Senior Dental Health Articles

Medicare and Medicaid are the two large government-facilitated healthcare programs in the United States. Their similar names may cause some confusion, but the programs differ in terms of funding, eligibility, intended use, and administration. Medicare is a federal program designed to provide healthcare coverage to retirees. Medicaid provides coverage to low-income individuals and families, and it is administered by a combination of federal and state agencies. While some people qualify for both, the target beneficiaries are different. Medicare Basics Medicare is primarily for people older than 65, though people with certain diseases and disabilities are also included. It has three primary segments. Part A is hospital insurance that covers inpatient care. There generally is no monthly premium paid, because it is covered by payroll taxes paid throughout a person’s working life. Medicare Part B covers other medical expenses such as doctors, outpatient care, and certain home health services. It is meant to supplement Part A, and it generally requires monthly premiums paid by the insured. Medicare Part D is a prescription drug insurance plan, and it also generally requires monthly premiums.  You may have noticed that Medicare Part C isn’t one of the three primary elements of Medicare. Part C does exist, but it functions differently because it offers government-approved health plans available for purchase from private insurance companies. These are often called Medicare Advantage plans, and they function like an HMO or PPO that may be more advantageous or preferable for some individuals. Medicare will typically pay a set portion of the monthly premium, and the insurers must follow certain rules, but variations exist in other plan terms, such as out-of-pocket cost. Medicare is an important piece of most people’s financial plan in retirement because people no longer have coverage through their employer during the years when they are likely to incur most of their healthcare expenses. You can go to the program’s website at medicare.gov for more information regarding costs, eligibility, and to enroll. You should consider all of your likely healthcare needs, as well as your retirement monthly income relative to cash requirements, before deciding which parts of the Medicare program to select. Medicaid Basics Federal and state governments jointly run Medicaid to provide healthcare coverage to low-income Americans, with roughly 25% of the population receiving benefits. [1] The terms and implementation of Medicaid vary state-to-state, meaning eligibility and covered treatments depend on where you live. Generally, eligible people and households can sign up for coverage either through the state program or an approved private insurance company. A combination of state and federal governments will pay for the cost of care. The federal government guarantees to match state expenditure and provide additional programs. Medicaid was expanded significantly in 2010 with the Affordable Care Act, with most states increasing eligibility to those falling within 133% of the federal poverty level. From a financial planning perspective, Medicaid programs have limited applications. If you are unable to afford the healthcare coverage that you need, you should visit your state’s Medicaid website to determine eligibility. It can be a great way to reduce monthly expenses and eliminate the risk of incurring a major future liability from expensive medical procedures. Medicaid comes into play for many seniors, especially those who require home care, nursing homes, or long-term care. Those bills can easily exceed $7,000 monthly in years when retirees are working on fixed budgets without prospects of earned income. Even seniors with sufficient assets to cover those expenses often explore Medicaid trust planning, in which they transfer assets to a trust controlled by a reliable loved one. Funds in the trust would not impact Medicaid eligibility, but those assets could still be distributed for the retiree’s benefit. Steps to Take Medicaid and Medicare are both government-run medical insurance programs, but they are administered in different ways. Many people qualify for both programs, and it is wise to determine eligibility if you are a senior, disabled, or from a low-income household. Ryan Downie is a consultant and former equity research analyst and financial planner with a BA in economics from Notre Dame. Sources: https://www.medicaid.gov/medicaid/program-information/medicaid-and-chip-enrollment-data/report-highlights/index.html

In retirement, you have options for collecting Social Security benefits. This can be a confusing or stressful decision that can have major ramifications, and there’s no going back once you’ve selected a path. Since there no universal rule exists to optimize retirement, the best option depends on a number of factors, including your birth year, how much you have paid into the system, other sources of income, and anticipated lifestyle and healthcare needs. Ultimately, the decision should be made in the context of an overall financial plan, and you should focus on ensuring your cash flow needs will be covered. Different Benefits at Different Ages Seniors can start collecting Social Security retirement benefits at any point between the ages of 62 and 70. The full retirement age is currently 66 years and two months, but it is rising to 67 for people born after 1960, and it may continue to rise. Delaying collection will increase the amount you receive. If you start collecting at 62, you will only receive 70% of your full benefit, whereas delaying payments to 70 will result in monthly distributions of 124% of your full retirement benefit. In 2021, the maximum monthly benefit for someone beginning payments at age 62 will be $2,324. The maximum for someone starting payments at 70 will be $3,895. For reference, the average retiree is collecting just over $1,500 each month, but the age dynamics are the same regardless of benefit level. The bonus for delaying Social Security payments is one of the trickiest factors in determining retirement age. Having cash now is a good thing, but having larger guaranteed monthly payments is also important. From the standpoint of total aggregate income through average life expectancy, full retirement age is the best time to start taking benefits. People in the United States who reach 65 years of age have a life expectancy of approximately 82.5. This means that somebody taking the maximum monthly payout at age 62 would collect, on average, $571,704. That same person choosing to delay collection until age 70 would receive $584,250 through average life expectancy. Starting at 66 and two months tops both of those, leading to lifetime collections of $610,148. The system is designed around life expectancy, so this should not be surprising. Unfortunately, the decision isn’t as simple as maximizing total benefits. While starting at 62 will reduce the amount you collect each month, that head start will take almost 16 years to overcome in terms of cumulative income if you wait until full retirement. Retirees need to focus on balancing monthly cash flows. The Rest of Your Financial Plan The major risks in retirement generally revolve around covering cash needs. Retirees may fall into lower tax brackets and no longer need income to pay off a mortgage, build savings, or support children. However, healthcare spending will likely rise, and freeing up 40 hours each week means that retirees deal with the clichéd “every day is a Saturday.” Inflation drives up the cost of living, and commonplace luxuries like cell phones and internet can cause basic lifestyle spending to rise. Retirees should be realistic about these monthly or annual cash outflows, build in some wiggle room for uncertainty, and analyze their budget relative to sources of income. Many people have accumulated savings in retirement accounts or investment portfolios, and most planners believe that you can withdraw 3% of the total value of these accounts each year safely. Many people also have pensions or private annuities that will deliver guaranteed income in retirement. If a cash flow shortfall occurs in retirement, taking Social Security at 62 may be the only viable option. If the early years are fine, but you are concerned about healthcare expenses in your 80s, then it might make sense to delay as long as possible. The right age to take Social Security benefits depends on many factors, and you should base the decision on cash needs in the context of an overall plan. Ryan Downie is a consultant and former equity research analyst and financial planner with a BA in economics from Notre Dame. Sources: https://www.nasi.org/learn/socialsecurity/retirement-age#:~:text=Currently%2C%20the%20full%20benefit%20age,they%20will%20be%20reduced%20more https://www.ssa.gov/oact/cola/examplemax.html https://www.ssa.gov/history/lifeexpect.html  

Is it safe to go through with a dental procedure if you’re taking blood thinners for any reason? After all, certain treatments, such as extractions and gum surgery, as well as cleanings, can lead to bleeding. What if you’re taking a blood thinner and it’s hard to stop the bleeding? That’s a frightening scenario! To learn more, check out the info below. With a better understanding of the effects of blood thinners on dental care, you’ll know what to expect.  Weighing the Risks: Should You Change the Way You Take Your Medicine? Your dentist will weigh the risks based on the type of blood thinner your doctor has prescribed. For example, if you’re taking an anticoagulant like warfarin or apixaban, or you need to take an antiplatelet like aspirin or clopidogrel, you may not need to change anything about your routine prior to undergoing a dental treatment. That’s because the risks of not taking these medications as prescribed are likely to be greater than bleeding that might occur from the dental procedure.  Also, if your dentist determines that bleeding can be controlled rather easily, he or she will probably tell you that it’s fine to continue taking your medications as you normally would.  On the other hand, if you’ve been diagnosed with other health problems that boost the odds of excessive bleeding, the risk might be too high. And the risk might also be too great if you’re taking other medications that can increase bleeding. In these cases, your dentist might want to talk to your doctor about what steps need to be taken to keep you safe while working on making your teeth and gums as strong as possible.  In the end, it all depends on various factors, such as: The medications that you’re taking Any other conditions that you’ve been diagnosed with The risk of bleeding associated with the procedure you need  No matter what, your dentist should work with your doctor to determine if you need to change anything about the way you take your medications, even if it means just altering the timing of your doses to reduce the risk of excessive bleeding.  Always Let the Dentist Know About Your Blood Thinners! It’s important to let your dentist  know if you’re taking any medications, including any type of blood thinner, and if you’ve ever experienced complications from taking your prescriptions.  In addition to disclosing the medicine you take, it’s also wise to let him or her know about your medical history. That way, he or she can take your overall health into consideration too. Plus, this information can shed more light on why you need to take blood thinners, and if you need to take them for a short span of time or if you need them for the long run.   With the help of all of these details, your dentist can tell you how to proceed if you’re planning on having your teeth cleaned or you need any type of treatment, from fillings and root canals to extractions and implant surgery, that can cause bleeding.  If you do need to change anything about the way you take your blood thinner, your dentist and doctor might recommend: Not taking the medicine before the procedure Changing the type of blood thinner you’re taking Changing the dose that you’re taking Changing the time of day that you take your dose Don’t Stop Using a Medication Unless You’re Told to Do So The good news is that you may not need to change a thing if you’re taking blood thinners and need a dental treatment. In fact, stopping use of the medication might be far more risky, especially since your dentist can use various strategies to stop any bleeding that occurs. For example, socket packing, pressure, and stitches might all be used to keep everything under control.  Ultimately, every patient is unique, so your dentist can work with your doctor to figure out the benefits versus the risks of taking blood thinners before an oral health procedure. The key is to be upfront about your health so your dentist has all of the info necessary to give you the right advice on how to proceed.    Sources: https://www.aaom.com/index.php?option=com_content&amp%3Bview=article&amp%3Bid=126:blood-thinners-and-dental-care&amp%3Bcatid=22:patient-condition-information&amp%3BItemid=120 https://www.ada.org/member-center/oral-health-topics/oral-anticoagulant-and-antiplatelet-medications-and-dental-procedures