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See what’s included:• 5 questions to ask before choosing coverage in retirement

• Your dental health: Don’t give it the brush-off when you retire

• Life Insurance: How it can work in every stage of your life

• Glossary

INSURANCE 101Answers & insights to help you make confident decisions

Questions? Give us a call at

1-800-325-7500

5 questions to ask before choosing coverage in retirement Knowing the differences between Medicare Supplement insurance and Medicare Advantage

can help you make the right decision.

Your dental health: Don’t give it the brush-off when you retire If you’re getting close to retirement, congratulations! You’ve worked hard. It’ll soon be time to

ease up on some of the demands you face while working full time. Something you don’t want

to ease up on, though, is your dental care.

Life insurance: How it can work in every stage of your life From your first step into adulthood to the time you retire, life insurance can help you protect your family if you were to pass away. From your first step into adulthood to the time you retire, life insurance can help you protect your family if you were to pass away. Learn how.

Glossary Use this reference to find the meaning of common terms used with Medicare and Medicare

Supplement insurance.

INSURANCE 101Answers & insights to help you make confident decisions

When it comes to choosing a Medicare plan, you have two options: Medicare (Parts A and B) with the option of Medicare Supplement coverage or Medicare Advantage (Part C). If you choose Medicare Advantage, you are opting out of Medicare.

Knowing the differences between Medicare Supplement insurance and Medicare Advantage can help you make the right decision.

5 questions to ask before choosing coverage in retirement

INSURANCE 101PhysiciansMutual.com

1| Is keeping your doctor or specialist important to you?

If you’re like most people, you have a doctor or specialist you trust. Medicare Supplement coverage allows you to use any doctor that accepts Medicare — which 93% do — and you don’t need a referral to see a specialist. With Medicare Advantage, you might have restrictions on which doctors you can see and you may also need a referral to go to a specialist.

2| Are you planning to travel?

With Medicare Supplement insurance, you’re covered anywhere you travel throughout the United States. Depending on your Medicare Advantage plan, you may not have coverage in some areas, even for non-emergency visits.

3| Do you need help paying for prescription drugs?

Many Medicare Advantage plans do cover prescription drugs, but you cannot customize your coverage. While Medicare Supplement insurance does not cover prescriptions, you can get help finding a separate Part D prescription drug plan to help fit your needs.

4| Is it easy to change your coverage?

Medicare Supplement insurance has a six-month Open Enrollment Period when you’re guaranteed coverage no matter what your health. But if you miss your Open Enrollment Period, you may have to answer health questions if you want to make a change — and you may lose your chance to get Medicare Supplement coverage at all.

5 questions to ask before choosing coverage in retirement continued

No matter what your health, you can get a Medicare Advantage plan, you won’t be asked any medical questions and you can change your plan from year to year. Medicare Advantage providers can also change their plan every year, so you will want to review your plan every year.

5| What does your budget look like?

Depending on the Medicare Supplement insurance policy you choose, you may have a higher monthly premium, but it can typically cover a larger share of your health care bills, meaning you’ll have fewer out-of-pocket costs.

A Medicare Advantage plan can cost less in monthly premiums, but your out-of-pocket costs can vary, depending on your situation. If your budget will allow for these variations, then Medicare Advantage could be an option for you.

People on Medicare can spend thousands in health care expenses. And as you get older, these costs can increase significantly. So, if you’re concerned about paying for health care either now or down the road, Medicare Supplement coverage may be an option for you.

About the New Medicare Card

In April 2018, the government began mailing out new Medicare cards, with a plan to complete distribution by April 2019. If you’re on Medicare, you should have your new card by now, which assigns you a new Medicare Number unique to you. That's the number you see on the new card instead of your Social Security number. Continue to guard your new Medicare card as you would your bank and credit card account numbers. If you haven’t received your new card, contact Medicare right away at 1-800-MEDICARE (1-800-633-4227).

Remember: Medicare will never call and ask you to give personal or private information to get your new Medicare Number and card — but a scam artist might. If this happens, hang up and call the Medicare number listed above. For more information, visit medicare.gov.


would have been lost in the past — 87 percent of people in that age group still have some or all of their natural teeth.

The need for dental care doesn’t diminish with age. But what does go away for many is their group dental insurance: Only about 10 percent of retirees have dental coverage from their former employer.

The lack of coverage probably plays a big role in today’s dental health landscape for older adults. About one in five people age 65 and older have untreated tooth decay, and fewer than half of older Americans see a dentist even once a year — often because they can’t afford to.

Like medical care, dental care is vital for your entire life. Regular visits to the dentist for X-rays, cleanings and exams are important to preserve your oral health and to spot problems early.

If you’re getting close to retirement, congratulations! You’ve worked hard. It’ll soon be time to ease up on some of the demands you face while working full time. Something you don’t want to ease up on, though, is your dental care.

If you’ve started planning for your health care in retirement, you’ve probably discovered Medicare doesn’t cover routine dental work. That’s partly because in 1965, when Medicare was enacted, dental benefits weren’t recognized as a priority. At that time, tooth loss was not uncommon: Nearly half of Americans ages 65-74 had lost their natural teeth. It must have seemed like the natural course of a person’s dental health.

Today, thanks to advances in dental care that help prevent tooth decay — and save teeth that


Your dental health: Don’t give it the brush-off when you retire


How do you plan to pay for dental care in retirement?With Medicare not covering routine dental care and many companies not extending group

dental coverage to their retirees, most older Americans must pay for dental care out of their pockets. How do they — and how will you — plan for that expense?

Your dental health: Don’t give it the brush-off when you retirecontinued

Pay all the costs yourself (‘self-pay’)

Some people plan to self-pay for routine dental visits, hoping those visits will help prevent major work. But that can be a bit of a gamble. Even if you’ve never missed an exam and are experiencing good dental health now, previous dental work can fail over time. And common dental procedures as people age include expensive crowns and fillings — including new fillings around old ones or at the root of a tooth.

In a recent Physicians Mutual® study of people 65 and over, we asked people at what point they would delay necessary dental care if they had to pay the cost themselves. Many said they would never delay care, which is great. But more than 20 percent of the respondents said they would delay care if the cost would be over $500. That could mean necessary treatment, for example, a crown — with a national average cost of about $960 — might not get done.

If you decide to self-pay and need major dental work, you can ask your dentist if they offer payment plans. Or if you have a dental school in your area, see if discounted treatment is available. The American Dental Association lists accredited dental schools on its website.

Buy individual dental insurance

Because predicting future dental costs is as difficult as predicting future medical costs, individual dental insurance can be an important part of a health care plan. In fact, sales of individual dental plans are on the rise, and retiring baby boomers appear to be one of the reasons why.

In our survey, we asked those who don’t have dental insurance why they don’t. The top answer was that they feel it’s too expensive.

But — like all insurance — you have to consider the cost of not having it if you need it. For example, the national average monthly Social Security benefit is $1,369. It’s easy to see how a fairly common but expensive dental procedure such as a root canal (national average cost is also about $960) could deeply cut into that. Dental insurance can help you deal with these kinds of expenses.

Shopping for Dental Insurance?

Dental insurance can help you cover the costs of your dental care in retirement. If you’re in the market for dental insurance, look for coverage that:

• Allows you to choose any dentist you like

• Helps cover preventive benefits right away

• Pays benefits for a wide range of dental procedures, like fillings and crowns

Ensure the coverage you choose has no deductible — and no annual maximums on the cash benefits you can receive.

As you shop, keep in mind that it’s not uncommon for insurance policies that cover basic and major services — like fillings and crowns — to include waiting periods before they’ll pay benefits. These waiting periods (some as short as three months for basic services) help make dental insurance more affordable.


Your dental health: Don’t give it the brush-off when you retirecontinued

Factoring in the cost of dental care is an important part of your retirement planning. Weigh the pros and cons of self-pay versus insurance — and shop around if you decide to buy dental insurance. If you’ll be researching dental insurance and would like a few tips to keep in mind, check out “Shopping for Dental Insurance?” below.

However you decide to pay for it, don’t neglect dental care in your retirement years. It can go a long way toward helping you keep your teeth — and your overall health — in good shape.


Life insurance:How it can work in every stage of your life

Getting StartedYoung, healthy people just starting out in their careers may think they don’t need life insurance just yet.

But you might want to consider it to:

• Take advantage of low rates while you’re young and healthy

• Cover your debts, especially if you have an auto loan, college loans, or purchased a home with a cosigner

• Cover your funeral/memorial expenses

• Help support a child, parent or grandparent

Rather than create an unexpected financial burden for those left behind, it’s better to purchase life insurance to help give them peace of mind.

Getting MarriedIf you’re a newlywed with no children (and maybe no mortgage payments yet) and believe you

don’t need life insurance — think again. If you died, would your spouse be able to cover expenses like these?

• Rent and household expenses

• Car loans

• School loans

• Credit card debt

When you do buy a house, consider increasing your life insurance coverage so that your spouse could handle the mortgage payments if you die.

Growing Your FamilyOnce you start having children, increasing your life insurance coverage becomes very important

because — as we all know — raising a family is expensive. Whether your family lives on one income or two, both spouses should have enough life insurance to help:

• Take care of child care expenses

• Handle household/living expenses like rent, mortgage, home equity loans, car loans, etc.

• Cover future plans for your children, like college

• Maintain the same standard of living

From your first step into adulthood to the time you retire, life insurance can help you protect your family if you were to pass away. Here are some ways this important coverage can help you and your loved ones at every stage of your life.

About six in 10 Americans own life insurance today. Among those who don’t, many agree they need it.

Enjoying RetirementAs you reach those long-awaited golden years of retirement, your need for life insurance changes.

Your children are likely independent adults who don’t depend on you financially. You may have paid off your mortgage and reduced your debt.

Even with these financial accomplishments, you might want to consider using life insurance to help cover:

• Final expenses such as medical bills

• Funeral and memorial service expenses

• Estate taxes

Or, you might want to leave a donation to your favorite charity.

No matter what stage of life you’re in, having the right amount of life insurance coverage will help you take care of your loved ones for years to come.


Life insurance:How it can work in every stage of your life continued

Emptying Your NestAs an empty nester, it’s a good time to re-evaluate your insurance needs once the kids are out of

the house. Here are a few things to think about:

• If you’re helping your kids financially as they start their college years, life insurance could help make sure they continue college uninterrupted if you were to pass away. Life insurance cash benefits can help ease the financial burden of college costs for your children.

• If you have life insurance through your job, keep in mind your employer may not cover your life insurance when you retire. Consider purchasing individual life insurance coverage in addition to the life insurance benefits provided by your employer.

Three of the most common reasons people buy life insurance are to help cover burial and other final expenses, help replace lost income, and help pay off their mortgage.

Affordable Care Act: The Patient Protection and Affordable Care Act (PPACA/ACA) is a federal law passed in 2010. The ACA aims to reform the United States’ health care industry and make health insurance more widely available.

Beneficiary: A person who has health care insurance through the Medicare or Medicaid programs.

Carrier: A private company that has a contract with Medicare to pay your Part B bills.

Centers for Medicare & Medicaid Services (CMS): The Federal agency that runs the Medicare program. In addition, CMS works with the states to run the Medicaid program. CMS works to make sure the beneficiaries in these programs are able to get high-quality health care.

Coinsurance: The percentage of the plan charge for services you may have to pay after you pay any plan deductibles. Usually, the payment is a percentage of the cost of the service (like 20%).

Co-payment (co-pay): The cost for medical care you pay yourself. Usually, the co-payment is a pre-determined dollar amount you pay each time you utilize a particular service (like $10 each time you fill a prescription or $20 each time you visit your doctor).

Creditable drug coverage: Prescription drug coverage (like from an employer or union) that is, on average, at least as good as the Part D standard prescription drug coverage.

Deductible: The amount you must pay for health care before Medicare begins to pay, either for each benefit period for Part A, or each year for Part B and Part D. These amounts can change every year.

Disenroll: Ending your coverage with a health plan.

Durable Medical Equipment (DME): Reusable medical equipment, such as walkers, wheelchairs or hospital beds, that is ordered by a doctor for use in the home.DME is paid for under both Part A and Part B for home health services.

Gaps: Costs or services that are not covered under Medicare Parts A and B.

Group health plan: Insurance that provides health coverage to employees and their families, and is supported by an employer or employee organization.

Guaranteed issue rights: Rights you have in certain situations when insurance companies are required by law to sell or offer you coverage. The company can’t deny you coverage or place conditions on an insurance policy, must cover you for all old health problems, and can’t charge you more because of past or present health problems.

Health Maintenance Organization (HMO): A type of Medicare Advantage plan in which a group of providers agrees to give health care to Medicare beneficiaries for a set amount of money from Medicare every month. You usually get your care from the providers in the plan.

Intermediary: A private company that has a contract with Medicare to pay Part A and some Part B bills.

Managed care plan: A health plan that contracts with health care providers to offer care at lower costs. Plans must cover all Part A and Part B health care. Some also cover extra benefits, like additional days in the hospital. Your costs may be lower than in Medicare Parts A and B.

Medicaid (in California, Medi-Cal): A joint Federal and state program that helps with medical costs for some people with low incomes and limited resources. Programs vary by state, but most medical costs are covered if you qualify for both Medicare and Medicaid.

GlossaryCommon terms


Medically necessary: Services or supplies that are proper and needed for the diagnosis or treatment of your medical condition; are provided for the diagnosis, direct care and treatment of your medical condition; meet the standards of good medical practice in the local area; and aren’t mainly for the convenience of you or your doctor.

Medicare: The Federal health insurance program for people 65 years of age or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure with dialysis or a transplant).

Medicare Advantage Plan (MA): A Medicare Part C program that allows you to choose private health plans to help provide your health care. Everyone who has Part A and Part B is eligible, except those with End-Stage Renal Disease (unless certain exceptions apply).

Medicare-approved amount: The fee Medicare sets as reasonable for a covered medical service. This is the amount a doctor or supplier is paid by you and Medicare for a service or supply. It may be less than the actual amount charged by a doctor or supplier. The approved amount is sometimes called the “approved charge.”

Medicare Supplement insurance: A Medigap insurance policy sold by private insurance companies to supplement some of the “gaps” in Medicare coverage. There are 10 standardized plans (except in Minnesota, Massachusetts and Wisconsin). Medigap policies only work with Medicare Parts A and B.

Network: A group of doctors, hospitals, pharmacies and other health care experts contracted or hired by a health plan to take care of its members.

Out-of-pocket costs: Health care costs you must pay on your own because they are not covered by Medicare or other insurance.

Preferred Provider Organization (PPO): A type of Medicare Advantage plan in which you use providers that belong to the network. You can use providers outside of the network for an additional cost.

Preventive services: Health care to keep you healthy or to prevent illness (for example, Pap tests, pelvic exams, flu shots, mammograms and other screenings).

Private Fee-for-Service Plan (PFFS): A type of Medicare Advantage plan in which you use providers that belong to the network (unless certain exceptions apply). The health plan, rather than the Medicare program, decides how much it will pay and what you pay for the services you get. You may pay more or less for Medicare-covered benefits. You may have extra benefits Medicare Parts A and B don’t include.

Provider: A doctor, hospital, health care professional or health care facility.

Referral: A written okay from your primary care doctor for you to see a specialist or get certain services. In many Managed Care plans, you need a referral before you can get care from anyone except your primary care doctor. If you don’t get a referral, the plan may not pay for your care.

Service area: The area where a health plan accepts members. For plans that require you to use their doctors and hospitals, it is also the area where services are provided. A plan may disenroll you if you move out of its service area.

Questions? Give us a call at

1-800-325-7500

Information from: Medicare.gov and the Medicare & You handbook, 2019

GlossaryCommon terms continued


5 questions to ask before choosing coverage in retirement

“Older Americans 2016: Key Indicators of Well-Being,” publication of Federal Interagency Forum on Aging-Related Statistics, https://agingstats.gov, August 2016

“Primary Care Physicians Accepting Medicare: A Snapshot,” by Christina Boccuti, Christa Fields, Giselle Casillas and Liz Hamel, kff.org, website of Kaiser Family Foundation, October 30, 2015

“You’re getting a new Medicare card!”, medicare.gov, September 2017

“Your Medicare card,” medicare.gov, accessed July 20, 2018

“Difference between Original Medicare and Medicare Advantage Plans,” medicareinteractive.org, website of Medicare Rights Center, 2018

“When can I buy Medigap?”, medicare.gov, accessed August 29, 2018

“Joining a health or drug plan,” medicare.gov, accessed September 11, 2018

“Medicare Vs. Medicare Advantage: How To Choose,” by Judith Graham, khn.org, website of Kaiser Health News, October 19, 2017

“Where’s My New Medicare Card? How to Find Out the Status,” elderlawanswers.com, November 28, 2018

Your dental health: Don’t give it the brush-off when you retire

“5 key factors of dental savings plans in retirement,” by Rachel Hartman, Bankrate, bankrate.com, March 10, 2016

“Dentistry Advocates Aim To Fill Medicare Gaps,” by Phil Galewitz, Kaiser Health News, khn.org, March 6, 2017

“Seniors keeping teeth longer than ever, tips for keeping it up,” SeniorJournal.com, seniorjournal.com, December 18, 2014

“Long-in-the-Tooth Dental Advice,” by Ann Carrns, The New York Times, nytimes.com, November 18, 2014

“5 Ways to Actually Afford Dental Work When You’re Retired,” by Kate Ashford, Prevention, prevention.com, October 11, 2016

“The 5 Biggest Dental Problems For People Over 50,” by Andrea Atkins, huffingtonpost.com, updated December 6, 2017

“Dental Health and Tooth Fillings,” reviewed by Alfred D. Wyatt Jr., DMD on January 24, 2017, webmd.com, January 24, 2017

“Blurred Lines — Individual and Group Dental Market Trends,” by Deborah Sternberg, Advisor Magazine, lifehealth.com, July 1, 2015

“Fact Sheet, Social Security, Snapshot of a Month: June 2017 Beneficiary Data,” ssa.gov, accessed December 18, 2017

Dental Panel Survey, Physicians Mutual, 2016

Life insurance: How it can work in every stage of your life

“Life Insurance at Various Life Stages,” 360 degrees of Financial Literacy, 360financialliteracy.org, accessed March 28, 2016

“Facts from LIMRA / Life Insurance Awareness Month, September 2015,” limra.com, accessed June 1, 2016

“Volunteering and its Surprising Benefits,” by Jeanne Segal, Ph.D., and Lawrence Robinson, helpguide.org, last updated April 2017

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