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Delta is the big player in insurance. It’s done on various employer levels as to premium paid & what your Co insurance will b. We have Delta & I can’t comment on premiums but on what services have cost: covered at 100% twice a year cleaning and full mouth exam and 1 set bitewings; fillings 70% & X-ray for that tooth 100%; Crowns @50% & run abt $900-1200. Our dentist is a 2 DDS general practice w 3 hygienists and they do NOT do any root canal or gum or bridge or implant work ever. All that referral to speciality DDS or DMD and of those maybe 70% take Delta. Endodontist for root canal work per tooth 700-2K and Delta pays 50%. Delta was great for orthodontist, paid 70-80% but does not pay orthodontist in full till after all work is done. Which for us was 2.5 years as our kid had a spanner (loads of fun). We had to pay the estimated copay in full up front & sign off financial responsibility on the balance before we could start braces. He also had extractions needed before braces went on & the Oral Surgeon at 50% but surprisingly our United Health medical insurance covered nurse anesthetist cost.
If we had no insurance, we would have to pay in full upfront.
To me that’s why dental insurance matters as you at least get a seat at the dentist office with insurance. Our dentist will actually bill us for the copay. But a lot of dentists won’t, they will want payment based on estimate before work started if no insurance. My point is, there probably is going to be even with insurance a significant copay involved. That either she or you will need to pay. Id want to have a good idea of just how much $ it will likely be ahead of starting.
My mom did a huge spend down years before entering a NH to get all her old vintage bridge work replaced with implants, like canine to canine on top and some premolars/ molars in the lower. Took abt 3 years. Maybe 40k. She was FEHIB and had FEDVIP for dental. She had the $, she was in good health and wanted it done. In retrospect it was a really good thing to have done. She was able to bite & chew any foods. She had teeth she could brush and floss that were sturdy and no bleeding & her teeth held up once she became bedfast at the NH and dental hygiene was those pink sponge swab on a stick. While others at the NH would be would only able to eat soft foods, she was laying into a pork chop. The nursing staff commented often on it and how it helped keep her cognition going. The whole reaching for the right utensil, cutting foods, loading a fork, taking it to your mouth, chewing, etc is a big ADL. Mom had the time, $ & incentive to get dental work done. She was very fortunate, otherwise, the only other option that MediCARE will cover is for full extractions and then 1 set of full dentures. Or have a auto accident and shatter a jaw & teeth, that work MediCARE will cover if you can find a oral surgeon who takes Medicare and does dental reconstruction.
You will not know how things will effect Mom until you talk to the Social Security office if...Mom is on Social Security Disability. As Vegas said, SSI is a Suppliment income. I thought with that Medicaid is included. I know my Aunt had both. If Mom is getting Supplimental Income, then I would check with Social Services to see if she can get Medicaid for health. Ask if vision, prescriptions and dental are included in ur State.
With my nephew he was born with physical and neurological problems. He receives an annuity from his Moms pension from the Government. She did not pay into SS. I was able to get him full Medicaid thru Social Services. He then applied for Social Security Disability and received it. This gave him Medicare and Medicaid became his secondary insurance. He receives just over 1k a month which with help from the State for his rent, he lives on.
And to Sendhelps reply. I was lucky when my grandson was born and my daughter was 16 that the State of NJ Blue cross allowed us to put grandson on our policy. But if we had had BC/BS of Del, we would not have been able to do it. So, you really need to check with ur insurance company to find out if u can even put Mom on the insurance. Then go from there.
Q: Who is eligible to get coverage under my health insurance?
A: Generally, family members qualify for coverage if they meet the specific criteria and definitions in the health plan contract. Typically, these family members include:
Legal spouse
Biological children and stepchildren
Legally adopted children and children placed with you or your covered spouse for adoption
Children for whom you or your spouse have been appointed legal guardian
Foster children placed with you or your covered spouse
Financially dependent grandchildren who live with you or your covered spouse continuously from birth*
Children allowed to obtain health coverage by a Qualified Medical Child Support Order
Disabled dependent children older than age 26 who meet specific criteria
A domestic partner of an unmarried contract holder*
Children of the domestic partner*
*Self-insured employer plans may not cover these dependents.
Q: How long can a dependent child stay on my health insurance?
A: You can include eligible children on your plan until they reach age 26. Your health plan will discontinue coverage on your children’s 26th birthday.
Q: Can I add my parents or my spouse’s parents to my plan?
A: No, you cannot include your parents on your plan. They must enroll in their own health plan through their job, an individual insurance plan or Medicare (if they are eligible).
You need to see a tax specialist about this.
If grandma has SSD, does she not have Medicaid? If not look into that first. In my State prescriptions, dental and vision are covered.
It shouldn't mess up her Medicare or SSD but would not hurt to call SS and run it by them.