4 Important Steps For Choosing Dental Insurance

Dental insurance will cost you much less in premiums than health insurance, but of course there’s a catch. Most health insurance policies cover a hefty percentage of even towering expenses once you’ve paid your deductible. But dental insurance policies have an annual limit to coverage, from $1000 to $1500 a year, along with a $50 to $100 deductible. While plans may pay 80% to 100% of exams, x-rays and cleanings, when it comes to crowns, root canals and gum-disease treatments by in-network dentists the benefit may be only 50% of the cost. Some procedures, such as orthodontia and cosmetic dentistry, are not covered at all.
It's not surprising that cost constraints can make even people with dental insurance delay needed procedures. Some put off care because their insurance doesn’t cover the procedure, and others because they have used up their maximum coverage for the year, according to a survey by Consumer Reports.
To avoid getting caught with unexpected expenses, here some key steps to take when buying dental insurance.
1. Find Out If You Can Get Group Coverage
The great majority of people with dental insurance have benefits through their employer or other group coverage programs such as AARP, Affordable Care Act marketplace health insurance policies or public programs such as Medicaid, Children’s Health Insurance Program and TriCare for the military.
These plans are generally less expensive than purchasing individual insurance and may also have better benefits.But take a good hard look at the details of even an employer-sponsored plan to decide whether the premiums are worth the money for someone in your situation.
2. Check Into Individual Policies
More expensive than group policies – and often with more limited benefits – individual policies (whether you're buying one just for yourself or for your family) often have waiting periods for major procedures. If you’re thinking of signing up for a plan “just in time” because you need implants or a new set of dentures, realize that insurers are well aware of that tactic and institute a waiting period of perhaps a year before you can start using certain benefits.
It's best to comparison shop. Get price quotes and policy details from insurance-company websites or talk to a knowledgeable insurance agent.
3. Examine the List of Dentists in the Network
Indemnity insurance plans allow you to use the dentist of your choice, but the common PPO and HMO plans limit you to dentists in their networks. If you have a dentist you like, ask which insurance and discount plans he or she accepts. If you’re OK with using a new dentist, a PPO or HMO might fit your needs.

But be wary if a new dentist you visit says you need a great deal of unexpected work. A revealing account by the son of a dentist describes how some in-network dentists may recommend unnecessary procedures to make up for income lost on preventive services, for which they are reimbursed at a low rate by dental insurers. Ask health professionals, neighbors and friends if they can recommend a local dentist they’ve found to be good. Then check what insurance and discount plans those practitioners accept.
4. Know What the Policy Covers
In order to budget for dental expenses, it's important to carefully review the policies you’re considering. For example, from the time your insurance begins, AARP Delta policies cover gum cleanings, denture repairs, restorations, oral surgery and root canals. But you need to wait until your second year of coverage to get benefits for gum-disease treatment, crown and cast restorations, dental implants or dentures. Even then, the benefit is limited to 50% of costs.
If you or your child need major dental work, know that you’ll likely have to pay a hefty share of the cost. With both group and individual policies, remember benefits are limited and can vary significantly. Group plans may also have waiting periods, and almost all plans pay only a fraction of costs for major work, so check the details. Your coworkers or friends may be insured by the same company but have a different benefit package from the one you are offered.
The Bottom Line
The bright spot of dental insurance is that coverage is good for preventive care, such as check ups, cleanings and dental x-rays (though x-rays may be covered less frequently than eager dentists want to take them). Adults and children with dental benefits are more likely to go to the dentist, receive restorative care and experience greater overall health, according to a report by the National Association of Dental Plans. Purchasing insurance may well motivate you to get preventive care and avoid more expensive and uncomfortable procedures.
When purchasing individual dental insurance (rather than group insurance through your employer or another source), be aware that major procedures may not be covered in the first year, and even then the benefit is likely to be only half of what the dentist charges. You’ll need to set aside money in a health savings account or personal fund so you’re not caught short if you need major work. For more on this topic, see Do You Need Dental Coverage? and Should You Bite On Dental Insurance?

How To Buy A Health Plan With A Chronic Condition

'Tis the season for health insurance, whether you're buying a plan through your employer, through a government-run marketplace in your state or directly from a health insurance company on your own.
Thanks to the Affordable Care Act, you can no longer be denied health insurance because you have a pre-existing condition. But that doesn't mean your choice of health plan gets any easier. If anything, having a chronic condition makes a purchase decision more difficult.
According to the Partnership to Fight Chronic Disease, more than 133 million Americans -- about 45 percent of the population -- has at least one ongoing or chronic condition such as heart disease, cancer, diabetes or asthma.
Your health insurance decisions are the same whether or not you have a pre-existing condition, says Craig Rosenberg, health and wellness practice leader for Aon Hewitt, a human resources solutions firm. Everyone has to look at coverage levels, premiums, deductibles and other out-of-pocket expenses. "But your choices become even more important simply due to the fact that you're likely to use more health care than someone who is healthy," he says.

Start the decision with your doctors

A good place to start is with your health care providers. Before you sign up for a health plan, talk to your health care providers about what the coming year might look like for you, advises Glenda Terry, a registered nurse on Aon Hewitt's advocacy team. Are you likely to need surgery or costly procedures? Or is your disease well managed? You may need little more than prescription refills and periodic checkups. While it's impossible to predict exactly how healthy you'll be, having an idea of what's in store will help you crunch numbers and see what options are best.
Too many people buy health insurance based on the monthly premiums alone, Rosenberg says. Big mistake. You should never automatically choose the most expensive plan or the least expensive or even the one in the middle, he says. Look at the plan's copays, annual deductible and out-of-pocket maximum. Then make yourself a worksheet. Look at how much you may spend in the next year going to doctors and whether you're likely to be hospitalized.
"If you have a chronic condition and use a lot of health care, the plan that is the most expensive to purchase could end up being the lowest cost given how it covers your needs," Rosenberg says.
In addition, here are 5 big mistakes when buying a health plan at work.

Check the provider networks and medications

Another major consideration when you have a chronic illness: What providers and hospitals are in the plan's network? Most plans pay more when providers participate in their networks. Some plans provide some coverage for out-of-network providers and some don't.
Checking that your doctors are in network is always important but even more so if you have a chronic condition, says Pamala McIntire, a benefits advisor with Reames Employee Benefits Solutions Inc. in Daytona Beach, Florida.

Don't assume because your doctors were in your plan this year that they will be next year. Health insurers change their plan networks all the time. Plans generally list their providers on their website. You also can call your doctor's office and ask. If you call, be sure to be very specific about the plan name because some doctors may take a plan from your company (Aetna, Blue Cross Blue Shield, UnitedHealthcare, etc.) but not your particular plan from that insurer.
Even seeing your doctor on the list doesn't guarantee that he'll be there the whole year. Here's what to do when your doctor disappears from your plan's provider network.
If you have been seeing a doctor for your condition and he won't take your insurance next year, you have a big decision to make.
"You have to decide if you want to continue to see your doctor or choose another doctor who is in your plan," Rosenberg says. "You have to decide how important your relationship with your current provider is." You also have to consider whether you could afford to pay more toward your care if you go out of network.
You should also check whether your medications are covered. Most plans have "formularies," or lists of preferred drugs that they cover at a higher rate. "Someone who has a chronic health condition is more likely to take medications on a regular basis," Rosenberg says. Some plans might require that you get your medications by mail order. That requirement could play into your choice, Rosenberg says.

Consider your lifestyle and pre-certification requirements

Think about your lifestyle as well, McIntire advises. If you have a chronic condition and travel a great deal, you might want to choose an HMO. Here's why: HMOs must treat emergency room visits and resulting hospital stays, no matter where the ER is, as in-network. Preferred provider organizations (PPOs) or point of service plans (POS) don't have to. If you have a PPO or POS and end up being admitted to the hospital while out of town, you could be billed for out-of-network follow-up care by the different providers who treat you.
On the other hand, McIntire says, HMOs tend to have more restrictive formularies. So if you have a chronic condition and need a new prescription, it may not be covered. Also, HMOs often require you to get pre-certification for treatment or tests or they won't reimburse you for them. You have to weigh the pros and cons of each of your choices, she says.
Employers today often provide online tools to help you chart your possible copays and out-of-pocket costs. Take full advantage of them, Rosenberg says.
Finally, Terry says, see whether the plan offers a disease-management program for your chronic condition. The plan may offer close coordination of care to help you manage your disease better. And that could be a factor in its favor when you're making a health insurance comparison.
More from Insure.com
10 things to know about open enrollment for 2015 individual & family health plans
Using your health plan for doctors who don't take your insurance
The original article can be found at Insure.com:
How to buy a health plan when you have a chronic medical condition

Medigap Insurance: Who Needs It?

If you’re looking for an example of a large government program that’s difficult to understand, look no further than Medicare. Medicare.gov contains hundreds of pages of information – few of which are easy reading.
But one of the most confusing aspects is why, given all of Medicare's parts (see Medicare 101: Do You Need All 4 Parts?) Americans on Medicare are encouraged to buy even more health insurance: a Medicare Supplementary Medical Insurance policy, also known as Medigap. These answers will explain why.
1. What is Medigap Insurance?
Medigap is additional insurance for Medicare recipients. Insurance for your insurance, basically.
2. Why do I need more health Insurance?
Because Medicare has holes (or gaps – get it?). "Original Medicare," as the government calls it, defined as parts A, B, and D, doesn’t do a very good job of really covering you if you were to get seriously ill or injured. It pays some of your expenses, but far from all.
That’s where Medigap insurance kicks in. Depending on the plan you get, Medigap will pay all or a potion of the costs Medicare doesn’t cover.
3. Those “extra” charges can’t be that substantial, can they?
Oh, yes they can. Here are a few examples. If you are admitted to the hospital and only have Original Medicare, you have to pay the first $1,216 of expenses. If you stay more than 60 days, you have to pay a portion of each day’s cost from then on.The size of your daily payment depends on how long you have been in the hospital and goes up the longer you stay.
Doctor visits and medical procedures are going to cost you too. Your deductible is $147 but, after that, you have to pay 20% of "the Medicare-approved amount" for most doctor services. What if you have a $250,000 bill? Look for a $50,000 bill in your mailbox – even more if the Medicare-approved fee is lower than $250,000. There’s no limit on how high it goes.
Prescription drugs can also eat at your budget. Original Medicare will leave you paying as much as 72% of the cost of some of your prescription drugs if you need enough medication to push you into notorious doughnut hole, the period when Part D gives people with high medication costs no coverage until their spending exceeds $4,550.
4. How do Medigap insurance policies work?
Glad you asked! You know all those “parts” of Medicare? Part A, B, and D? Medigap policies have parts of their own.They're labeled with the letters, A–N (though E, H, I, and J are no longer offered). The last thing you need with Medicare is more letters, but these letters make the options consistent across every provider.

Because private insurance companies offer these policies, you have to do some comparison shopping. Your shopping is made easier because an “F” plan, for example, is the same no matter which insurance company offers it. You don’t have to worry about one insurance company offering something different in the “F” plan than another does.
5. Which Medigap insurance plan is right for me?
You know what we’re going to say, right? “Talk with a qualified insurance agent or Medicare advisor to find the plan that fits your individual profile.” Here's some other advice. First, read the Medicare publication, “Choosing a Medigap Policy.” On page 11 you’ll find a chart of each policy type and what it covers. If you want to be completely covered—as in 100% of everything—“F” is your choice. The other options cost less but allow more of those gaps to remain open.
6. What’s the difference between Medigap insurance and Medicare Advantage?
A Medicare Advantage plan is similar to an HMO or PPO; it incorporates your Original Medicare benefits, plus additional coverage, such as for preventive care, within a pre-selected network of doctors and hospitals.
A Medigap policy supplements your Original Medicare coverage, paying expenses Original Medicare doesn't cover. It will probably give you more freedom of choice than Medicare Advantage (as long as your physician or facility accepts Medicare) and is a better option for snowbirds and others who travel a great deal or live in more than one location. You need to be signed up for Medicare before you can get Medigap. For more on the pros and cons, see Medigap Vs. Medicare Advantage: Which Is Better?
7. Can I have both Medicare Advantage and Medigap Insurance?
No. However, an insurer can sell you a Medigap policy if you explain that you’re leaving Medicare Advantage. This allows you to start your Medigap coverage the day after your Advantage plan runs out.
8. Does a Medigap policy cover both my spouse and me?
Unfortunately, it doesn’t. A Medigap policy covers only one person.
9. Can the insurer cancel my Medigap insurance if I get sick?
No…that’s illegal. As long as you pay your premiums, your policy is renewable for the rest of your life.
The Bottom Line
Original Medicare has coverage gaps. Without some type of supplemental insurance, you could end up paying a lot of money out of pocket. Medigap insurance closes those gaps. If you want to search for a policy that is right for you, click here for Medicare's official Medigap search capability.

Strategies To Use Life Insurance For Retirement

Can the right life insurance policy help you meet your retirement savings goals? Yes, but maybe not in the way you’re thinking. While life insurance agents will try to sell you on the benefits of permanent life insurance that accumulates cash value, such policies usually only make sense for individuals with a net worth of at least $5 million, the threshold where estate taxes kick in after death.
For almost everyone else, the best way to incorporate life insurance into your retirement-planning strategy is to get the right death benefit for your family at the lowest cost so you have the most money left over to take other key steps toward financial security. Let’s take a look at how this strategy works.
Step 1: Buy Term
If you have a spouse or children who depend on your income or who depend on your “free” services as a stay-at-home parent or homemaker, life insurance should be part of your financial plan. In other words, almost everyone needs life insurance. Even if you miss out on retirement because of an early death, you’d still like your spouse to be financially secure enough to have a chance at enjoying retirement, right? The least expensive type of life insurance, not just considering your out-of-pocket expense but also considering how much coverage you get for what you pay, is term life insurance. (For related reading, see Insuring Against the Loss of a Homemaker.)
Life insurance prices vary significantly depending on your age, health and policy features, but here’s one example that shows how much extra cash you could have to work with if you buy term instead of permanent life insurance. A nonsmoking, 35-year-old New York man in good health, meaning his blood pressure and cholesterol might be a bit higher than the ideal, might be able to get a 20-year term policy with a $1 million death benefit for $1,030 per year. If the same man bought a whole life policy, a type of permanent life insurance, the premium might be $14,090 annually for the same death benefit. That’s a $13,060 difference per year.
Given these costs, term life insurance can be an ideal retirement savings tool in two ways. First, it provides the basic financial protection your family will need if you pass away before you’ve accumulated enough savings for them to live off of. Second, its low, fixed price frees up more of your disposable income to create an emergency fund, purchase long-term disability insurance and invest in low-cost funds.
How long a term you should buy depends on how long you think it will take to amass enough savings for your family to live comfortably without you. It also depends on your current age, because it can be difficult to get term insurance past age 65. How much life insurance you should carry depends on how much debt you have, how much income you need to replace and the cost of any future obligations you want to fund, such as a child’s college tuition.
If you get life insurance as a benefit through work, your employer-provided life insurance may not be enough; you may need to supplement if with a policy you buy on your own. Also, if you want the security of knowing that your insurance will be renewed each year as long as you pay the premiums and of knowing that your premiums will be the same every year for as long as the policy is in force, get a level-premium, guaranteed renewable and noncancellable term life insurance policy.
Step 2: Create an Emergency Fund
The first way you should put the savings from buying term life insurance to work is by building yourself an emergency fund of three to six months’ worth of expenses – maybe more, if you’re really risk averse or have an irregular income. Having an emergency fund prevents you from going into debt to handle times of increased expenses or reduced income.

Avoiding debt means avoiding paying interest; having to pay interest, especially at credit card rates, makes it that much harder to recover from a setback. A financial emergency often means temporarily stopping your retirement contributions; the sooner you can bounce back, the sooner you can get back on track with your retirement savings.
Step 3: Protect Your Income with Long-Term Disability Insurance
Ideally, you’d take this step at the same time as you’re building your emergency fund; there’s no reason to wait. While many people think they can get disability benefits from Social Security if a serious illness or injury prevents them from working, it is hard to qualify for these benefits and they might be far below what you’d need to maintain your household’s standard of living. What’s more, you won’t qualify for those benefits if you haven’t paid into the system; many public employees have not.
Among disability insurance policies, an own-occupation policy will cost you more than an any-occupation policy, but it will provide more comprehensive coverage. If you’re unable to work in your own profession – say, accounting – you won’t have to become a retail store greeter to get by; your disability insurance will replace a significant percentage of your lost income. Again, look for a guaranteed renewable and noncancellable policy, which ensures that your premiums won’t increase and you won’t have to worry about requalifying. You can keep the policy as long as you pay the premiums. Even if you're single and don't have children to support, having disability insurance is still important – maybe more so, as you don't have a spouse or other immediate family to help you get by should you become seriously ill.
Choosing the best disability insurance means either purchasing your own policy to protect your income and anyone who depends on it or making sure you have enough coverage through your employer. As personal finance guru Dave Ramsey likes to say, “your most powerful wealth-building tool is your income.” Without an income, you have no way to save for retirement. (Learn more in our Intro to Disability Insurance.)
Step 4: Invest the Rest
You’ve got life insurance, an emergency fund and disability insurance. Finally, let’s talk about investing the rest of the money you’ve saved by using term life insurance as a retirement tool.
While permanent life insurance policies have a cash value component that accumulates savings and can be invested, you’ll have the greatest control over your money and the potential to earn the highest returns if you invest it yourself, through the brokerage of your choosing, rather than through a life insurance policy. You won’t pay the high policy fees and agent commissions associated with permanent life insurance, your investment performance won’t be tied to the life insurance company’s financial performance, and you won’t be limited to the investments the insurance company offers.
You can set up a tax-advantaged retirement account at a brokerage that offers rock-bottom investment fees, which is one of the keys to growing your portfolio. You can create a well-diversified portfolio of uncomplicated index funds or exchange-traded funds. For even more hands-off investing, consider a target-date fund, which – depending on the fund's strategy – adjusts your portfolio mix to become more conservative as you get closer to retirement age.
The Bottom Line
Buying term life insurance and investing the difference isn’t what most people think of when considering how a life insurance policy can help meet their retirement savings goals. Yet, for most people, it’s the most effective strategy.

Tips for Finding Affordable Health Insurance

When the Affordable Care Act went into full effect this year, it gave uninsured Americans a powerful incentive to go out and obtain a health policy: a fee if they didn’t comply. And while the penalty was relatively mild in 2014, it’s only going to increase starting in 2015. As a result, many individuals who never thought they could afford health insurance are being pushed into the marketplace.
There is some good news for those on a budget, however. The ACA provides more insurance options than before. And those on the lower end of the income scale qualify for subsidies that make premiums a lot more manageable.
If you’re one of the many Americans looking for insurance on their own because they don’t get coverage through work, here’s what you need to know to keep your payments as low as possible.
See if you can get a subsidy
If you’re buying an individual health care plan, you can either do so the old-fashioned way – purchasing it directly from a carrier – or shop policies on your state’s health insurance exchange. An exchange, or “marketplace,” is comprised of private insurers who must offer standardized plans for individuals, families and small businesses.
From a cost perspective, going through this marketplace is a double-edged sword. Because the government sets minimum standards for what’s covered under these plans, their sticker price is sometimes higher than plans sold outside the exchange. However, some consumers can get income-based tax credits if they use the marketplace. For that reason alone, it’s worth checking them out when you go looking for a policy.
To obtain a subsidy as an individual, you have to be a citizen or legal resident of the U.S. and earn less than 400% of the federal poverty level. Currently, that amounts to $46,680 or less per year for an individual and below $95,400 for a family of four. Once you go on the exchange website, you’ll be asked for your income and family size to determine your eligibility.
Decide if a basic plan fits your needs
One of the easiest ways to keep your monthly expenses in check is to choose a high-deductible health plan (HDHP). You’ll have lower premium, but also a lot more risk if something unforeseen should happen – they’re called high-deductible plans for a reason.

A nice benefit of HDHPs is that you can pair them with a health savings account, which enables you to pay for out-of-pocket medical expenses using pre-tax dollars. If you’re in the 15% income tax bracket, it’s like getting a 15% discount on all the health-related charges you incur, from doctor bills to eyeglasses.
If you’re even more daring, a so-called “catastrophic” plan might be worth a look. These offer bare-bones protection – you’re covered for three office visits a year – but saddle you with higher deductibles and co-insurance expenses. Not everyone qualifies, either. You have to be under 30 years of age or obtain a hardship exemption that demonstrates you were unable to afford coverage on the exchange.
See if you’re eligible for Medicaid
In its quest to increase the number of insured, the ACA created a minimum eligibility for Medicaid, the joint federal and state health care program for low-income residents. Now that threshold must be at least 133% of the national poverty level. That’s $15,521 a year for an individual and $31,720 for a family of four. If you’re historically in the middle class but your income has dropped recently – for example, you went part-time at work because you’re taking classes – you might just qualify. You’re chances are even higher if you live in a state that’s raised the income cut-off above the federal requirements.
Fortunately, determining your eligibility for Medicaid doesn’t require any extra work. The same application that you fill out to see if you can get a tax credit will tell you whether you’re entitled to Medicaid benefits.
Investigate parent’s plan
A lot of college graduates these days are having a tough time finding a full-time job with health insurance. However, the ACA is making it a lot easier for cash-strapped young adults to get coverage.
Now, individuals can join or stay on their parent’s plan until they turn 26. There are some restrictions here. You have to be single and living under your own roof. You also have to be financially independent and ineligible to obtain insurance through your employer’s plan.
The Bottom Line
One of the easiest ways to save money is to compare plans sold on an exchange and those sold directly through a carrier. But keep in mind that policies with lower premiums aren’t always the best deal if they mean dramatically higher deductibles and co-insurance.