Fong Law Group

Medicare Would Cover Dental, Vision, and Hearing Under Senate Democrats' Spending Plan

The Senate Democrats' proposal for a $3.5 trillion spending plan includes expanding Medicare to provide dental, vision, and hearing benefits. The proposal is now being negotiated in Congress. 

Currently Medicare does not offer much in the way of dental, vision, and hearing benefits. Medicare Part A will cover certain emergency or necessary procedures that are received in the hospital. For example, if you are hospitalized after an accident and require jaw reconstruction, Medicare Part A will pay for the dental work required as part of that procedure. 

Medicare Part B offers very limited coverage of some vision and hearing services. For example, while Medicare Part B won’t cover routine eye exams, it does cover yearly glaucoma screenings for people at high risk and cataract surgery, among a few other limited exceptions. Part B will also cover some diagnostic hearing and balance exams if they are ordered by a doctor, but it will not cover routine hearing exams or hearing aids. There is no coverage at all for routine dental work.

Many people choose Medicare Advantage plans, which are run by private insurers, instead of traditional Medicare because it is possible to get some dental, vision, and hearing benefits in most plans. According to the Kaiser Family Foundation, 79 percent of people in Medicare Advantage plans have vision coverage, 74 percent have dental coverage, and 72 percent have hearing aid coverage. 

Under the Democrats’ proposal, Medicare beneficiaries would be able to receive dental, vision, and health benefits through traditional Medicare, making it more competitive with Medicare Advantage. The exact details of the proposal are unknown, but in a 2019 bill that passed the House, Medicare beneficiaries would have paid 20 percent of the cost for basic dental coverage and routine eye and hearing exams. Democrats want to pass the spending bill through the reconciliation process, which requires all 50 Democrats to agree to the plan. Negotiations are currently underway to craft a bill that has the support of all the Democratic senators.

For more information about the Democrats’ proposal, click here and here.

Make Sure You Are Counted in the 2020 Census

The 2020 census is starting soon, and seniors need to be counted. This may be more of a challenge this year because for the first time, the census will be completed largely online.

The U.S Constitution mandates that the federal government conduct a census every 10 years. Information from the census is used to determine how many representatives each state sends to Congress as well as where hundreds of billions of dollars from federal programs, such as Medicare, Medicaid, nutrition assistance and supportive housing, is allocated. In addition, communities rely on census data to apportion services like new roads, schools, libraries and emergency services.  Think of it as America’s 10-year checkup.

While the census is being conducted largely online, you do not need to fill out the form online if you don’t want to. Beginning in March 2020, the census will mail out postcards to each household, giving instructions on how to respond. You will have the option of responding online, by mail, or via the phone. If you don’t respond, a census worker will visit your home to collect the data. 

If someone visits your home to collect information for the 2020 Census, check to make sure that they have a valid ID badge, with their photograph, a U.S. Department of Commerce watermark, and an expiration date. Census workers will not ask for donations or for your Social Security or bank account information. 

For more information about the 2020 census, click here.

Emergency Planning for Seniors: Simple to Do, Critical in a Crisis

“The common advice for a crisis is to remain calm and try to think clearly. That's not always possible, but prior planning and preparation – much like with fire drills or tornado drills – can help you to stay focused and make better decisions during an emergency situation.”

What if a crisis should strike an elderly person living alone, or a senior couple who lives in their own home? No one likes to think that it will happen, but inevitably it does, says WRAL in a useful article titled “Having an emergency plan critical for safety and health of seniors.” It’s good to stay calm—and it’s even better to stay calm and quickly access the information and resources that could make the difference between life and death.

Sounds dramatic, but it’s true.

Why should you know how you’ll react in a crisis? The best way, say aging experts, is to think about the situation and the different parts in advance. Knowledge is power, and nowhere is this truer than in emergency situations.

Start by discussing health concerns with your doctor. When should you call the office, and when should you call 911? What is a normal ache or pain, and what kind of pain or sudden change signals an emergency?

If you are not sure what you or a loved one is feeling, call 911. There’s no need to hesitate because you’re not sure about whether it’s an emergency. Dispatchers are trained to identify emergencies and they can assess the situation quickly, even if you can’t.

One thing we should all have, regardless of our age, is a printed-out list of medications, diagnoses, names and phone numbers of medical providers and family contact information. This should be kept in a place where emergency responders and family members will have access to it quickly. EMS workers may not have time to review your medicine chest or a stack of bottles on the night table, but they will need to know what medications you are taking. A list—and one that you keep current—could save your life.

As a crisis unfolds, another list becomes important: documents from your estate plan. That includes your general power of attorney, health care power of attorney, and DNR (Do Not Resuscitate, if that is appropriate in your situation). The health care power of attorney will cover any health care decisions that arise, and the general power of attorney will cover financial, business and personal decisions.

Copies of these designations should be kept easily at hand at home. Make sure to tell the people you have appointed that you have done so, and what the expectations are for them.

Plans for what happens after the emergency has passed the crisis stage should be discussed, also preferably in advance. If the emergency was a fall or the senior is no longer capable of living independently, there may need to be changes made to the senior’s living situation. Rather than being forced to make a fast decision about a new living situation after an emergency, devote time to touring independent or assisted living communities to make a transition to a new home easier, than doing so in haste.

Identifying possible future living arrangements in advance also provides the opportunity to make the necessary financial arrangements. The hope is to prevent the senior from feeling like they’ve abruptly gone from the comfort and familiarity of their own home to a new and unwelcoming environment with no advance notice.

Preparing for a crisis in the short and long term may require some difficult conversations, but with the right care and planning, it may make life easier and more pleasant for the senior and the family.

Reference: WRAL (Jan. 2, 2019) “Having an emergency plan critical for safety and health of seniors”

You Can Age in Place but You Need to Plan

“Many homeowners plan to stay in their homes over the long-term, and some may plan to live independently at home, rather than moving into a retirement community, if possible.”

Aging in place is what most people hope for as they enter their 60s and 70s.  However, to make it a reality, there is a need to plan, according to the article “BBB On Homes: Focus on several things when aging in place,” from LMTonline.com. The Centers for Disease Control and Prevention define aging in place, as the ability to live in one’s own home and community safely, independently and comfortably regardless of age, income or ability level.

Changes in health or finances don’t always allow this to happen. Here are four things to keep in mind, when considering whether you or a parent will be able to remain at home:

Safety updates. This generally includes a walk-in shower, safety rails, widened doorways that can accommodate wheelchairs, non-slip flooring, ramps and accessible kitchen drawers and food preparation surfaces.

Getting food and supplies. Food and medication deliveries are crucial to aging in place. What will happen, if you are no longer able to drive? If you depend on local stores for delivery and there is a major weather event, how will you manage? There are some non-profits who deliver but people must be open to the idea of receiving help from others.

Preparing for disasters and emergencies. Living alone makes it difficult to get help immediately after an accident. When time is of the essence, it can be difficult. There are many options, including medical alert systems and home surveillance cameras. However, the person has to be willing to have them. Arranging for a friend or family member to check in daily is good for every day safety.  However, it will not help in an emergency.

You’ll need health care and transportation. If you live in a city or suburb where there is public transportation, you’ll be able to get to your doctor’s appointments. If not, you’ll need to budget for taxi services.

Budgeting. Living on your own means more independence and privacy. It may cost more because certain fixed costs can only be reduced so far.

If you are considering how to remain at home, make sure to speak with family members, so they are aware of what your wishes are. With their support and if you are financially able to do so, it may make a big difference in the quality of your life.

Reference: LMTonline.com (Aug. 26, 2018) “BBB On Homes: Focus on several things when aging in place”