Seniorstar Insurance Group

Category: Dental

  • AEP Success Unveiled: John’s Quest for Better Dental Care and Lower Premiums

    AEP Success Unveiled: John’s Quest for Better Dental Care and Lower Premiums

    “…As the AEP approached, he recognized the need for a change. While his current plan had served him well, he sought a solution that would not only alleviate his financial burden but also offer a more extensive network for dental care – a facet that was notably lacking in his present plan.”

    The Annual Enrollment Period (AEP) in the realm of Medicare is a pivotal time for Medicare beneficiaries to reassess their healthcare plans and make choices that can have a significant impact on their overall well-being. This case study revolves around “John Smith”, a 68-year-old resident of New Jersey, who found himself at a crossroads during the AEP. With the help of a dedicated and knowledgeable Medicare Independent Agent, his journey through plan exploration, decision-making, and enrollment culminated in a successful transition to a new Medicare Advantage plan that not only reduced his monthly premium but also broadened his access to dental care – a true testament to the value of personalized guidance during this critical period.

    John’s Dilemma: The Need for more Dental coverage and, if possible, lower premiums

    John Smith had been a loyal member of the XYZ Health Medicare Advantage (Part C) plan for several years. However, as the Annual Election Period (AEP) approached, he recognized the need for a change. While his current plan had served him well, he sought a solution that would not only alleviate his financial burden but also offer a more extensive network for dental care – a facet that was notably lacking in his present plan.

    Enter SeniorStar Insurance Group: A Trusted Guide

    Stepping into the scene was SeniorStar Insurance Group, a seasoned Medicare Independent agency with a wealth of experience in navigating the complexities of Medicare plans. The first step was to conduct an in-depth needs assessment with John and take the time to understand his unique healthcare requirements, including existing medical conditions, prescribed medications, preferred medical practitioners, and all-important dental care needs.

    Research and Tailored Comparisons

    Equipped with a profound understanding of John’s needs and preferences, SeniorStar embarked on an extensive research endeavor. The goal was to find the best-fitting Medicare Advantage plans that would fulfill John’s desires for a reduced monthly premium and enhanced dental care. The careful analysis yielded a curated selection of plans that aligned with his healthcare priorities.

    Informed Decision-Making: Empowering John

    John was presented with three viable options. The merits of each plan were outlined, emphasizing the potential financial savings and the expanded dental network that each alternative offered. John was informed at every step, enabling him to make a decision that was not only pragmatic but also aligned with his medical preferences.

    Seamless Enrollment Process

    Once John had made his choice, he was seamlessly guided through the enrollment process. John and SeniorStar navigated the paperwork and met the enrollment deadline, ensuring a smooth transition to the chosen plan. 

    The Fruitful Outcome

    The culmination of John’s journey was met with resounding success. His transition from the XYZ Health Medicare Advantage plan to the new plan was marked by a substantial reduction of $58 in his monthly premium – a financial respite he hadn’t anticipated. Additionally, the new plan opened doors to an expanded dental care network, addressing a longstanding concern he had grappled with.

    Continued Support and Satisfaction

    SeniorStars role didn’t conclude with enrollment. They continued to engage with John, ensuring that he seamlessly transitioned to the new plan and that he was reaping the benefits he had been promised. Dedication to providing personalized support underscored the profound impact a well-informed and empathetic guide can have on the Medicare journey.

    Conclusion: A Testimony to Guided Decision-Making

    John Smith’s journey through the AEP encapsulates the essence of how a knowledgeable and empathetic Medicare Independent Agent can significantly impact beneficiaries’ lives at no cost. SeniorStars’ strategic approach to understanding John’s needs, meticulous plan comparisons, and unwavering support culminated in a success story that highlights the essence of personalized assistance during the AEP. John’s tale underscores the transformative power of a skilled guide in helping individuals navigate the intricacies of the Medicare landscape, leading to empowered choices that optimize healthcare coverage and security.

  • What Isn’t Covered by Original Medicare?

    What Isn’t Covered by Original Medicare?

    What Isn’t Covered by Original Medicare?

    If you choose to enroll in Original Medicare, it covers most of your healthcare needs after you turn 65 or if you qualify earlier due to certain disabilities or End Stage Renal Disease (ESRD). Original Medicare Part A covers inpatient hospital stays, surgeries, skilled nursing facilities, and some hospice and home care. Original Medicare Part B covers doctor visits, preventative services, durable medical equipment and supplies, and outpatient care. With all that coverage, Original Medicare still leaves you are responsible for some out-of-pocket costs, and there are still services left uncovered. If you choose to keep your Original Medicare coverage, enrolling in a Medicare Supplement, aka Medigap, plan can help fill in some of these gaps. You also have the option to opt for a Medicare Advantage (Part C) plan; these plans offer at least as much coverage as Original Medicare Parts A & B. They also may include additional benefits as well as prescription drug coverage.

    Here are a few things Original Medicare Parts A & B don’t cover.

    Prescription Drugs

    Original Medicare Part A & Part B do not cover prescription drugs. You will need to enroll in a standalone Medicare Part D Prescription Drug Plan to receive prescription drug coverage (and avoid penalties ) if you plan on enrolling in Original Medicare. You can enroll in Medicare Part D during your initial enrollment period. If you choose to enroll in a Medicare Advantage (Part C) Plan, prescription drug coverage may be included.

    Long-Term-Care

    Original Medicare Parts A & B do not cover long-term care. While some of the care in a skilled nursing facility may be covered, not all is. The average cost of a nursing home is upwards of $100,000 without any form of insurance. There is long-term care insurance to help individuals cover these costs.

    Co-pays and Deductibles

    Although Original Medicare covers trips to the doctor’s office, hospital stays, or any outpatient care, you still have to pay co-pays or deductibles. Original Medicare Part A will require a deductible before coverage begins, and you must pay a portion of the cost of a long hospital stay starting at day 61. Original Medicare Part B will also require a deductible, but you also must pay 20% of the costs of doctors’ services with Part B. Medicare Supplements can help ease the burden of some of these costs.

    Dental and Vision Care

    Most routine dental care is not covered by Original Medicare. Routine visits, cleanings, fillings, extractions, and dentures will have to be covered by a separate insurance plan if you choose to enroll in Original Medicare. Some Medicare Advantage (Part C) Plans can cover these basic cleanings and X-rays, but these plans have an annual coverage cap (as may some standalone dental plans). Routine vision care is also not covered by Original Medicare. There are exceptions to this, such as if you have diabetes or must have cataract surgery; you may get an annual eye exam through this exception. Some Medicare Advantage (Part C) Plans include routine vision care. For those choosing to enroll in Original Medicare, you may want to consider a standalone vision insurance plan.

    Hearing Care

    Hearing aids are another essential healthcare item for many. However, unfortunately, Original Medicare does not cover hearing aids or routine hearing exams. Just like vision or dental, some  Medicare Advantage (Part C) plans may be able to cover hearing care costs. Standalone hearing care plans are also an option.

    Traveling Abroad

    Any care you receive while abroad will not be covered by Original Medicare. However, some Medicare Supplements offer emergency care coverage when traveling abroad.

    Choosing the Best Coverage for Your Needs

    It’s important to fully understand the coverage you will receive, regardless of which type of plan you choose to enroll in when the time comes. For some people, Original Medicare and a Medicare Supplement provide the most effective mix of coverage, along with a Medicare Part D Prescription Drug Plan. Others may find the best option for their needs & budget is to enroll in a Medicare Advantage (Part C) plan. If you have questions about evaluating your Medicare options, give us a call for a no-cost, no-obligation coverage review.

  • Does Medicare cover Dental Implants?

    Does Medicare cover Dental Implants?

    Does Medicare cover Dental Implants?

    Dental implants are devices implanted into the gums that help restore a person’s ability to chew or restore a smile or appearance. They can also be used as an alternative to dentures. These are great solutions for lost teeth from injury or periodontal disease.

    Without coverage, these implants can cost as much as $25,000 out of pocket, depending on your needs.

    For many people, dental problems can become more common with age and can profoundly impact their health. This may leave you wondering if Medicare covers dental implants. Although dental implants are not covered by Original Medicare [SH1] (as is the case with most dental care under Original Medicare), that does not mean that you do not have options to find the coverage you need.

    How Can I Get Coverage for Dental Implants?

    Medicare Advantage (Part C) Plans

    If you are looking for comprehensive coverage that will help you get coverage for dental implants, one option is to look at Medicare Advantage (Part C) [SH2] plans. Some Medicare Advantage (Part C) plans include dental coverage that covers dental implants. Be sure you fully understand your plan’s coverage when you enroll, as some Medicare Advantage (Part C) plans only include routine dental services. Also, it is essential to note most of these plans also have a maximum dental benefit. This means that after you reach the limits of the maximum dental benefit, you will be responsible for 100% of any additional costs. When choosing a Medicare Advantage plan, these things are essential to consider, especially if you know you will need dental work.

    Standalone Dental Plans

    If you prefer to stay enrolled in Original Medicare, you are not out of luck – you can always enroll in a standalone dental insurance plan. If you are not concerned about the cost of another premium, you can always add a separate dental insurance plan. These plans are through private insurance companies, or carriers, and provide similar dental coverage you may have had through an employer. These plans typically come with coinsurances, deductibles, and annual maximums.

    Working with a licensed insurance agent can help you decide what coverage makes sense for you. At Seniorstar Insurance Group, we can help you sift through and evaluate the options that meet your needs and fit your budget. Call 844-779-5010 today to get a no-cost, no-obligation coverage evaluation.