Author: Matt McColm

Do I Need to Enroll in Medicare if I Am Working in Washington State?

Posted on by Matt McColm
Medicare Advantage or Medigap Suzie at wenatchee can help

The Question: So, you’re still clocking in at the 9-to-5 grind, enjoying those free office donuts, and now, on top of that, Medicare is knocking on your door. You’re probably thinking, “Do I really need to enroll in Medicare while I’m still working?” Well, don’t worry—Suzie from Wenatchee Insurance has got your back, and she’s got answers that are as clear as a sunny day in North Central Washington!

1. Is Your Employer Big Enough to Be a Bouncer?

  • Large Employers (20 or more employees): If your employer is big enough to need name tags at the company picnic, they probably have a health plan that stays primary while Medicare takes a back seat. You can think of Medicare Part B as that friend who always offers to pay, but you don’t really need them to—yet. Suzie suggests you might want to grab Part A (it’s free, like a leftover doughnut in the break room), but hold off on Part B if you’re happy with your employer’s coverage.
  • Small Employers (fewer than 20 employees): If your employer is more like a cozy family reunion where everyone knows your middle name, then Medicare will want to be your primary insurance. Suzie says this is the time to roll out the red carpet for Medicare Part A and B, or you might find yourself stuck with some unexpected bills—like when you forget it’s your turn to bring snacks to the staff meeting.
talk with Suzie

2. Are You Playing HSA Roulette?

  • HSAs and Medicare: A Tricky Tango: If you’re still playing the HSA game, you’ve got to be careful. Suzie warns that enrolling in Medicare will throw your HSA contributions out the window faster than your New Year’s resolutions. If you’re not ready to give up on that sweet, sweet HSA money, you might want to keep Medicare at bay for a little while longer.

3. Dodge the Medicare Penalty Like a Pro

  • Suzie’s Tip: If you think you’re too cool for Medicare Part B, think again! Suzie’s seen too many folks who thought they could outsmart the system, only to end up paying a penalty that follows them like a persistent telemarketer. So unless you’re into paying more for less, make sure you don’t miss that Special Enrollment Period (SEP).

4. Special Enrollment Period: Your Get-Out-of-Jail-Free Card

  • Still working and covered by your employer? Great news! Suzie says you’ve got a Special Enrollment Period to sign up for Medicare Part B whenever you’re ready—or within eight months after you finally decide to trade your desk job for a hammock. No penalty, no problem. It’s like finding out you don’t have to attend the annual budget meeting after all!

5. What About Part D?

  • Is Your Prescription Coverage Up to Snuff? If your employer’s prescription plan is as strong as the coffee in the break room, you can skip Part D for now. But if your plan’s looking a little weak, like the decaf everyone avoids, Suzie suggests enrolling in Part D to avoid any late penalties. Nobody likes paying extra, especially when that money could be spent on something important—like more office donuts.

In Summary: If you’re still working, it’s not a one-size-fits-all when it comes to Medicare. Suzie from Wenatchee Insurance is here to help you navigate the maze of Medicare decisions without breaking a sweat. Whether you’re working for a big corporation or a small business, Suzie’s got the advice you need to keep your coverage (and your sanity) in check. After all, the only thing more confusing than Medicare is trying to figure out who took the last donut!

Talk with Suzie for Medicare

Topics: health insurance, Medicare, Medicare Advantage, Home Insurance, Car Insurance, Business Insurance, Suzie,  Chelan County, Okanogan, Grant County, Douglas County, 509, Leavenworth, Quincy, Cashmere, Entiat,

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Can I Switch Medicare Plans, and If So, How Often?

Posted on by Matt McColm
switch medicare during annual enrollment for Medicare advantage

Switching Medicare plans is like swapping seats at the Wenatchee Wild—you can do it, but you need to know when and where you’re allowed. Medicare gives you several chances to switch Medicare if your needs change, just like moving from the bleachers to next to the glass when the view isn’t quite right.

Suzie from Wenatchee Insurance is like a friendly usher who knows all the best seats.

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Annual Enrollment – Oct 15 through Dec 7

During the Medicare Annual Enrollment Period (AEP) from October 15 to December 7, you can switch from Original Medicare to a Medicare Advantage plan, change your Medicare Advantage plan, or sign up for a Part D prescription drug plan.

During the AEP, you want to double-check your plan (ticket) to make sure that it is in the section that you want to be. You also get the chance to change the plan on your side kind of like upgrading your tickets to make sure you’re seeing the action from the best spot.

Medicare Advantage Open Enrollment Jan 1 -March 31

If you’re enrolled in a Medicare Advantage plan and decide it’s not for you, there’s also the Medicare Advantage Open Enrollment Period from January 1 to March 31. Suzie can help you switch back to Original Medicare or find a new Medicare Advantage plan during this time.

Medicare prescription plan d talk to Suzie at Wenatchee about Inflation Reduction Act

Special Enrollment Periods like losing a plan or moving

And if life throws you a curveball, like moving to a new area or losing other insurance, Suzie can check if you qualify for a Special Enrollment Period (SEP), giving you even more flexibility to switch medicare plans.

Suzie tip: We have another blog post that has a timeline for a Medicare Advantage plan leaving Washington State.

So, whether you’re looking for a better seat or just want to see the game from a new angle, Suzie will make sure you have the perfect Medicare plan to enjoy the show.

Suzie with Wenatchee Insurance has been helping people in Washington State navigate the twists and turns of Medicare for over a decade. If you have been a long-time resident, you may have encountered her when she was a Pharmacy Technician in Wenatchee. She has people who have set appointments years in advance to do the change from healthcare to Medicare.

Suzie Appointment
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Topics: health insurance, Medicare, Medicare Advantage, health alliance, wellcare, Molina, humana, Suzie,  Chelan County, Okanogan, Grant County, Douglas County, 509, Leavenworth, Quincy, Cashmere, Entiat, switch medicare,

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Who do I call for Medicare Fraud

Posted on by Matt McColm

We hear about medicare fraud more than we like. Suzie and Matt have been working with health and medicare insurance for over a decade in Washington State. In addition with Shayla we make up Wenatchee Insurance. We do not work for Medicare. Here is the disclaimer:

“We do not offer every plan available in your area. Currently, we represent 16 organizations which offer 62 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all your options.”

Every agent is required to tell you a disclaimer and you will even see them on their websites. If you don’t receive one then you know that something strange is occuring.

Medicare Fraud does occur during the annual enrollment period.

The Medicare annual enrollment period runs October 15 through December 7 every year. It allows people with Medicare Prescription plans and Medicare Advantage plans to review and change plans every year. There is a lot of activity and chaos so we want to make sure that if you encounter anything strange that you can lend a hand in prevention. Having an appointment with an agent that you know can reduce the chance of fraud from occurring.

recommend setting appointment

If you are not in our office in Wenatchee at 413 Mission Street then we are talking over the phone, it is on a recorded line. Medicare enrollments over the phone have been required for the last couple of years to be recorded. Yes, trained medicare agents record calls.

Medicare Fraud prevention tips

The Washington Office of the Insurance Commissioner has some great medicare fraud tips. The suggest checking the credentials when ever you have a question about who is selling you a medicare plan. We post copies of our licenses in our office lobby.

If you see Fraud then call 800-562-6900

When you report them. Let them know who they said they were and their phone number.

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What Is Medicare, and Who Is Eligible for It?

Posted on by Matt McColm
wenatchee medicare suzie

Suzie from Wenatchee Insurance— has seen this before. She can be your guide through the trails of Medicare Mountain. Suzie’s like the friendly tour guide; she has been trained about the ins and outs of Medicare and can make the whole experience as smooth as a glass of your favorite local vintage.

OK, storytime.  You are strolling through one of the scenic vineyards near Lake Chelan sipping on a crisp glass of Riesling and enjoying the view. Life is pretty sweet, but you are getting close to 65, and suddenly, Medicare looms on the horizon like a far-off mountain range. You have had coverage for years from your job. What is this Medicare everyone’s talking about, and do you need to start climbing that mountain now?

Medicare 101

Medicare is a federal health insurance program designed primarily for people aged 65 and older, though younger folks with certain disabilities or conditions like End-Stage Renal Disease (ESRD) can also qualify. Think of Medicare as a big safety net, ensuring that as you transition into your golden years, you’re covered for hospital visits, doctor’s appointments, and other essential health services.

But wait—Medicare isn’t just one massive umbrella. It’s more like a series of cozy cabins at Mt Index’s Espresso Chalet, each with a different purpose:

  • Part A covers your hospital stays, kind of like the main lodge where you’ll spend most of your time resting and recovering.
  • Part B is your medical coverage, taking care of things like doctor visits and preventive services—think of it as your day trips around the area, keeping you in tip-top shape.
  • Part C (also known as Medicare Advantage) bundles Part A and B together with some extra perks, like dental and vision—imagine this as an all-inclusive spa package.
  • Part D is your prescription drug coverage, ensuring you have everything you need, from allergy meds to daily vitamins—like stocking up on brownies before taking a picture with Bigfoot.
chat with Suzie

Who’s Eligible for Medicare?

Now, who gets to enjoy this Medicare experience? If you’re a U.S. citizen or legal resident who’s been living in the country for at least five years and you’re about to turn 65, congratulations—you’re eligible for Medicare! That is correct not everyone can get Medicare, you have to be eligible.

But Suzie knows that life isn’t always a straight path forward. Maybe you’re still working at the local apple orchard, or perhaps you’re basking in semi-retirement, splitting your time between Wenatchee and your cabin in Conconully. If you’re already receiving Social Security benefits, you’ll be automatically enrolled in Parts A and B when you hit 65. Keep an eye on that mailbox. Otherwise, you’ll need to sign up during your Initial Enrollment Period (IEP)—a seven-month window that starts three months before your 65th birthday and ends three months after.

Suzie’s tip: Mark your calendar! Missing this window could mean penalties down the road, like forgetting to RSVP to that big community BBQ and getting stuck at the end of the line and getting the potato salad with raisons.

Suzie Medicare Initial Enrollment, Annual Enrollment or Special Enrollment

How Suzie Makes Medicare Fun

Suzie’s got your back, ensuring you’re not just surviving the Medicare process, but thriving. Picture this: It’s a sunny day in Wenatchee, and Suzie invites you to her office for a Medicare 101 session. She’s got a spread of local snacks—cheese from Walla Walla, apples from Stemilt Growers orchards, and we will skip the wine for the moment because we want to be clear-headed.

She’ll walk you through each part of Medicare, breaking down the insurance lingo into simple, easy-to-digest bites, just like that dutch apple pie you can’t resist. Maybe you’ve heard rumors that Medicare is complicated—like trying to figure out which trail to take on a hike through the Cascades. But with Suzie, it’s more like a leisurely stroll around town, where she points out all the highlights and makes sure you don’t miss a thing.

Need help choosing between Original Medicare and Medicare Advantage? Suzie’s got you covered, like marked-up trail map that shows you the best route based on your needs. She’ll make sure you’re not paying too much, missing out on any benefits, or accidentally wandering off the beaten path into a bears den in Leavenworth.

Wrapping Up the Medicare Adventure

By the end of your chat with Suzie, Medicare will seem less like a daunting mountain and more like a gentle, rolling pasture—beautiful, manageable, and maybe even enjoyable. So, when you’re ready to start your Medicare journey, remember that Suzie from Wenatchee Insurance is there to make it as delightful as a day spent exploring the best of Eastern Washington. Cheers to that!

talk with Suzie
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What are the costs associated with medicare prescription Drug Plans?

Posted on by Matt McColm
Medicare prescription plan d talk to Suzie at Wenatchee about Inflation Reduction Act

Unpacking Medicare Part D Costs: A Comical Adventure with Wenatchee Insurance

When it comes to understanding the costs of Medicare Prescription Drug Plans (Part D), it can feel like you’re opening a Walla Walla sweet onion—each layer revealing yet another hidden fee or charge. But don’t worry! Suzie & Wenatchee Insurance is here to make this journey as entertaining as a treasure hunt with a map that only partially makes sense. Let’s embark on this comical adventure together!

talk with Suzie

The Entrance Fee: Monthly Premiums

First stop on our treasure hunt: monthly premiums. Think of this as the entry fee to the amusement park. You need it to get in, but the rides are extra.

Sample: “Imagine paying to enter the park, only to find that all the rides have separate fees. Welcome to the world of monthly premiums! Some are like the pricey but thrilling dragon roller coasters, others are more like the budget-friendly but equally fun unicorn merry-go-rounds.”

The First Clue: Annual Deductibles

Next, we encounter the annual deductible. This is the amount you pay out-of-pocket before your insurance plan starts covering costs. It’s like the troll bridge before you can access the treasure mountain.

Sample: “Picture a toll booth on your way to Treasure Island. You have to pay up before you can cross the bridge. Deductibles work the same way. Until you pay, you’re on the mainland, dreaming of buried treasure.”

insurance deductibles are important to the policy

The Treasure Map: Formularies

As we delve deeper, we find the formulary—a list of covered medications. Think of it as Big X on the treasure map. If your medication isn’t on the list, it’s like looking for treasure in the wrong place.

Sample: “Navigating the formulary is like following a pirate’s map. If your meds aren’t listed, it’s like trying to dig for gold in a child’s sandbox—frustrating. Always check the map (formulary) before setting sail.”

The Hidden Charges: Co-pays and Co-insurance

Along our adventure, we can stumble upon co-pays and co-insurance—those sneaky hidden charges that pop up when you least expect them. Co-pays are fixed amounts you pay for medications, like the fee for the funhouse. Co-insurance is a percentage of the cost, like splitting the bill for the bumper cars.

Sample: “Co-pays are like knowing the cost of the funhouse upfront—predictable and straightforward. Co-insurance, on the other hand, is like agreeing to pay a percentage of your friends’ bumper car rides—unexpected and potentially pricey.”

The Final Prize: Catastrophic Coverage

Finally, we reach the ultimate prize: catastrophic coverage. Once you’ve spent a certain amount, your costs drastically decrease. It’s like finding the buried treasure after a long, arduous journey.

Sample: “Catastrophic coverage is the X marking the spot on your treasure map. After navigating premiums, deductibles, and co-pays, you finally strike gold with lower costs and peace of mind.”

Wenatchee Insurance: Your Treasure Hunt Guide

Navigating the costs of Medicare Part D plans doesn’t have to feel like a solo quest through uncharted waters. With Suzie and Wenatchee Insurance as your trusty adventure guide, you’ll find the fastest routes, avoid the pitfalls, and maybe even have a few laughs along the way.

Whether you’re a swashbuckling adventurer or a cautious explorer, let Wenatchee Insurance help you uncover the treasures of Medicare Part D plans. Because with the right guide, the journey is just as rewarding as the destination.

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What Is The Difference Between Orginal Medicare And Medicare Advantage?

Posted on by Matt McColm
Medicare Advantage Prescriptions talk to Suzie at Wenatchee Insurance

When it comes to choosing between Original Medicare and Medicare Advantage, it’s kind of like deciding between a road trip along Highway 97 or hopping on a Greyhound bus tour through Eastern Washington. Both will get you where you need to go, but the experience can be quite different.

Original Medicare, the trusty old Ford wood paneled Station wagon of the Medicare world, offers Parts A and B. It’s like cruising along the Columbia with the windows down 55 miles an hour —simple with no air conditioning. You get hospital coverage with Part A and medical insurance with Part B, but you’re pretty much on your own for extras like dental, vision, or hearing aids. (Yes, Medicare does not cover everything). And just like a road trip, if you want snacks or souvenirs (prescription drugs), you’ll have to plan ahead and get yourself a Part D plan. If you skip Plan D at the start of your Medicare trip then you may have a late enrollment penalty.  

Now, Medicare Advantage (Part C) is the private bus tour with the tinted windows. Suzie from Wenatchee Insurance can guide you through the process like your seasoned tour guide. Medicare Advantage plans are offered by private companies and bundle Parts A, B, and usually D together, plus extra perks like gym memberships (perfect for keeping fit while exploring the Cascades or checking out the local wineries). Suzie can help you pick a plan that stops at all your favorite sights, whether that’s routine checkups or specialty care.

So, whether you’re a solo adventurer or prefer the all-inclusive package, Suzie has you covered. Just give her a call, and she’ll help you figure out which route is best for your Medicare journey.

health or medicare enrollment suzie makes it easier

Topics: health insurance, Medicare, Medicare Advantage, Suzie,  Chelan County, Okanogan, Grant County, Douglas County, 509, Leavenworth, Quincy, Cashmere, Entiat,

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What medications are covered under medicare prescription Drug Plans?

Posted on by Matt McColm
prescriptions cost money a medicare plan d can save medicare prescription

Understanding Medicare Part D Coverage: A Hilarious Adventure with Wenatchee Insurance

Navigating which medications are covered under Medicare Prescription Drug Plans (Part D) can feel like deciphering an ancient scroll written in hieroglyphics. But fear not! Suzie & Wenatchee Insurance is here to turn this daunting task into a hilarious adventure that’s as enlightening as it is entertaining.

talk with Suzie

The Treasure Map: The Formulary

The formulary is your treasure map, showing you which medications are covered by your plan. Each plan has its own formulary, which can vary widely. It’s like a map with X’s marking the spots where your gold (meds) is hidden.

Sample: “Imagine being a pirate with a treasure map. Each X marks a spot where your treasure (medication) is hidden. Some maps are better than others, so choose wisely!”

The X Marks the Spot: Tiers of Medications

Medications in the formulary are divided into tiers, with each tier representing different levels of cost. Think of it as a hierarchy in a medieval kingdom.

Sample: “Tier 1 is the peasant tier—affordable and plentiful. Tier 2 is the knight tier—costs a bit more but offers more benefits. Tier 3 and beyond are the noble and royal tiers—high costs for high benefits. Choose your allegiance!”

health or medicare enrollment suzie makes it easier

The Scroll: Reading the Formulary

Understanding the formulary is like reading an ancient scroll. You’ll see medication names, tiers, and restrictions like prior authorization or step therapy.

Sample: “Deciphering the formulary is like reading an ancient scroll. Some words are clear, others require a magnifying glass and a translator. But don’t worry, we’re here to help!”

The Gatekeeper: Prior Authorization

Some medications require prior authorization, meaning your doctor needs to get approval before the plan covers the medication. It’s like asking the castle gatekeeper for permission to enter.

Sample: “Prior authorization is like asking the castle gatekeeper if you can enter. Sometimes they’ll wave you through, other times they’ll demand to see your credentials (doctor’s approval).”

The Quest: Step Therapy

Step therapy is a process where you must try cheaper medications before the plan covers more expensive ones. It’s a quest where you must complete tasks to progress.

Sample: “Step therapy is like a knight’s quest. You must complete the first task (try a cheaper med) before moving on to the next challenge (getting the expensive med covered).”

The Allies: Preferred Pharmacies

Some plans have preferred pharmacies where you can get your medications at lower costs. It’s like finding friendly allies in different towns during your journey.

Sample: “Preferred pharmacies are your allies in various towns. They offer you safe haven (lower costs) and help you on your quest (managing your meds).”

The Dragon: The Donut Hole

Ah, the donut hole—the fearsome dragon guarding the treasure. It’s a coverage gap where you pay more out-of-pocket for your medications. But with the right plan, you can slay the dragon and move forward.

Sample: “The donut hole is the dragon in your story—scary and expensive. But fear not, brave knight! With Wenatchee Insurance’s guidance, you can slay the dragon and continue your quest.”

calling suzie for medicare or health insurance help

The Ultimate Prize: Catastrophic Coverage

Finally, after navigating the formulary, prior authorization, step therapy, and the donut hole, you reach catastrophic coverage. It’s the ultimate prize where your costs decrease dramatically.

Sample: “Catastrophic coverage is the Holy Grail of your quest. After facing all the challenges, you find your costs reduced and your treasure (meds) more affordable. Victory!”

Wenatchee Insurance: Your Quest Companion

Understanding which medications are covered under Medicare Prescription Plan doesn’t have to be a solo quest through treacherous lands. With Wenatchee Insurance as your trusty companion, you’ll have a guide, map, and ally to help you every step of the way.

So, if you’re ready to embark on this epic adventure, let Wenatchee Insurance lead the way. Together, we’ll turn the daunting task of understanding Part D coverage into a thrilling, victorious quest.

talk with Suzie
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How Do I avoid Late Enrollment Penalty for Medicare?

Posted on by Matt McColm
Medicare and Medicare Advantage help with suzie avoid late enrollment penalty

Avoiding Medicare late enrollment penalty is like making sure you’re not stuck in traffic on the George Sellar Bridge trying to pick up your kid at the mall—you want to plan so you don’t miss out (or have an upset kid!). The secret sauce is to sign up for Medicare on time, during your Initial Enrollment Period (IEP).

The Initial Enrollment Period is three months before your 65 Birthday, your Birth month, and then three months after your birthday. Seven months can seem like a long time but yes, we have encountered a fair number of people who have missed their IEP.

Suzie from Wenatchee Insurance is like your pocket navigator, guiding you to avoid any wrong turns. If you miss your IEP and don’t have other creditable coverage, you could face penalties when you enroll. The penalties do not go away and grow the longer you delay coverage.  

Late Enrollment Penalty Example

For example, for Part B, the late enrollment penalty is an extra 10% added to your monthly premium for each full 12-month period you were eligible for but didn’t sign up.

But here’s the fun part—Suzie trained to understand the shortcuts. Maybe you have employer coverage or are covered under a spouse’s plan? In these cases, you might qualify for a Special Enrollment Period (SEP), which is like getting a personal police escort across the bridge to make it on time.

health or medicare enrollment suzie makes it easier

Suzie can also help you figure out if delaying Medicare makes sense for your situation. Just like knowing when you can grab a coffee and when you need to get going, having Suzie’s advice will ensure you’re on time and on budget. For some people, it makes sense to start their Medicare Part A Coverage while others may want to delay their Part B.

Suzie with Wenatchee Insurance has been helping people in Washington State navigate the twists and turns of Medicare for over a decade. If you have been a long-time resident, you may have encountered her when she was a Pharmacy Technician in Wenatchee. She has people who have set appointments years in advance to do the change from healthcare to Medicare.

set appointment with Suzie
Home Health Medicare Car Dental Prescription insurance corndog

Topics: health insurance, Medicare, Medicare Advantage, wenatchee insurance, Suzie,  Chelan County, Okanogan, Grant County, Douglas County, 509, Leavenworth, Quincy, Cashmere, Entiat,

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Can Dreamers get health insurance in Washington state?

Posted on by Matt McColm
Dreams immigrant health washington suzie wenatchee

Who are Dreamers?

Today, Suzie & Matt are going to talk about Dreamers. The Deferred Action for Childhood Arrivals. The program was designed to provide temporary relief from deportation and allow people to legally work. There is about 16,030 Dreamers are in Washington State and there are probably more waiting.

Dreamer is not an easy process to achieve. There is an injunction in Southern District Court that prevents confirmation of new filings.  There is about another 100,000 applications in process. If you have not applied and meet the guidelines then filing could benefit you down the road

The website for U.S. Citizenship and Immigration Services goes into the details for Dreamer Status and has an online filing process. While we don’t do that at Wenatchee Insurance, we can talk about the insurance.

Immigrant Health in Washington

The important thing going on is the shift in Health Insurance for Immigrants.

In November 2023, Wenatchee Insurance started enrolling people into healthcare regardless of Immigration status. It is a great program that with a state-secure application grants access to the Healthplanfinder, Health Insurance, and monthly cost savings with tax credits.   

This was the largest group of uninsured in the state. They didn’t have access to a large group plan from an employer. They are students, stay-at-home parents, or even worked small businesses. At Wenatchee Insurance, we have advocated for immigrants to be covered for over a decade.

immigrant health washington wenatchee insurance

On July 1st, 2023, the Healthcare Authority Authorized the first 10,000 immigrants into the Apple Health Program. Those who were enrolled in other immigrant health programs or enrolled with a current plan went first and were under 158% of the poverty level. Yes, this is the regular Apple Health program level. It allowed people to get medical treatment and the providers to get paid promptly.

The next big change Dreamers:

CMS made a Final Rule in May to the definition of “lawfully present” for those who qualify for a health plan.  

If you are a Dreamer or a DACA recipient and other newly eligible individuals you will qualify for a Special Enrollment on November 1st, 2024, and have a plan on the Healthplanfinder starting as early as December 1st.

This will provide Dreamers access to Federal Advanced Premium Tax Credits which will lower their Healthcare costs further. If you have a current plan and are only using the state credits, then the application will have to be adjusted.

If you do not have health insurance, then we want to run the application, and you can have Healthcare before Christmas of 2024.

Set an appointment early as the Health Open Enrollment runs from  November 1st through December 15th for plans that start January 1st, 2025.

There is an additional enrollment period of December 15 through January 15 for plans starting February 1st.

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How Much Does Dental Insurance Cost in Washington?

Posted on by Matt McColm
Dental Insurance Wenatchee

Alright, let’s talk about the million-dollar question—well, hopefully not literally. “How much does dental insurance cost?” It’s a question that keeps people in North Central Washington up at night, somewhere between worrying about deer in Grandma’s flower garden and whether The Wild will have a winning hockey season. At Wenatchee Insurance, we get it.

First things first: the monthly premium. This is the amount you’ll pay each month, kind of like your subscription to that jam-of-the-month club. Except this time, it’s your teeth getting the care they need. Depending on your plan, premiums can range from about $15 to $75 a month. It’s like choosing between the extra-large caramel apple from the Grant County fair or just a bag of organic Fuji apples—both will cost you, but which one will make you feel better about your choice? Freedom is important.

Deductibles and Co-Pays

Next, we have deductibles and co-pays. If you’ve ever had to pay to park at Leavenworth during Oktoberfest, you know what these are. A deductible is what you have to pay out-of-pocket first before your insurance kicks in, and co-pays are the little bits you pay each time you visit the dentist. Imagine going to the local cider mill and having to pay a few bucks just to get in—that’s your co-pay. Most deductibles range from $50 to $150 annually, while co-pays can be $10 to $20 per visit for most plans.

Delta Dental has options.
October is when we can offer next year’s plans.

Funny Example

Take our pal Farmer Fred from East Wenatchee. Farmer Fred figured he’d save some dough by skipping dental insurance altogether. After all, how bad could it be? Well, that was before Farmer Fred’s epic caramel apple incident last Halloween. One crack of that candy-coated delight and Farmer Fred was down two teeth and up several thousand dollars in dental bills. Now, Farmer Fred’s a dental insurance convert, paying his monthly premiums like clockwork, and sticking to softer treats—like apple pie.

Major Work: Crowns, Implants, and More Dental Insurance

For major work, the cost can be higher. We’re talking crowns, root canals, and implants—like if you decided to replace your old beater with a brand-new truck. The insurance might cover 50% to 80% of the cost after your deductible, leaving you to pick up the rest. These are the services that often have waiting periods. But trust us, it’s a lot better than footing the entire bill yourself.

Protip: Be aware of plan dollar maximums per person per year. This is the amount that the insurance plan will help with before wandering off to the next year. Some plans have them and some do not.

While we do a lot online at Wenatchee Insurance, we especially like to go over coverage with clients. We have some new clients that want to shop by brand name not realizing there can be significant differences for each product. We have encountered people who didn’t realize they had current coverage and others who did not know there was an add-on available from their insurance plan.

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Topics: health insurance, Dental, Medicare, Implants, Braces, Bridge, Delta, Ameritas,  Dentures, Lifewise, Cavity, Suzie,  Chelan, Okanogan, Grant, Douglas, 509, Quincy, Cashmere, Entiat,

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