only from the providers on their list if you want to gain full advantage of this plan. In addition, unlike Medicare that lets patients pay a deductible and then they cover 20%, MA charges via a copay system — and, again, this can vary depending on the time of treatment and the services rendered.

Chiropractic Care and Medicare Supplements (Medigap)

Having a Medicare Supplement plan will also help in reducing the expenses or getting some of the procedures related to chiropractic care for free. For example, some Medigap plans can cover all of the Part B coinsurance and copayments, which may include chiropractic office visits for a subluxation. Medicare Supplement Plans F and G can take care of Part B excess charges, while Plans C and F can shoulder the Part B deductible. Plan will require you to shoulder a copay of $20 for doctor visits, while Plans K and L will have you making 50% and 75% in out-of-pocket costs, respectively.

To further understand how a Medicare Supplement figures into your specific needs for chiropractic care, it is best to talk with a qualified SecureCare65 advisor so you can see all the choices available for your situation and budget. You can give us a call at 1-800-354-1078 so our team can answer your questions immediately.