Archive for May, 2024

Share or Cost: Are family dental plans worth buying? 

Monday, May. 27th 2024 10:00 AM

Question: I am self-employed and do not have dental insurance currently. Is buying a family dental plan worth it? I have two teeth that are starting to bother me, and I would like to see a dentist. My wife and son are okay, but I want them to get a dental checkup. The few dental discount plans I have reviewed do not seem to save you money when a crown can still cost up to $300–$400, which does not seem like a significant saving. I have also looked at a few dental insurance plans, but with their much higher waiting periods and costs, they do not seem like I would be saving anything by buying them. So, what should I be looking for to help me with my dental cost? 

Dental Plans: Braking Down Cost Savings

Answer: On average, crowns can run $500-$800 without insurance. Based on what you stated, the discount plans save you between $100-$400 on a crown based on your post. Dental discount plans run between $7.95 and $9.95 monthly for an individual. Savings are good when taking into account the cost of the plan. Call a few dentists for crown rates without insurance to compare if the savings are truly there for you. 

Depending on your state, we may have dental HMO insurance plans. Our HMO insurance plans do not have waiting periods for their dental services to be covered and will typically have lower costs for their covered services than the dental plans do. You may want to compare these plans as well. Due to the waiting periods, our Dental PPO and Indemnity plans may not be the best way for you to go. In this case, the waiting period for crowns can be up to a year or more.

You can contact our member service line at 310-534-3444, where our team of experts will help you understand each plan’s different options and benefits. They will guide you in selecting the best plan to provide your family with the necessary coverage at a price that fits your budget.

Posted on Monday, May. 27th 2024 10:00 AM | by Share of Cost | in Share of Cost | Comments Off on Share or Cost: Are family dental plans worth buying? 

Share or Cost – Dental PPO Insurance and Children 

Monday, May. 20th 2024 10:00 AM

Question: I have an almost two-year-old child looking to buy dental insurance. I am not sure I want to keep the dental insurance plan. I may wish to do something short-term to get my child’s teeth checked out.  

Reply: Choosing a plan that provides adequate coverage for pediatric dentists is essential. PPO plans are typically a good choice for families with children. PPO plans offer a broader range of in-network providers and often benefit outside-network providers. This can be particularly helpful if you’re looking for a specific pediatric dentist outside your plan’s network.

However, it’s important to note that PPO plans are not intended for short-term use. They usually have waiting periods, meaning you’ll need to have the plan for a certain amount of time before certain benefits become available. For example, you may need to have the plan for six months before getting coverage for a basic dental procedure.

If you’re only looking to get your child’s teeth checked out in the short term, consider paying out of pocket or a dental discount instead of buying a PPO plan. These options can be more affordable and may be a better fit for your needs.

When shopping for dental insurance, it’s essential to read the plan terms and conditions carefully to make sure you’re choosing the best plan for your family’s needs. Look for a plan that provides coverage for pediatric dentists, has a reasonable waiting period, and fits within your budget.

Posted on Monday, May. 20th 2024 10:00 AM | by Share of Cost | in Dental Insurance, Share of Cost | Comments Off on Share or Cost – Dental PPO Insurance and Children 

Elimination of Asset Limit for Medi-Cal Enrollees in California: ShareofCost.com Offers Help for Affordable Healthcare

Thursday, May. 16th 2024 10:00 AM

Are you or a loved one struggling to afford healthcare due to the asset limit requirement for Medi-Cal in California? The good news is that ShareofCost.com, a trusted resource for healthcare information and assistance, is here to help. With the recent elimination of any asset limit for enrollees, Medi-Cal will now consider only applicants’ income when assessing financial eligibility for benefits. This move is a significant step toward achieving health equity for Californians who are elderly or have disabilities. If you have any questions, please visit our website, ShareofCost.com, or call us at 310-534-3444. We offer dental insurance that helps to zero out your share of cost so you can get the care you need without worrying about financial insecurity.

Importance of Dental Insurance for Affordable Healthcare in California

Purchasing dental insurance can be a wise financial decision for those struggling to afford healthcare due to the asset limit requirement for Medi-Cal in California. By purchasing dental insurance, you can significantly reduce out-of-pocket costs and eliminate your medical share of cost. This empowers you to take control of your healthcare expenses and plan your budget more effectively.

With ShareofCost.com, for instance, their comprehensive dental insurance covers a wide range of services, including cleanings, fillings, and major procedures. This insurance helps zero out your share of cost, so you can get the care you need without worrying about financial insecurity. This means that you won’t have to pay anything out of pocket when you need dental care.

Not only can dental insurance help you save money on dental care, but it can also help you maintain good oral health, which is essential to your overall health. Regular dental cleanings and checkups can prevent more serious dental problems from developing, which can be costly to treat. This knowledge empowers you to prioritize your oral health and understand its long-term benefits.

In addition, having dental insurance can give you peace of mind, knowing you can access affordable dental care when needed. You won’t have to worry about how you’ll pay for dental care if you experience a dental emergency or need a major dental procedure.

Overall, purchasing dental insurance can be a wise financial decision for those struggling to afford healthcare due to the asset limit requirement for Medi-Cal in California. It’s important to note that dental insurance is often more affordable than paying for dental care out of pocket. It can help reduce your out-of-pocket costs, eliminate your medical share of cost, and give you peace of mind knowing that you can access affordable dental care when needed.

Medi-Cal Now Considers Income, Not Assets, of Enrollees

Maria had been actively involved in volunteer work at her local church for many years. When one of her acquaintances passed away several years ago, Maria inherited $80,000 unexpectedly. At that time, Maria faced significant expenses, including vehicle repairs, and the legacy provided her with much-needed financial relief.

However, Maria later discovered that her inheritance would disqualify her from participating in Medi-Cal, California’s Medicaid program for low-income people. At that time, anyone with over $2,000 in qualified assets, including cash savings, was ineligible for Medi-Cal.

“We had to scurry around to see how we could make health care affordable for my mom,” said her daughter, Tatiana Fassieux, an education and training specialist with California Health Advocates.

Now, after years of planning and implementation by state officials, people like Maria are no longer faced with the financial and health insecurity created by the asset test. On January 1, 2024, Medi-Cal eliminated any asset limit for enrollees. This means that your savings, investments, and other assets will no longer be considered when determining your eligibility for Medi-Cal. Instead, only your income will be assessed. This significant change can greatly benefit those with low incomes and some financial assets.

The asset test, which originally applied to everyone in Medi-Cal, has undergone significant changes over the years. In the 1980s, the state removed the requirement for pregnant women, infants, and children. When the Affordable Care Act took effect in 2014, the asset test was no longer applied to adults under 65 without disabilities. That left only older people, people with disabilities, and those living in long-term care facilities as the remaining applicants still affected by the asset limit. This context is important to understand the significance of the recent elimination of the asset limit for these groups.

Governor Gavin Newsom signed Assembly Bill 133 into law in 2021, starting a two-phase process to eliminate the asset test. Phase I began in 2022 by raising the individual asset limit from $2,000 to $130,000. In the first 18 months, more than 12,000 individuals became newly eligible due to the Phase I changes in policy.

Phase II of implementation began in January 2024, when Medi-Cal eliminated asset limits entirely, making California the first state in the nation to do so. This change is particularly beneficial for people who seek long-term care services through Medi-Cal because of age or disability. They will no longer be penalized for having savings, which will give them and their families greater financial security. While officials have yet to release updated numbers from the Phase II changes, the state estimates that 30,000 Californians with low incomes are newly eligible to enroll. This change is a significant step toward achieving health equity for older Californians and state residents with disabilities.

According to Griselda Melgoza, a spokesperson for the California Department of Health Care Services (DHCS), the motivations for the change were simple – to offer people enrolled in Medi-Cal a better opportunity to achieve financial stability and to create a more equitable system for older Californians and state residents with disabilities.

While advocates agree that the policy change has many upsides, they also raise valid concerns. The new asset test policy, while beneficial in many ways, raises questions about how Medi-Cal can continue improving access, advancing equity, and treating patients with dignity. This perspective is important to consider when evaluating the impact of the policy change.

One of the most immediate benefits to consumers is that people with low incomes and some financial assets will no longer be forced to drain their savings to qualify for services like skilled nursing and long-term care. The practice of “spending down” one’s assets to be eligible for Medi-Cal severely affected individuals and their families.

Tiffany Huyenh-Cho, JD, director of California Medicare and Medicaid advocacy at Justice in Aging, which fights poverty among older people, said, “People were being forced to impoverish themselves and risk their financial future to access Medi-Cal benefits.” When the asset limit was in place, her colleagues would try to educate clients on ways to spend down responsibly, usually by prepaying anticipated expenses, like rent. Still, the result was that individuals had fewer dollars available for emergencies.

Advocates say the elimination of the asset test is a significant step toward achieving health equity for Californians who are elderly or have disabilities. The policy change has many immediate benefits, such as allowing people with low incomes and some financial assets to no longer be forced to drain their savings to qualify for services like skilled nursing and long-term care. This practice of ‘spending down’ one’s assets to be eligible for Medi-Cal severely affected individuals and their families. The elimination of the asset test provides these individuals and their families with greater financial security and peace of mind.

Source: California Health Care Foundation

Affordable Healthcare in California: Elimination of Asset Limit for Medi-Cal Enrollees and How ShareofCost.com Can Help You

In conclusion, eliminating the asset limit for Medi-Cal enrollees in California is a significant improvement toward achieving health equity for Californians who are elderly or have disabilities. This change enables them to access affordable healthcare without worrying about financial insecurity and empowers them to prioritize their health and well-being.

If you are struggling to afford healthcare due to the asset limit requirement for Medi-Cal, ShareofCost.com is here to help. Our trusted resource offers dental insurance to help you save money on dental care and eliminate your share of cost. By purchasing dental insurance, you can significantly reduce out-of-pocket costs, plan your budget more effectively, and maintain good oral health, essential to your overall health.

Visit our website, ShareofCost.com, or call our office at 310-534-3444 for a free dental insurance quote or any questions. Our team of experts is always ready to assist you with your healthcare needs and provide the information you need to make an informed decision.

Remember, oral health is essential to overall health, and we are here to help make it more affordable. Don’t let financial insecurity keep you from accessing the healthcare you need. Contact us today to learn more about our dental insurance plans and how we can help you achieve affordable healthcare in California.

Posted on Thursday, May. 16th 2024 10:00 AM | by Share of Cost | in Dental Insurance, Medicaid, Medicare, Share of Cost | Comments Off on Elimination of Asset Limit for Medi-Cal Enrollees in California: ShareofCost.com Offers Help for Affordable Healthcare

Share of Cost – How Medical Bills Paid to Non-Medi-Cal Providers Count Towards Share of Cost

Monday, May. 13th 2024 10:00 AM

Question: I had to pay a few medical bills to a healthcare provider who does not accept Medi-Cal. Do those payments count towards meeting my Share of Cost? If so, how do I show the expense?

Answer: If you paid medical bills to a non-Medi-Cal provider, those payments count towards your Share of Cost. However, you must provide proof of payment to your Eligibility Worker. Such expenses can also apply to medical-related services that Medi-Cal does not cover. It’s essential to remember that personal care services paid to an independent provider must be prescribed by a licensed physician and included in a plan of care to qualify as a personal care expense. Providing the necessary proof of payment and documentation ensures that your medical bills adequately apply to your Share of Cost.

Posted on Monday, May. 13th 2024 10:00 AM | by Share of Cost | in Share of Cost | Comments Off on Share of Cost – How Medical Bills Paid to Non-Medi-Cal Providers Count Towards Share of Cost

Share of Cost – Getting the best value under a PPO plan. 

Monday, May. 6th 2024 10:00 AM

Understanding the network of providers is crucial when selecting a PPO plan. It can greatly affect the coverage provided under the plan. While PPO plans offer greater flexibility than HMO plans, they also come with higher premiums and deductibles. Therefore, getting the best value out of your PPO plan is essential, and using the plan network of providers is an excellent way to do that.

The network of providers consists of healthcare providers who offer services to the PPO plan’s members at a discounted rate. When you use an in-network provider, you will have to pay lower out-of-pocket costs and receive more significant benefits than an out-of-network provider. Most PPO plans benefit outside-network dentists, but they may reduce coverage for non-provider use.

As An Example

Let’s say you need preventive dental care and use a dentist within the plan network of providers. The plan may pay 100% of the cost. However, if you choose a dentist who is not in the plan network of providers, the plan may only pay 80% of the cost. This means you must pay the remaining 20% out of your pocket.

Furthermore, even if the PPO plan you are considering does not reduce its benefits for out-of-network dental providers, you still risk having a greater chance of UCR(Usual, Customary, and Reasonable) fees. This is because inside-network providers have mostly agreed to reduce their costs to stay within the plan, whereas UCR rates and non-providers have made no such concession.

To summarize, using the network of providers is crucial in getting the best value out of your PPO plan. It can help you save money on out-of-pocket costs and receive more significant benefits. Therefore, it is essential to understand how the network of providers works and choose providers within the network whenever possible.

Posted on Monday, May. 6th 2024 10:00 AM | by Share of Cost | in Share of Cost | Comments Off on Share of Cost – Getting the best value under a PPO plan.