Medicare Will Now Cover Medically Necessary Dental Care
Entrusted Legacy Law
Dec 09, 2022
Pennsylvania - Greater Pittsburgh Area
Email US
Click to Email Us
In November 2022, the Centers for Medicare and Medicaid Services (CMS) announced that Medicare coverage will be expanded to include medically necessary dental services. This change in Medicare rules will allow people with life-threatening conditions to receive dental care and operations related to conditions approved by CMS.
The provisions in the final rule become effective on January 1, 2023.
What Makes Dental Care Medically Necessary?
The final rule expanded the definition of “medically necessary.” Medicaid currently defines “medically necessary” as “health care services or supplies needed to diagnose or treat an illness, injury, condition, disease, or its symptoms and that meet accepted standards of medicine.”
When it goes into effect, the final rule will include dental care in the definition of medically necessary care.
The final rule also expanded the definition of “physician” to include dentists and oral surgeons.
What Dental Care Is Included in the Final Rule?
The types of dental care and procedures covered will be limited to patients who:
1. Have a jaw fracture and need their teeth stabilized or immobilized.
2. Need a tumor surgically removed, and ridge reconstruction must be performed to remove the tumor.
3. Have a neoplastic disease, and teeth extraction is necessary to prepare the jaw for radiation.
4. Have certain heart diseases and need to receive examinations and treatment before receiving cardiac valve replacement, organ transplant procedures, or valvuloplasty.
5. Need dental splints (only if they get this treatment in connection with a medically necessary treatment).
In addition to the above services, Medicare coverage will be applied to other necessary medical care, including:
- Anesthesia
- X-rays
- The use of an operating room to perform dental services
Expanded Dental Coverage Does Not Apply to Patients With Diabetes
Neither the final rule nor the interim rule expanded dental coverage for diabetes patients. The final rule does not cover normal dental examinations for diabetic patients, despite the importance of regular dental checkups for this population. However, coverage could expand over the next several years.
The Effect of Having Dental Coverage on Medicare Recipients
The expansion of Medicare dental coverage will have a positive impact on some seniors, while others will not receive any benefit. Because of the language included in the final rule, some seniors will receive savings for dental care if dental work is required to treat qualifying medical conditions. Seniors who do not qualify for the expanded dental care coverage in the final rule are still required to pay a fee for services not covered by Medicare.
Patients with diabetes can expect to continue to pay for dental examinations and surgeries out-of-pocket if Medicare does not cover the procedure.
The Future of Expanded Coverage for Medicare Recipients
Seniors enrolled in Medicare can expect more changes to coverage in the future. CMS announced its intention to complete an annual review of covered services, as well as possibly expand the definition of “medically necessary” and include more services for dental care.
Other Articles You May Like
Healthy Eating Tips for Older Adults: Nourishing Your Body at Every Age
As we age, our nutritional needs changebut the importance of eating well never does. A balanced, nutrient-rich diet can help older adults maintain energy, support brain function, strengthen bones, manage chronic conditions, and boost immunity. Healthy eating doesnt have to be complicated, its about making small, consistent choices that nourish the body and promote overall well-being.Here are some practical and easy-to-follow healthy eating tips tailored to older adults: 1. Focus on Nutrient-Dense FoodsAs metabolism slows with age, the body needs fewer calories but more nutrients. Prioritize foods that pack a nutritional punch without empty calories. Choose fruits and vegetables in a variety of colors for a range of vitamins and antioxidants. Opt for whole grains like oatmeal, brown rice, and whole-wheat bread for fiber and sustained energy. Include lean proteins such as chicken, turkey, eggs, beans, and fish. Add healthy fats from sources like avocados, nuts, olive oil, and fatty fishlike salmon. 2. Watch Portion SizesOlder adults often need fewer calories than they did in their younger years. Be mindful of portion sizes and aim to listen to your bodys hunger and fullness cues. Eating smaller, more frequent meals can also help manage appetite and blood sugar levels. 3. Stay HydratedDehydration is common in seniors because the sense of thirst often decreases with age. Make a habit of drinking water regularly throughout the day, even if you dont feel thirsty. Flavor water with fruit slices or herbs for variety. Limit caffeine and sugary drinks, which can dehydrate or add empty calories. Include hydrating foods like cucumbers, melons, and soups. 4. Prioritize Bone HealthAs bones naturally lose density over time, its important to consume enough calcium and vitamin D to maintain bone strength. Choose low-fat dairy products, fortified plant-based milk, leafy greens, and canned salmon with bones. Talk to your doctor about whether a vitamin D supplement is right for you, especially if you spend limited time in the sun. 5. Limit Added Sugar and SaltToo much sugar and sodium can increase the risk of heart disease, high blood pressure, and diabetes. Read food labels and aim for low-sodium and no-added-sugar options. Season meals with herbs, spices, or lemon juice instead of salt. Swap sweets for naturally sweet fruits like berries, apples, or grapes. 6. Eat Fiber-Rich FoodsFiber supports digestion, helps prevent constipation, and can lower cholesterol levels. Include beans, whole grains, fruits, vegetables, and nuts in your meals. Gradually increase fiber and drink plenty of fluids to help your body adjust. 7. Dont Skip MealsSkipping meals can lead to dips in blood sugar, fatigue, and overeating later in the day. Try to eat regular meals and snacks to maintain steady energy and avoid nutrient deficiencies. 8. Pay Attention to Dental HealthDental problems can make chewing difficult, which may lead to avoiding healthy foods. Choose softer, easy-to-chew options like: Cooked vegetables Soft fruits (bananas, applesauce) Ground or shredded meat Smoothies, soups, and stews If you wear dentures or experience mouth pain, talk to your dentist about comfortable food options. 9. Enjoy Your MealsEating should be a pleasant and social experience. Make mealtime enjoyable by: Sharing meals with family, friends, or neighbors Trying new recipes or healthy versions of favorite dishes Eating in a well-lit, calm environment At Avondale Care Group of Pennsylvania our services are fully customizable, allowing us to create a care plan that perfectly matches your personal routines and preferences.
How to Stay Safe When Living Alone: Practical Tips for Seniors
How to Stay Safe When Living Alone: Practical Tips for SeniorsLiving alone offers independence, freedom, and comfortbut it also comes with unique safety concerns, especially for older adults. Whether you're aging in place by choice or circumstance, taking steps to stay safe can bring peace of mind to you and your loved ones.From fall prevention to emergency planning, here are practical tips for staying safe, secure, and confident while living on your own. 1. Prevent Falls at HomeFalls are one of the most common safety risks for seniors. The good news is that many are preventable with a few simple changes: Remove tripping hazards like throw rugs, loose cords, and clutter. Install grab bars in bathrooms near the toilet and inside the shower or tub. Use non-slip mats in wet areas like the kitchen and bathroom. Ensure good lighting in all rooms, especially hallways and staircases. Wear supportive, non-slip shoes indoors instead of socks or slippers. Keep frequently used items within easy reach to avoid climbing or bending. 2. Invest in a Medical Alert SystemIn an emergency, a medical alert device can be a lifesaver. These systems allow you to call for help with the press of a buttonsome even offer fall detection and GPS tracking. Choose a system that suits your needs (wristband, necklace, or wall-mounted). Look for 24/7 monitoring and an easy-to-use interface. Let family members know how the system works. 3. Stay Connected with Family and FriendsRegular communication not only combats lonelinessit also keeps others aware of your well-being. Set up daily or weekly check-ins with loved ones. Join phone trees or neighborhood watch groups. Use video calls or text messaging to stay in touch more frequently. If you're ever unable to reach out, those regular check-ins could alert someone quickly if somethings wrong. 4. Secure Your HomeHome security helps deter intruders and gives you confidence when living alone. Always lock doors and windows, even when youre home. Install a peephole or video doorbell so you can see whos at the door without opening it. Use motion-sensor lights around entryways. Avoid sharing personal information or travel plans on social media. 5. Create an Emergency PlanBeing prepared gives you control and helps you act quickly if needed. Keep a list of emergency contacts, including family, neighbors, and healthcare providers, in a visible place. Store important medical information (medications, allergies, health conditions) in an accessible location. Plan and practice how to exit your home in case of fire or other emergencies. Keep a flashlight, batteries, and a charged cell phone nearby at all times. 6. Be Cautious with StrangersUnfortunately, seniors living alone can be targets for scams or fraud. Protect yourself by: Never giving personal or financial information over the phone or internet unless you initiated the contact. Being cautious about unsolicited offers, especially for home repairs or investments. Reporting suspicious activity to local authorities or a trusted family member. 7. Manage Medications SafelyMedication mistakes can be serious. Stay organized with: A weekly pill organizer to track doses. Medication reminders via phone alarms or apps. Reviewing medications regularly with your doctor or pharmacist. 8. Consider a Home Safety Assessment Some organizations or healthcare providers offer in-home safety assessments to help you identify potential hazards. They may recommend simple upgrades like handrails, better lighting, or rearranging furniture.At Avondale Care Group of Pennsylvania our services are fully customizable, allowing us to create a care plan that perfectly matches your personal routines and preferences.
Transportation Options for Seniors Who No Longer Drive
Transportation Options for Seniors Who No Longer DriveGiving up the keys doesnt mean giving up independence. While not being able to drive can be a major life change, there are many reliable and accessible transportation options available to help seniors stay active, connected, and engaged in their communities.Whether it's getting to a doctors appointment, running errands, or visiting family and friends, here are several practical transportation alternatives for older adults: 1. Public TransportationBuses, light rail, and subways can be a convenient and affordable way to get around, especially in urban areas.Benefits: Senior discounts are often available. Fixed routes and schedules make planning easy. Many systems offer priority seating and wheelchair access. Tips: Check with your local transit authority about reduced fare programs for seniors. Consider traveling during non-peak hours for a more comfortable experience. 2. Senior Transportation ServicesMany communities offer transportation specifically for older adults through local agencies, non-profits, or senior centers.Features may include: Door-to-door service Help with boarding or carrying bags Medical appointment transport How to access: Check with your local Area Agency on Aging, senior center, or county health department for programs in your area. 3. Ride-Sharing ServicesApps like Uber and Lyft offer flexible transportation, and many now provide services tailored to seniors.Benefits: On-demand transportation at your fingertips No need to carry cash Can be used for errands, appointments, or social outings Senior-Friendly Options: Some services allow family members to schedule rides. Uber Health and similar programs coordinate non-emergency medical transportation. Note: A smartphone is usually required, but there are programs that help seniors use ride-share apps with phone-based or caregiver support. 4. Volunteer Driver ProgramsThese are community-based services where volunteers drive seniors to appointments, grocery stores, or social activitiesoften for free or a small fee.Advantages: Personal and friendly service Flexible scheduling Often provided through churches, nonprofits, or community groups 5. Non-Emergency Medical Transportation (NEMT)If you're enrolled in Medicaid or another qualifying healthcare plan, you may be eligible for free or low-cost rides to medical appointments.How it works: Coordinated through your insurance provider or case manager Often requires advance scheduling May include wheelchair-accessible vans 6. Family, Friends, and CaregiversDont underestimate the value of a strong support system. Family members or neighbors may be willing to help with transportation, especially if a schedule is worked out ahead of time.Tips: Coordinate a regular ride schedule to reduce last-minute stress. Consider offering gas money or another small thank-you for their help. 7. Community Shuttles and Senior VansSome cities and towns operate community shuttle services that stop at popular destinations like grocery stores, libraries, and senior centers.Perks: Usually low-cost or free for seniors Friendly drivers familiar with senior riders Accessible vehicles designed for comfort and ease of use At Avondale Care Group of Pennsylvania our services are fully customizable, allowing us to create a care plan that perfectly matches your personal routines and preferences.
Local Services By This Author
Entrusted Legacy Law
Special Needs Trusts 100 Pinewood Lane Suite #303, Warrendale, Pennsylvania, 15086Comprehensive Special Needs Estate Planning & Special Needs Trusts in PennsylvaniaEstate planning for families with special needs children presents a unique set of financial, legal, and healthcare challenges that require the expertise of a special needs planning attorney. Not all estate planning lawyers understand the intricacies involved, but the experienced special needs estate planning attorneys at Entrusted Legacy Law are dedicated to ensuring your child with special needs is fully protected when you are no longer able to serve as their primary caregiver.We provide a full range of estate planning services tailored to families with special needs children in Pennsylvania. Our goal is to help you preserve assets for your childs future care while ensuring they remain eligible for essential government benefits like Medicaid and Supplemental Security Income (SSI). We assist in setting up special needs trusts (SNTs) to safeguard financial resources, appointing legal guardians and trustees, and identifying long-term care options to ensure your child receives the best possible support and housing solutions.Special Needs Trusts & Asset ProtectionOne of the most significant challenges in special needs financial planning is ensuring that your child has adequate resources without jeopardizing their eligibility for public assistance programs. Many families unknowingly risk disqualifying their child from essential benefits by leaving them a direct financial inheritance. Instead, the best strategy is to establish a special needs trust to provide financial security while preserving their access to Medicaid, SSI, and other government assistance programs.A properly structured special needs trust allows funds to be used for supplemental expensessuch as medical care, therapy, education, and personal carewithout affecting eligibility for disability benefits. However, the regulations governing these trusts are complex. Funds must be managed by a designated trustee and cannot be distributed directly to the beneficiary, as this could trigger disqualification from public benefits. Additionally, a child's needs evolve over time, making it critical to have a trust that can adapt to changing circumstances and legal requirements.By working with an experienced Pennsylvania special needs attorney, you can ensure that your childs special needs trust is legally sound, structured correctly, and customized to their specific requirements.Special Needs Planning for Families in PennsylvaniaAt Entrusted Legacy Law, we specialize in estate planning for children with disabilities, including Down syndrome, autism, cerebral palsy, and other developmental or intellectual disabilities. Our firm helps families create a comprehensive life care plan that provides financial security while safeguarding access to government benefits and essential support services.Whether you need help establishing a special needs trust, securing a legal guardian, or planning for long-term care and housing, our Pennsylvania special needs planning attorneys are here to guide you through every step of the process.Contact Entrusted Legacy Law today to start creating a sustainable, secure future for your child with special needs.
Entrusted Legacy Law
Estate Planning 100 Pinewood Lane Suite #303, Warrendale, Pennsylvania, 15086Estate Planning for Everyone You Love and Everything You OwnHave you ever considered what would happenlegally and financiallyto you, your family, your assets, and everything you care about if the unexpected were to occur?If your estate plan is outdated or non-existent, your assets could be lost to the State Department of Unclaimed Property, subjected to an expensive and time-consuming probate process, or even end up in the wrong hands. Without a comprehensive estate plan, your loved ones may face unnecessary financial hardship, legal disputes, or court intervention at a time when they need certainty and protection the most.If you dont know exactly what would happen to everything you own and everyone you love, the first step is to gain clarity. You need to understand how your current estate plan (or lack thereof) will impact your family so you can make informed decisions about whether it truly aligns with your wishes.How Entrusted Legacy Law Helps You With Estate PlanningWe offer customized estate planning solutions designed to protect your family, preserve your wealth, and ensure your wishes are honored. Through our Life and Legacy Planning Session, we take the time to educate you on the legal, financial, and personal implications of your estate choices.Step 1: The Life and Legacy Inventory & AssessmentBefore your Life and Legacy Planning Session, you will complete a comprehensive estate inventory that outlines your financial assets, real estate holdings, retirement accounts, life insurance policies, and other valuable property. This step ensures that we have a full picture of your estate and can identify potential gaps in your asset protection strategy.Step 2: Creating a Personalized Estate PlanIf you decide that your current estate plan is inadequateor if you dont have one at allwe will work together to design a legally sound and strategically structured estate plan that meets your familys unique needs. The foundation of your estate plan will often include a revocable living trust, which allows you to transfer your assets into the trust while maintaining control during your lifetime.Benefits of a Revocable Living Trust: Avoid Probate Prevents the time-consuming and expensive court process that could otherwise delay asset distribution. Minimize Estate Taxes Helps reduce tax liabilities and protect your wealth for future generations. Ensure Privacy Unlike a will, which becomes public record, a trust ensures your estate remains private. Maintain Control Dictate how and when your assets are distributed to your heirs.For families with complex financial portfolios, business ownership, or special circumstances (such as blended families or special needs children), we offer advanced estate planning strategies tailored to your specific goals.Can You DIY Your Estate Plan?Many people wonder if they can create an estate plan using online templates or generic legal services. Unfortunately, most DIY estate plans fail when families need them the most. What often passes for "estate planning" is nothing more than basic document generation, where you answer a few questions and receive a generic template that may not fully protect your assets or your loved ones. No Personalization A generic template cannot address your unique family dynamics, financial situation, or specific legal concerns. Legal Loopholes Improperly structured wills or trusts may be contested in court, leaving your family in legal disputes. No Ongoing Maintenance Estate laws change, and without updates, your plan may become outdated and ineffective.At Entrusted Legacy Law, we dont just draft documentswe provide comprehensive estate planning services that ensure your estate plan actually works when it matters most. We take the time to understand your familys needs, educate you on your options, and create a legally enforceable, tax-efficient, and conflict-free estate plan that gives you peace of mind.Protecting Families & Minor Children Through Estate PlanningIf you are a parent with young children, your estate plan should begin with a solid foundation that ensures your children will always be taken care of, no matter what happens. Without the proper legal protections in place, your children could end up in the custody of someone you wouldnt have chosenor worse, under state guardianship.At Entrusted Legacy Law, we specialize in estate planning for families with minor children. We help parents:Name Legal Guardians Ensure your children are raised by trusted individuals of your choosing.Set Up Trusts for Minor Children Prevent financial mismanagement by appointing a responsible trustee to oversee assets.Establish Emergency Plans Provide clear instructions for immediate care in case of sudden incapacity or death.Whether youre planning for minor children, adult dependents, elderly parents, or a complex estate, we can guide you through the estate planning process with personalized strategies to protect your familys future.Secure Your Legacy With Entrusted Legacy LawEstate planning isnt just about who gets whatits about ensuring that your loved ones are financially secure, legally protected, and prepared for the future.If you want to create a comprehensive estate plan that reflects your wishes, avoids probate, minimizes taxes, and keeps your loved ones out of court and out of conflict, then now is the time to take action Contact Entrusted Legacy Law today to schedule your Life and Legacy Planning Session and take the first step in protecting your family, your assets, and your future.
Entrusted Legacy Law
Probate 100 Pinewood Lane Suite #303, Warrendale, Pennsylvania, 15086Pennsylvania Probate: What You Need to Know After the Passing of a Loved OneIf you are here to learn about Pennsylvania probate laws after the passing of a loved one, we first want to extend our sincere condolences. We understand that this is a difficult time, and we hope the information on this page provides clarity and helps minimize the legal and administrative challenges you may otherwise face.What Is Probate in Pennsylvania?Probate in Pennsylvania is a court-supervised legal process that ensures the transfer of assets from a deceased individual to their rightful heirs or beneficiaries. This process is essential for: Proving the validity of a will Appointing an executor (if there is a will) or an administrator (if there is no will) Inventorying and appraising estate property Paying outstanding debts, estate taxes, and creditors Distributing assets as directed by the willor by Pennsylvania intestacy laws if no will existsIn Pennsylvania, if a deceased person owned real estate or assets solely in their name, their estate must go through probate before assets can be legally distributed.The Downsides of Pennsylvania Probateand What You Can Do NextMany residents in Allegheny County, Butler County, Beaver County, Washington County, and Westmoreland County have heard that probate is a lengthy, expensive, and public process. Unfortunately, this is truewithout proper estate planning, probate can be costly and time-consuming.The best way to avoid probate in Pennsylvania is to plan ahead using strategies such as revocable living trusts, beneficiary designations, and joint ownership structures. However, if you are already in a position where probate is required, the best thing you can do is educate yourself and seek experienced probate legal assistance to complete the process as efficiently and cost-effectively as possible.How Is a Probate Case Started in Pennsylvania?Probate can be initiated by any beneficiary or creditor, but most often, the process begins when the Executor named in the will files the original will and a petition with the Pennsylvania probate court.If there is no will, a close relative of the deceased (such as a spouse, child, or sibling) typically files the petition to become the Administrator of the Estate.Choosing the Executor for a Pennsylvania EstateIf a valid will exists, the individual named as Executor will handle the probate processif they are eligible and willingIf no Executor is available or no will exists, any interested party (such as a family member) can petition the Pennsylvania Orphans' Court to be appointed as the Administrator of the Estate.Executor Compensation in PennsylvaniaUnder Pennsylvania probate law, Executors and Administrators receive compensation based on a percentage of the total probate estate value. This is designed to fairly compensate them for their time and effort in managing estate matters.However, Executors can be held personally liable for any mistakes made during the process. Given the complexity of Pennsylvania probate rules, its critical to work with a skilled probate attorney to avoid legal pitfalls.Do You Need to Go Through Probate If a Trust Exists?In most cases, no. If the deceaseds assets were properly titled in the name of a trust, probate is not required. Instead, the successor trustee will work with an estate planning lawyer to administer the trust and distribute assets.However, many families are surprised to learn that simply having a trust does not guarantee that probate will be avoided. Common mistakes include: The trust was not updated over time to reflect new assets. The decedents assets were never properly transferred into the trust.To ensure your estate plan works as intended, its important to work with an estate planning attorney who provides ongoing trust maintenance and reviews.Which Assets Are Subject to Probate in Pennsylvania?Assets that must go through probate include: Real estate, bank accounts, or investments owned solely in the deceaseds name Personal property and valuable assets without a beneficiary designationAssets that bypass probate include: Jointly owned property with Right of Survivorship Bank accounts or investment accounts with Transfer on Death (TOD) or Payable on Death (POD) designations Life insurance policies and retirement accounts with named beneficiariesHowever, some assets that normally bypass probate can still become subject to the process under certain circumstances. Consult with a Pennsylvania probate attorney to determine if probate applies to your specific situation.How Pennsylvania Intestacy Laws Distribute an Estate When There Is No WillIf no valid will exists, Pennsylvania intestacy laws dictate how the estate will be distributed:1 Spouse (If married, a portion or all of the estate goes to the spouse)2 Children (If the deceased had children, they inherit next)3 Parents (If there are no children, parents inherit)4 Siblings (If no spouse, children, or parents, siblings inherit)This highlights the importance of estate planningwithout a will or trust, the state determines who receives your assets.How Long Does Pennsylvania Probate Take?The timeline for Pennsylvania probate varies depending on the estates complexity. On average: Minimum of 12 months for simple cases Up to 2+ years for complex estates, disputes, or tax-related mattersWhat Are the Costs of Probate in Pennsylvania?Probate costs in Pennsylvania include: Attorneys fees (Based on estate size and complexity) Court filing fees Executor fees (set by Pennsylvania law) Appraisal and valuation fees Publication and administrative costsIn more complex estates, additional fees may apply, increasing probate expenses and delays.How to Choose the Right Pennsylvania Probate AttorneySelecting the right probate lawyer in Pennsylvania is crucial. Many general practice lawyers dabble in probate law, but only experienced probate attorneys have the knowledge to navigate complex estate matters efficiently. You do NOT have to use the attorney who prepared the will. You have the right to choose a specialized probate lawyer who understands the nuances of Pennsylvania estate law and can expedite the process. Avoid costly mistakes. Working with an experienced probate attorney prevents errors that could increase costs, cause delays, or result in legal disputes.Contact Entrusted Legacy Law for a Complimentary Pennsylvania Probate ConsultationIf youre ready to begin the probate process in Pennsylvania, our Allegheny County and Butler County probate attorneys are here to guide you.Call us at 412-347-1731 to schedule a complimentary 15-minute consultation to determine your next best steps.During your consultation, we will: Answer your probate-related questions Provide guidance on estate administration Help you navigate the Pennsylvania probate process efficientlyWe are here to relieve the legal and administrative burden during this difficult time and ensure that your loved ones estate is handled with care.