Posts Tagged ‘MEDICARE CARD COVERAGE’

Here is a quick summary of what you need to know about dental, your rights, and how cost sharing works on dental plans:

  • A child must be offered dental, but you don’t have to take it.  
  • If you have dental coverage through the Marketplace it will typically have a maximum of $700 for a child or $1,400 for a family.    
  • Adults don’t have to be offered dental. However, many Marketplace plans offer dental as part of the plan, or as a standalone. You can’t cancel dental that is part of your plan, so keep this in mind.    
  • If dental is part of your plan, you can still use cost assistance to lower your plan costs.    
  • Even with cost assistance, when you reach the maximum,you typically pay 100% of the costs for dental work. This is the opposite of health insurance under the ACA where you pay 0% after your maximum. So don’t be confused by that.    
  • Oral surgery may be covered by medical insurance in some specific cases, but generally it doesn’t cover non-medically necessary procedures.    
  • Dental works best for routine care, it is uncommon to find any insurance that covers major dental work past a certain dollar amount. (“The Dental Gap”?)

CMS is not finalizing removal of the Alcohol Use Brief Intervention Provided or Offered and Alcohol Use Brief Intervention (SUB-2/2a) measure or the Tobacco Use Treatment Provided or Offered and Tobacco Use Treatment (TOB-2/2a) measure in response to comments indicating that these measures still provide benefits that outweigh the costs of retaining them in the IPF QRP measure set.

Did you know that dental insurance, for the most part, is not covered under the Affordable Care Act?  However, children’s dental coverage is a required benefit included on all Affordable Care Act compliant plans and cost assistance can be applied to any Marketplace plan that includes dental.     Although Dental is not a required benefit of the Affordable Care Act, it is certainly an important aspect of health and wellness.

CMS proposed to remove three chart-abstracted measures from the IPF QRP for the FY 2024 payment determination and subsequent years because the costs associated with these measures outweigh the benefits of continuing to retain them in the IPF QRP. CMS is finalizing removal of one of these measures (Timely Transmission of Transition Record (Discharges from an Inpatient Facility to Home/Self Care or any Other Site of Care)). The removal of this chart-abstracted measure reduces information collection burden by nearly 290,000 hours or approximately $0.5 million per year across all IPFs.

Individual – Family dental insurance plan help and information – InsuranceCompany.com is a specialist in dental insurance and dental discount plans, vision and prescription coverage programs for individuals, families and groups. We have been serving the dental insurance community since 1983, you will find our licensed dental insurance agents are well informed and ready to assist you.

Compare dental insurance plans and decide which one is right for you and your family. Many of our dental plans have next day benefits including vision and prescription. InsuranceCompany.com offers quotes for individual and family dental insurance plans including an option to compare dental national coverage plans. Remember, buying dental insurance does not have to be a painful process.

We offer individual and family dental insurance benefit coverage in all 50 states. Insurance company is a national leader of dental health and related products with an e-market place to compare affordable dental insurance from the nations largest dental companies.

For the FY 2023 payment determination and subsequent years, CMS is finalizing its proposal to adopt the COVID-19 Vaccination Coverage Among Healthcare Personnel (HCP) measure to the IPF QRP. The measure addresses the quality priority of “Promote Effective Prevention & Treatment of Chronic Disease” through the Meaningful Measures domain of Preventive Care. The process measure was developed by the Centers for Disease Control and Prevention (CDC) to track COVID-19 vaccination coverage among HCP in the IPF setting. This measure will be reported using the COVID-19 Modules on the CDC’s National Healthcare Safety Network web portal.

The IPF QRP requires IPFs to submit quality data to CMS in accordance with the IPF QRP’s requirements or receive a payment reduction of 2.0 percentage points to their annual update. CMS makes the IPF QRP data submitted by IPFs publicly available. This public reporting helps consumers make more informed decisions about their health care options.

In FY 2022 and for subsequent years, CMS is adopting conforming changes to the IPF PPS teaching policy with respect to displaced residents from IPF hospital closures and closures of IPF teaching programs, thus aligning IPF teaching policy with changes that the Inpatient Prospective Payment System (IPPS) finalized in the FY 2021 IPPS/LTCH PPS final rule.

For FY 2022, CMS is updating the IPF PPS payment rates by 2.0% based on the final IPF market basket estimate of 2.7%, less a 0.7 percentage point productivity adjustment. In addition, the final rule updates the outlier threshold to maintain outlier payments at 2.0% of total payments. This adjustment will result in a 0.1% overall increase to aggregate payments. Total payments to IPFs are estimated to increase by 2.1% or $80 million in FY 2022 relative to IPF payments in FY 2021.

On July 29, 2021, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that updates Medicare payment policies and rates for the Inpatient Psychiatric Facility (IPF) Prospective Payment System (PPS) for Fiscal Year (FY) 2022 and finalizes changes to the IPF Quality Reporting Program (QRP). CMS is publishing this final rule consistent with the requirements to update Medicare payment policies for IPFs on an annual basis.

The Centers for Medicare & Medicaid Services (CMS) proposed a rule which would enable states to make payments to third parties on behalf of certain individual health care practitioners, including home care workers and personal care assistants. These changes would make it easier for those workers to obtain and retain health insurance, training, and other employee benefits, fulfilling a key promise made by President Biden on the campaign trail to support home care workers. The rule, if finalized, would foster a stable and qualified health care workforce by making it easier for such practitioners to access benefits customary for full-time employees.

Medicare is a national health insurance program in the United States, begun in 1965 under the Social Security Administration (SSA) and now administered by the Centers for Medicare and Medicaid Services (CMS). It primarily provides health insurance for Americans aged 65 and older, but also for some younger people with disability status as determined by the SSA, including people with end stage renal disease and amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease).

Question: My husband just lost the job, I am only working part time and we have two kids under the age of ten.  We were a low income household before my husband got laid off now we are just hardly getting by each day.  My husband  is looking for a full time job.  In the mean time I would like to know if there are any low income dental plans we could get. 

Answer: I would say to start your search for dental insurance by reviewing our Dental HMO plans we have available in most states. You may also wish to review our dental discount plans as they to are lower cost plans that help you save money on your family dental care needs.

Your gummy smile treatment options include gum contouring, jaw surgery, and lip lowering, or your black gums can be permanently treated to be brighter.  

  • Gum contouring:  Gum contouring, which may also be called crown lengthening, is a procedure that is used to remove excess tissue and expose more of the natural tooth for a more proportionate, harmonious smile. This can be used alone or in conjunction with lip lowering surgery
  • Jaw surgery (orthognatic surgery): Jaw surgery may be needed for those with severe structural abnormalities that are causing or contributing to their gummy smiles. 
  • Lip lowering:  Lip lowering is a conservative alternative to more invasive orthognathic surgery and involves adjusting the position of the lip to expose less gum tissue. Botox can also be used to relax the lip muscles and may be used in conjunction with and after lip lowering surgery

Fluoride Toothpaste Should be Given to Babies, When First Tooth Appears.   Previously, the American Dental Association had recommended kids younger than two years old have their teeth brushed with water, before moving onto a pea-sized amount of fluoride toothpaste through the time they’re six years old.      

Now, the ADA says go ahead and give your baby fluoride toothpaste that is about the size of a grain of rice once that first tooth comes in.    

This recommended change comes after a new review published in the February issue of the Journal of the American Dental Association found that brushing with fluoride toothpaste had statistically significant benefits on preventing decay and cavities.    

The new guidance says kids younger than three should just get a “smear” of toothpaste before graduating to a pea-sized amount when three to six years old to prevent cavities and avoid fluorosis. Kids should spit out the toothpaste as soon as they are old enough to do so.

 A study conducted by University of Manchester researchers finds a toothbrush can contain over 10 million bacteria including E. coli and Staph. Toothbrush can be contaminated by the water splashed when we wash our hands, or worse, by bacteria from an open-flushed toilet.  Nasties that fall from toilet spray remain airborne long enough to settle on surfaces throughout the bathroom. And if you drop your toothbrush on the floor, the five second rule does not apply.  Think about keeping your toothbrush out of your bathroom. Also you may want to soak you toothbrush in germ killing mouthwash once a week or so.

It is not hard to teach your child or children as the case may be good at home dental care habits.  I sure you may have heard the saying “Monkey see Monkey do”  When it comes to teaching your kids dental care habits it really is a case where leading by example is good advise.  

Heed the hygienist’s or dentist advice by brushing frequently (in the morning, at night, and after meals), floss daily, and put a cap on sugary drinks and snacks.  By doing so you will help to instill the same tooth-friendly habits in your kids. With infants, clean your baby’s teeth with a soft cloth or gauze pad as soon as they start to come in, you can switch to a soft toothbrush when more teeth emerge

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