Medicare coverage for dental care; coping with Seasonal Affective Disorder
December 1, 2018
Dear Savvy Senior: I will turn 65 in a few months and will be enrolling in Medicare, but I am concerned about Medicare’s coverage of dental care. Does Medicare cover dental procedures? And if not, where can I get dental coverage? - Almost 65
Dear Almost: Medicare’s coverage of dental care is extremely limited. It will not cover routine dental care including checkups, cleanings, or fillings, and it won’t pay for dentures either.
Medicare will, however, cover some dental services if they are required to protect your general health, or if you need dental care in order for another health service that Medicare covers to be successful. For example, if you have cancer and need dental services that are necessary for radiation treatment, or if you need surgery to treat fractures of the jaw or face, Medicare will pay for these dental services.
Although Medicare’s coverage of dental services is limited, there are other ways you can get coverage and care affordably. Here are several to check into.
Consider a Medicare Advantage plan. While dental services are mostly excluded under original Medicare, some Medicare Advantage plans do provide coverage for routine dental care. If you are considering joining a Medicare Advantage plan, find out what dental services, if any, it covers. Also, remember to make sure any Medicare Advantage plan you’re considering covers the doctors and hospitals you prefer to use and the medications you take at a cost you can afford. See http://www.Medicare.gov/find-a-plan or call 800-633-4227 to research plans in your area.
(Editor’s note: There are currently no Medicare Advantage Plans available in Alaska.)
Purchase dental insurance. If you have frequent gum problems and need extensive dental care, a dental insurance plan may be worth the costs versus paying for care yourself. Expect to pay monthly premiums of $15 to $40 or more for insurance. To find dental plans in your state, go to http://www.NADP.org and use the “find a dental plan” tool. Then review a specific plan’s website.
Consider dental savings plans. While savings plans aren’t as comprehensive as insurance, they’re a good option for those who can’t get covered. How this works is you pay an annual membership fee – around $80 to $200 a year – in exchange for 10 to 60 percent discounts on service and treatments from participating dentists. To find a savings plan, go to http://www.DentalPlans.com (or 888-632-5353) where you can search for plans and participating dentists, as well as get a breakdown of the discounts offered.
Check veterans’ benefits. If you’re a veteran enrolled in the VA health care program or are a beneficiary of the Civilian Health and Medical Program (CHAMPVA), the VA offers a dental insurance program that gives you the option to buy dental insurance through Delta Dental and MetLife at a reduced cost. The VA also provides free dental care to vets who have dental problems resulting from service. To learn more about these options, visit http://www.VA.gov/dental or call 877-222-8387.
Shop around. www.FairHealthConsumer.org and http://www.HealthcareBlueBook.com lets you look up the cost of different dental procedures in your area, so you can comparison shop – or ask your regular dentist for a discount.
Try community health centers or dental schools. There are many health centers and clinics that provide low-cost dental care to those in need. And all university dental schools and college dental hygiene programs offer dental care and cleanings for less than half of what you would pay at a dentist’s office. Students who are supervised by their professors provide the care. See http://www.ToothWisdom.org to search for a center, clinic or school near you.
How to cope with Seasonal Affective Disorder
Dear Savvy Senior: What can you tell me about seasonal affective disorder? I have always hated wintertime, but since I retired and am home a lot more, the dark and cold winter months make me depressed and lethargic. - Fighting the Blues
Dear Fighting: If you get depressed in the winter but feel better in spring and summer, you may indeed have seasonal affective disorder (or SAD), a wintertime depression that affects roughly 6 percent of Americans.
In most cases, SAD is related to the loss of sunlight in the winter months. Reduced sunlight can upset natural sleep-wake cycles and other circadian rhythms that can affect the body. It can also cause a drop in the brain chemical serotonin, which affects mood, and can increase the levels of the hormone melatonin, which can make you feel more tired and lethargic.
If you think you may have SAD, a trip to your doctor’s office is the best way to diagnose it or you can take a SAD “self-diagnostic” test at the Center for Environmental Therapeutics website at http://www.CET.org/self-assessment. In the meantime, here are several treatment options and remedies that can help.
Light therapy. The most effective treatment for SAD is sitting in front of a specialized light therapy box for 15 to 20 minutes a day. Light therapy mimics outdoor light to cause a change in brain chemicals linked to mood. It’s most effective when timed to fit a person’s individual circadian rhythm, which varies widely from person to person depending on whether they’re a night owl or a morning lark. You can calculate the proper time for doing light therapy by taking the circadian rhythm test at CET.org/self-assessment.
The best light therapy lamps provide 10,000 lux of illumination, many times stronger than typical indoor light, and have a diffuser screen that filters out ultraviolet rays and projects downward toward the eyes.
Some top-rated products as rated by http://www.Wirecutter.com include the Carex Day-Light Classic Plus Lamp ($115), Verilux HappyLight Deluxe 10,000-Lux Sunshine Simulator ($160), and the Northern Light Technology Boxelite Desk Lamp ($190), all of which are available at http://www.Amazon.com.
Cognitive behavioral therapy. Even though SAD is considered to be a biological problem, identifying and changing thought and behavior patterns can help alleviate symptoms, too. To help you with this, choose a therapist who specializes in cognitive behavioral therapy and who has experience in treating SAD. To locate someone in your area, check with the Association for Behavioral and Cognitive Therapies ( http://www.FindCBT.org ), or the Academy of Cognitive Therapy ( http://www.AcademyofCT.org ).
Antidepressants. Some people with SAD benefit from antidepressant treatment, especially if symptoms are severe. Some proven medications to ask your doctor about include the extended-release version of the antidepressant bupropion (Wellbutrin XL, Aplenzin), and antidepressants selective serotonin reuptake inhibitors (S.S.R.I.s), sertraline (also known as Zoloft) and fluoxetine (also known under the brand name Prozac).
But keep in mind that it may take several weeks to notice full benefits from an antidepressant. In addition, you may have to try different medications before you find one that works well for you and has the fewest side effects.
Lifestyle remedies. Some other things you can do to help alleviate your SAD symptoms include making your environment sunnier and brighter. So, open up your blinds, sit closer to bright windows and get outside as much as you can. Even on cold or cloudy days, outdoor light can help, especially if you spend some time outside within two hours of getting up in the morning. Moderate exercise such as walking, swimming, yoga and even tai chi can also help alleviate SAD symptoms, as can social activities.
Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.