September 28, 2022

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Drawers opened and shut. Garbage bags filled with clothes, birthday cards and pocketbooks. They had to go.

So did 95-year-old Judith Goodman.

Goodman had called Raydiant Health Care of Brandon her home for 13 years. By the next day, she would be gone.

“I feel horrible — I don’t want to leave,” she said late last month as she watched her two daughters pack her belongings. “But what can I do?”

Residents of the 120-bed Tampa Bay nursing home learned in June that it was closing. They said they were told that they had 30 days to find places to live.

About half of its 87 residents left within a week of the announcement, according to a spokesperson for the Centers for Medicare & Medicaid Services.

The nursing home on Wednesday became the latest in Florida formerly affiliated with Consulate Health Care to lose its federal benefits since May because of poor patient care. The federal government considers termination of Medicare and Medicaid a “last resort,” implemented only after “all other attempts” fail to resolve health and safety deficiencies.

Related: Consulate nursing homes are changing names. Are they changing ownership?

A bankruptcy filing and bad press have plagued Consulate — the state’s largest nursing home chain — over the past few years. The local nursing home, about 14 miles east of Tampa, appears to have changed hands at least twice since January. Such corporate intrigue is a mere secondary concern, however, for vulnerable residents who are caught in the fallout of the for-profit industry.

Goodman sat in her wheelchair next to her roommate’s bed. She and her roommate had greeted the morning together like always.

By noon, the roommate had already moved out. Goodman wasn’t sure if she’d see her again.

Judith Goodman, 95, sits among her things as her daughters prepare to move her out of Raydiant Health Care of Brandon on June 26, 2022. [ Hannah Critchfield ]

‘A last resort’

The news broke during bingo.

Residents recalled tears in the nursing home administrator’s eyes as she delivered the message on June 21: Within a month, the place would close. Residents suddenly found themselves in need of housing.

That same day, the federal government said it would terminate Raydiant Health Care of Brandon’s Medicare contract, according to a letter, stating that it had failed to “meet Medicare’s basic health and safety requirements.”

Related: Bill changing Florida nursing home standards was written by the industry, emails show

The nursing home no longer can receive federal money for the services it provides. The loss of such payments often makes it difficult for a place to survive, as Medicaid pays the bills for more than half of all nursing home residents in Florida. Individual costs can approach $80,000.

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3. Other solutions for dental coverage or bargains

1st, look to your business or spouse’s employer if either of you is nevertheless doing the job. Half the individuals 65 or more mature who had dental coverage have been workers, spouses of employees or retirees, in accordance to the Countrywide Poll on Wholesome Ageing. In some instances, employers may present retirees entry to a dental positive aspects plan or offer a referral to a business that provides benefits, suggests Richards of Delta Dental.

Next, you may be able to get dental coverage or a dental lower price software through a Medigap policy. In 2020, about 1 in 8 Medicare beneficiaries ended up enrolled in Medigap ideas with added dental, eyesight or hearing advantages, according to the Commonwealth Fund, a century-old foundation that focuses on improved wellness treatment. Some dental courses present 30 per cent to 40 per cent reductions for products and services these as cleanings, crowns, exams and fillings applying eligible dentists and have no copays, protection limits or waiting around periods.

Also:

  • You can enroll in a stand-on your own dental lower price system, commonly with an up-entrance annual charge.
  • Check with your dentist if he or she participates in any other strategies, these as in-house dental membership programs or discounts for up-front payments.
  • Medicaid provides dental coverage in some states for men and women who meet up with profits and asset requirements. About 1 in 9 Medicare beneficiaries experienced dental protection by means of Medicaid in 2019, according to the Kaiser examine. Much less than half the states supply care further than emergency dental providers for older people. Make contact with your point out Medicaid place of work for particulars.

4. Your dentist can be an ally to control expenses

Right before you retire, discuss with your dentist about the care that is vital to have in the next couple many years, states Leonard Brennan, a retired dentist and codirector of the Harvard University of Dental Medicine’s Geriatric Fellowship Method. If you need some pricey products and services, think about scheduling them even though you however have dental protection from your employer that could be much better than your potential protection.

Really do not skip preventive dental visits such as enamel cleansing due to the fact you’re concerned about the price tag. The shorter-time period personal savings could direct to larger well being issues, Brennan claims.

Your dentist may possibly be able stretch your protection bucks. If you are nearing your policy’s annual coverage cap, the dentist may be able to unfold out some services you want into the next calendar year. To get an concept about how substantially diverse strategies value in your space, Delta Dental has a price estimator.

5. Tax-absolutely free HSA dollars can assist with out-of-pocket dental expenses

Even if you have dental coverage, you even now might have a large amount of fees you can expect to have to pay back for. If you presently have a health cost savings account (HSA) 

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William Stork of Cedar Hill, Missouri, is delaying a surgical tooth extraction in the hope that Congress will add a dental benefit to Medicare as part of President Joe Biden’s Build Back Better legislative package. The public insurance program for people 65 and older has excluded dental (and vision and hearing) coverage since its inception in 1965.

Kaiser Health News

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Your guide to Medicare open enrollment

The Medicare open-enrollment period ends Dec. 7. Here’s what you need to know before signing up.

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William Stork needs a tooth out. That’s what the 71-year-old retired truck driver’s dentist told him during a recent checkup.

That kind of extraction requires an oral surgeon, which could cost him around $1,000 because, like most seniors, Stork does not have dental insurance, and Medicare won’t cover his dental bills. Between Social Security and his pension from the Teamsters union, Stork said, he lives comfortably in Cedar Hill, Missouri, about 30 miles southwest of St. Louis. But that cost is significant enough that he’s decided to wait until the tooth absolutely must come out.

Nearly half of seniors didn’t visit dentist — rates higher for Blacks, Hispanics

Stork’s predicament is at the heart of a long-simmering rift within the dental profession that has reemerged as a battle over how to add dental coverage to Medicare, the public insurance program for people 65 and older — if a benefit can pass at all.

Health equity advocates see President Joe Biden’s Build Back Better agenda as a once-in-a-generation opportunity to provide dental coverage to those on Medicare, nearly half of whom did not visit a dentist in 2018, well before the pandemic paused dental appointments for many. The rates were even higher for Black (68%), Hispanic (61%) and low-income (73%) seniors.

The coverage was left out of a new framework announced by President Biden, but proponents still hope they can get the coverage in a final agreement. Complicating their push is a debate over how many of the nation’s more than 60 million Medicare beneficiaries should receive it.

Champions for covering everyone on Medicare find themselves up against an unlikely adversary: the American Dental Association, which is backing an alternative plan to give dental benefits only to low-income Medicare recipients.

Medicare has excluded dental (and vision and hearing) coverage since its inception in 1965. That exclusion was by design: The dental profession has long fought to keep itself separate from the traditional medical system.

READ NEXT: Drug costs are of control on Medicare — especially insulin. This proposal could help.

More recently, however, dentists have stressed the link between oral and overall health. Most infamously, the 2007 death of a 12-year-old boy that might have been prevented by an $80 tooth extraction prompted changes to Maryland’s version of Medicaid, the federal-state public insurance program for low-income people.

But researchers have also, for example, linked dental care with reduced healthcare spending in patients with Type 2 diabetes. When the World Health Organization suggested delaying

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2 min read

The White House-backed social spending framework will feature a pared-down expansion of both Medicare and Medicaid coverage as President BidenJoe BidenBiden administration takes aim at methane emissions McConnell blasts potential payments to separated migrant families Poll: 50 percent of Republicans don’t believe their vote will be counted accurately MORE seeks to secure enough support to advance the legislation.

The framework, previewed for reporters Thursday morning ahead of Biden’s meeting with House Democrats, would offer four years of subsidized private health insurance on the Affordable Care Act (ACA) exchanges for people with lower incomes living in states that did not expand Medicaid under the health care law.

According to the White House, the plan would provide $0 premiums for 4 million people in the “coverage gap,” meaning they don’t earn enough to qualify for ACA subsidies but, since they live in a nonexpansion state, also make too much to qualify for Medicaid. 

The temporary plan is more industry-friendly than the proposal offered by House Democrats in September, which would have created an entirely new “Medicaid-like” government program to provide coverage in the 12 nonexpansion states.

While many Democrats backed the idea, it was opposed in recent days by Sen. Joe ManchinJoe ManchinOn The Money — Presented by Citi — Progressives shrug off Manchin warning Cori Bush rips Manchin on spending bill opposition: ‘Anti-Black, anti-child, anti-woman and anti-immigrant’ Overnight Energy & Environment — Presented by The American Petroleum Institute — Glasgow summit kicks off MORE (D-W.Va.) and other lawmakers from states that have been paying for expanded Medicaid for years. They argued it wouldn’t be fair for their constituents if the federal government paid the whole cost of the holdout states to expand.

But at the same time, the temporary plan could be easier to set up and may avoid pushback from industry groups that worry a new federal program is a stepping stone to a larger-scale, government-run “public option.”

Backers of Medicaid expansion, including House Majority Whip James Clyburn (D-S.C.) and Georgia Democratic Sens. Raphael WarnockRaphael WarnockBiden reconciliation framework includes Medicaid workaround, no Medicare dental or vision benefits Senate GOP lines up behind Trump-backed candidates Perdue mulling primary challenge against Kemp in Georgia: report MORE and Jon OssoffJon OssoffBiden reconciliation framework includes Medicaid workaround, no Medicare dental or vision benefits Perdue mulling primary challenge against Kemp in Georgia: report McConnell backs Herschel Walker in Georgia Senate race MORE, wanted it to run for as long as possible.

On Medicare, the framework will expand coverage for hearing benefits, which is just one-third of what progressives were pushing for. 

Sen. Bernie SandersBernie SandersSanders hits back at Manchin’s spending concerns Manchin frustrates Democrats with latest outburst Democrats race to reach deal on prescription drug pricing MORE (I-Vt.) has drawn a line in the sand in recent days, saying that adding dental, hearing and vision benefits to Medicare in Democrats’ social spending package is “not negotiable.”

Progressives have long been pushing for expanding the Medicare benefits, but dental benefits

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2 min read

William Stork needs a tooth out. That’s what the 71-year-old retired truck driver’s dentist told him during a recent checkup.

That kind of extraction requires an oral surgeon, which could cost him around $1,000 because, like most seniors, Stork does not have dental insurance, and Medicare won’t cover his dental bills. Between Social Security and his pension from the Teamsters union, Stork said, he lives comfortably in Cedar Hill, Missouri, about 30 miles southwest of St. Louis. But that cost is significant enough that he’s decided to wait until the tooth absolutely must come out.

Stork’s predicament is at the heart of a long-simmering rift within the dental profession that has reemerged as a battle over how to add dental coverage to Medicare, the public insurance program for people 65 and older — if a benefit can pass at all.

Health equity advocates see President Joe Biden’s Build Back Better agenda as a once-in-a-generation opportunity to provide dental coverage to those on Medicare, nearly half of whom did not visit a dentist in 2018, well before the pandemic paused dental appointments for many. The rates were even higher for Black (68%), Hispanic (61%) and low-income (73%) seniors.

The coverage was left out of a new framework announced by President Joe Biden on Thursday, but proponents still hope they can get the coverage in a final agreement. Complicating their push is a debate over how many of the nation’s more than 60 million Medicare beneficiaries should receive it.

Champions for covering everyone on Medicare find themselves up against an unlikely adversary: the American Dental Association, which is backing an alternative plan to give dental benefits only to low-income Medicare recipients.

Medicare has excluded dental (and vision and hearing) coverage since its inception in 1965. That exclusion was by design: The dental profession has long fought to keep itself separate from the traditional medical system.

More recently, however, dentists have stressed the link between oral and overall health. Most infamously, the 2007 death of a 12-year-old boy that might have been prevented by an $80 tooth extraction prompted changes to Maryland’s version of Medicaid, the federal-state public insurance program for low-income people. But researchers have also, for example, linked dental care with reduced health care spending in patients with Type 2 diabetes. When the World Health Organization suggested delaying non-urgent oral health visits last year to prevent the spread of covid-19, the American Dental Association pushed back, with then-President Dr. Chad Gehani saying, “Oral health is integral to overall health. Dentistry is essential health care.”

The ADA-backed Medicare proposal would cover only seniors who earn up to three times the poverty level. That currently translates to $38,640 a year for an individual, reducing the number of potential recipients from over 60 million people to roughly half that number. Medicare has never required means testing, but in a world where Congress is looking to trim the social-spending package from $3.5 trillion over 10 years to $1.85 trillion, the ADA presents

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