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Why do health plans not include dental issues?

Yes, there is an historical reason. Several, in fact. Fundamentally it comes down to the nature of the way in which dentistry has evolved and in the continued autonomy of the dental profession (including education, licensure and regulation).The short answer is that the study of the diagnosis, prevention and treatment of diseases of the mouth and associated structures is a specialty that is entirely separate from any other, including medicine, in the U. S. While dentists are most certainly Doctors of Oral Health / "Doctors of Dental Surgery" (Or Medical Dentistry), their training is provided in dedicated dental schools. This is necessary, given the unique combination of oral science and craft needed to perform dental tasks. Furthermore, dental professionals rarely, very rarely, practice in hospital settings. The typical practice setting is that of a small independently owned and operated business.Dental science and education evolved, more or less autonomously from the practice of medicine. When one studies to become a dentist, one generally obtains a 4-year scientific degree first (similar to pre-med), say, in biology, or something similar and then goes to dental school for 4 years. If the practitioner decides to specialize, additional schooling may be required (for example, to become a Board-Certified Orthodontist or Oral-Maxillofacial Surgeon).Dental licensing is completely separate from medical in all ways. It is handled by dental licensing boards at the state and at the federal level. Dental education is similarly regulated. There are a defined number of accredited dental schools and they have been relatively static over the past few decades (although some schools have closed in the last couple of decades).Dental practitioners are trained and generally do, once out of school and licensed, work in a "solo or small group practice" business model. They have no common affiliation with hospitals or MDs. (There are exceptions, such as pediatric dentist and others that may need access to OR resources upon occasion.) This makes for the need for a separate financing of dental benefits in the U. S.Dental insurance in the U. S. really began in earnest (with a few exceptions) on the West Coast beginning around 1954 when, at the urging of labor unions, organized dentistry in WA, OR, and CA formed what was to later become the Delta Dental system to aid in the provision of employer-sponsored dental benefits. These early Dental Service Corporations were created by the Washington Dental Association, the Oregon Dental Association and the California Dental Association and were known as Washington Dental Service, or WDS and, similarly, ODS and CDS respectively. Today, companies within the Delta Dental system are estimated to provide dental benefits to more than one-third of the Americans with coverage. This statistic is an important one for also explaining why "dental services are not covered by 'Health Plans'". When dental benefits are provided, they are often provided on a stand-alone basis, that is, by a separate 'dental specialty' plan--especially for large and jumbo employers.In 1965, an estimated 1.7% (3.3M) of the U. S. population was covered by dental benefits (insurance). By 2010, an estimated 175.6M, or 56.9% of the population was covered by dental benefits.The U. S. health / hospitalization insurance industry developed along a different trajectory than did dental and can best be viewed through a post-WWII lens.In 1940, enrollment in group hospital plans was about 9% of the civilian labor force.Although some of the earliest records of coverage for health services in the back to 1798, modern employer-sponsored health care has its roots in thewartime economy of World War II. Because of the shortage of labor and materialsduring the war, wage and price controls were enacted, thus holding wages and pricesartificially low and further exacerbating the shortage of labor and materials. Facedwith labor shortages and unable to offer higher wages, employers began to offer freemedical insurance to workers as a substitute for higher wages. This was the way themarket chose to respond to the wartime economy and government intervention,albeit, a necessary one, which had created such severe shortages.After wage and price controls were lifted, it might have been unnecessary to providemedical benefits to attract workers. Employers could have just paid a highermonetary wage. Instead, many continued to offer health care benefits as a way to compete forlabor talent. One likely reason for the continuance of employer-provided benefitsstems from Congressional action in 1942 that exempted expenses foremployer-sponsored health care from taxation. And, the growing strength of labor unions gaveworkers more bargaining power and a tax-free, employer-sponsored health programbecame a common concession.--Dental Benefits, a Guide to Managed Plans, 3rd Ed pp 1. Cathye L. Smithwick Author.It should also be mentioned, that dental procedure (and thus) billing codes are entirely separate from medical and require a licensed dentist to review them for insurance purposes. These codes - known as Current Dental Terminology, or CDT - are owned by the American Dental Association. Health plans wishing to offer dental benefits often do so, but when they do, it will be either through expanding their own capabilities in this area, such as Cigna and Aetna have done, or by outsourcing the provision of dental benefits to specialty firms. The latter may or may not be obvious to consumers.What health plans cannot do, for the obvious legal and professional reasons is to mix coverage of dental procedures with medically covered ones. The infrastructure necessary to support the coverage on the health (really the medical) side, does not include that which is necessary to support the provision of dental care services. There are exceptions to this, however, such as when reconstruction is needed due to, say, an auto accident, but this would be a special case.Cathye L. Smithwick, RDH, MADental Hygienist for >4 decades; Health Economist & ConsultantAuthor: Dental Benefits, a Guide to Managed Plans, 3rd Ed

What are the pros and cons of going active duty or Army Reserve?

Q: What are the pros and cons of going active duty or Army Reserve?A: I am qualified to answer this! I went US Army Reserve under the mistaken impression that it would be one weekend a month and two weeks a year. Instead, during my thirteen years as a Reservist, I spent more than half my time on active duty.Edit: I have updated with suggestions from Steve Yi in the comments.Active Duty vs. Reserve DutyActive Duty =AReserve Duty = RAge RequirementsA: Be between the ages of 17-42 years.R: Be between the ages of 17-42 years.Note that returning service members can actually come in after the 42 years of age cut-off. Subtract your years of service from your age. If that number is in the range, then you could possibly get back in. This is limited by open spots for prior enlisted.Length of ServiceA: 2-6 year commitment/Serve a total of 8 years in the military *Including Inactive Ready Reserve serviceR: 1-6 year unit commitment/ Serve a total of 8 years in the military *Including Inactive Ready Reserve serviceRetirementA: May Retire after 20 yrs. of qualifying service. Once eligible, you start receiving your pension the day after you level the military.R: Modified retirement possible after 20 yrs. of qualifying service. Once eligible, you will wait till age 60 to start receiving your pension. The start of your pension can be reduced 3 months for every of 3 months of Active service.Another note is “double-dipping” as some governmental agencies allow for multiple pensions. My ex was a California Highway Patrol officer. He got a California pension as well as his US Army retirement.Job ChoicesA: 200 jobs to choose fromR: 180 jobs to choose fromMedical / Dental BenefitsA: Full Medical and dental benefits.Active duty service members pay nothing out-of-pocket.Active duty family members pay nothing unless using the point-of-service option.All other beneficiaries pay annual enrollment fees and network copayments.R: Medical and dental benefits when on active duty *See my comments about medical care I received while on “Active Duty”. In the reserves you can purchase medical insurance.Low Cost Health, Dental, & Life InsuranceAll eligible members of the Selected Reserve may qualify to purchase coverage under TRICARE Reserve Select (TRS). You must be a member of the Selected Reserve or the Ready Reserve, and you cannot be eligible for or enrolled in the Federal Employee Health Benefits (FEHB) program (or currently covered under FEHB).You’ll pay a monthly premium for health care coverage, just like most civilians do in their employer’s health care plans. The monthly premiums are:$50.75 for TRS member-only coverage*$205.62 for TRS member and family coverage*Job training opportunitiesA & R: Specialized job training (AIT)Note that some schools are run for Reserve vs. Active components only. In general you will get the same training. If you do go to a reserve component only course, it will likely be shorter and cover items in less detail.A: Once you start gaining rank, there are additional schools that provide greater leadership and technical training. Active duty almost everyone goes to these.R: Only a handful of reservists are sent to the senior MOS courses. It a combination of their SM being too busy in their regular jobs or there not being money available to send them.Location of dutyA: May be stationed at home or on foreign soil. Potential for selecting assignment.Active duty service members are often granted basic choice in where they will be stationed after recruit training and military occupational specialty school - called Advanced Individual Training (AIT) for Army Soldiers. Active duty enlistees can be stationed anywhere within the United States or abroad depending on the duties and mission of their respective unit.It’s basically up to one guy in charge of your MOS and rank to decide where you go, if you can get in good with that person you can go anywhere you want to go as long as there is an opening. Once you’re pretty senior you can start shopping units on your own.R: Stationed at home unless called to active duty. When called to active duty, activating unit makes choice.Reserve status members will be stationed near their home and only be subject to international station in the event they are called for active duty. If the Reserve Unit is more than 100 miles from their home, they might qualify for individual drill training. This must be approved in advance.If you plan ahead and contact your unit of choice. If they like you, you can arrange to have orders assigning you to that unit. And you can stay put as long as you do a good job. Just like Active duty, you deploy when your unit does. But, If you want to deploy more often you can find volunteer opportunity for Individual Augmentees.Work ScheduleA: Serve 5 days a week. *Typically. Not 100% across all jobs. Some are 4/10s.R: Serve one weekend a month and two contiguous weeks a year. *Unless called to active duty. Then active unit orders will determine work schedule.Vacation & LeaveA: 30 days military leave per year (paid vacation)R: Paid vacation only if you are on extended active duty. Key here - extended active duty.Social & Recreational ProgramsA: Unlimited access to all military Morale, Welfare and Recreation (MWR) facilities or programsR: Unlimited access to all military Morale, Welfare and Recreation (MWR) facilities or programs. *In theory. I personally have been turned away while I was a reservist. I was asked for my Active Duty orders before they would allow me access. Likely not per regulation, just because they said … Meh.Education BenefitsA: Educational benefitsThe Federal Perkins Loan Program allows you to cancel your current student loan debt if you have served on active duty in a combat situation.The College Loan Repayment Program will repay part of your current student loans.The Concurrent Admissions Program (ConAP) allows you to earn college credit towards your degree while you serve in the Army or Army Reserve.The Military Spouse Education And Career Opportunities (SECO) program will allow your spouse access to tuition funding, free career counseling services, and employment readiness tools that he or she can use to get an education.MONTGOMERY GI BILLThe Montgomery GI Bill provides education benefits to veterans and service members who have served at least two years on active duty. Montgomery GI Bill can be used to pay up to full tuition for numerous schooling programs, including college, technical school, and flight school. Benefits are generally payable for 10 years following your release from honorable military service.THE POST 9/11 GI BILLThe Post 9/11 GI Bill is open to members of the U.S. Military who began their service after Sept. 10, 2001. Can earn full tuition to the college of your choice for up to 36 months, plus a monthly housing allowance and a books and supplies stipend of up to $1,000 per year.R: Some Educational benefits.The Selected Reserve Montgomery Bill (SR-MGIB) provides Army Reserve Soldiers with cash to put toward college tuition.The Army Reserve Montgomery GI Bill “Kicker” is extra money eligible Army Reserve Soldiers can add on top of their Selected Reserve GI Bill benefits.The Reserve Education Assistance Program (REAP) provides educational assistance to Army Reserve Soldiers called to active duty in response to war or a national emergency.Under the Loan Repayment Program (LRP), the Army will repay 15 percent of the outstanding principal balance on your student loan or $500 per year (whichever is greater) after you spend a year in service.With the Tuition Assistance program, the Army will pay $250 per semester hour of college credit.The Concurrent Admissions (ConAp) program allows you to earn credit towards your college degree while serving in the Army or Army Reserve.The Minuteman Scholarship allows high school and college students to receive full tuition or $10,000 in room and board in return for a service commitment.Commissary PrivilegesA: Unlimited post exchange and commissary privilegesR: Unlimited post exchange and commissary privileges. *Commissary cards used to be issued with punch blocks for your visits. Several of the bases that I went to changed that to unlimited visits and only required a Reserve ID. But it could be limited to 24 visits per year.Physical RequirementsA: Physical training 3-4 times a weekR: Responsible for maintaining your own physical fitness (you will be tested twice a year)The physical standards are the same. The APFT tests are administered using the same scale: Military pay is governed by time in as well as rank. Example: An officer of rank O-2, with over 4 years of service would be paid $4,643.74 per month.Military Pay Charts for Active DutyR: National Guard and Reserve perform a minimum of one weekend drill per month, and two weeks per year of active duty for training. Compensation for drill is monthly Drill Pay, equal to one day's active duty base pay for each drill period. There are four drill periods in one weekend drill.*Based on 2014 military pay tables.**Pay for Private (E1) will be slightly lower for first four months of service.*Based on 2014 military pay tables.OtherA: If you are active duty you have job security, you are guaranteed a job for the length of your contract. If you want to stay in longer, as long as you don’t have a bar to reenlistment and the position is available, you can generally stay.Military Involuntary Separation Pay Rules & EligibilityIf you were discharged from active duty and received Special Separation Benefit or Voluntary Separation Incentive, read about VSI/SSB Recoupment before you consider applying for retirement.You will be required to repay the full gross VSI/SSB paid to date.Special Separation Benefit (SSB)Voluntary Separation Incentive (VSI)VSI/SSB RecoupmentDisability Severance PaySeparation with disability severance pay occurs when the Soldier's unfitting disabilities are determined by the Army to be service connected, the Soldier has less than 20 years of service as computed under 10 USC 1208, and the Soldier's combined disability rating assigned to the unfitting disabilities is less than 30 percent. Separation without entitlement to disability benefits occurs when the unfitting disabilities are determined to be non-service connected without permanent aggravation or incurred due to misconduct.Prior to January 28, 2008 members were required to have at least 6 months of service to qualify for discharge with severance pay. This rule no longer applies.Calculation and PaymentDisability severance pay is a one-time lump sum payment. The amount of the payment equals 2 months basic pay for each year of service not to exceed 19 years. Additionally, a minimum number of six years will be used for calculation purposes. Prior to January 28, 2008, a maximum of 12 years and minimum of three years creditable service was used.R: Soldiers of the Ready Reserve with 20 qualifying years and Soldiers of the Selected Reserve with 15 qualifying years with a disability disposition of separation with or without severance pay have an additional election in lieu of being separated.Final note:An Honorable discharge is actually a good thing in the civilian market. But should you get a Dishonorable Discharge, you will likely have problems finding employment as many companies will not hire someone if they have a dishonorable discharge. If you get an other than Honorable Discharge, you will likely have problems as well._______________________________________________________I got to “BE Active” but NOT “BE Active” at the same time. When I was mobilized, I was not given orders for more than twenty nine days at a stretch. The orders would be issued back to back, with a day in between so as to prevent me from being able to claim active duty benefits.As a reservist, I had to have a civilian job at the same time. Reserve pay did not pay the bills when I was not activated. Yet it was difficult to keep a job because I was constantly gone. Yes, I was protected by the Soldiers & Sailors Leave Act. No it didn’t matter.When on duty, if I was injured, I encountered lots of problems trying to get medical care. They would see me, with my orders. I had to fight to get my LOD *line of duty* form to prove that I was injured while on duty. If I did not get that piece of paper, I could not then get follow up care. EVEN with that piece of paper, getting follow up care was difficult. At the VA, as a Reservist, I was on the BOTTOM of the care priority list. I broke my leg on active duty - and was refused care at VA centers for a year. I basically did not work for several months because I could not walk. If I did, I would injure my leg even more.That priority list always seemed insurmountable for receiving care. Instead I went to civilian doctors and paid out of my own pocket because insurance doesn’t cover it either.You might think I was unhappy as a reservist. But that is not true. I would have gotten my 20 years had my husband not talked me out of staying. I loved every minute of it. I likely would have had an even better time as active. But who knows? I was a reservist, and I will never regret it.Priority Groups - Health BenefitsPriority Group 1Veterans with VA-rated service-connected disabilities 50% or more disablingVeterans determined by VA to be unemployable due to service-connected conditionsPriority Group 2Veterans with VA-rated service-connected disabilities 30% or 40% disablingPriority Group 3Veterans who are Former Prisoners of War (POWs)Veterans awarded a Purple Heart medalVeterans whose discharge was for a disability that was incurred or aggravated in the line of dutyVeterans with VA-rated service-connected disabilities 10% or 20% disablingVeterans awarded special eligibility classification under Title 38, U.S.C., § 1151, "benefits for individuals disabled by treatment or vocational rehabilitation"Veterans awarded the Medal Of Honor (MOH)Priority Group 4Veterans who are receiving aid and attendance or housebound benefits from VAVeterans who have been determined by VA to be catastrophically disabledPriority Group 5Nonservice-connected Veterans and noncompensable service-connected Veterans rated 0% disabled by VA with annual income below the VA’s and geographically (based on your resident zip code) adjusted income limitsVeterans receiving VA pension benefitsVeterans eligible for Medicaid programsPriority Group 6Compensable 0% service-connected VeteransVeterans exposed to Ionizing Radiation during atmospheric testing or during the occupation of Hiroshima and NagasakiProject 112/SHAD participantsVeterans who served in the Republic of Vietnam between January 9,1962 and May 7,1975Veterans of the Persian Gulf War who served between August 2, 1990 and November 11, 1998*Veterans who served on active duty at Camp Lejeune for at least 30 days between August 1, 1953 and December 31, 1987Veterans who served in a theater of combat operations after November 11, 1998 as follows:Currently enrolled Veterans and new enrollees who were discharged from active duty on or after January 28, 2003, are eligible for the enhanced benefits for five years post discharge.**Combat Veterans who were discharged between January 2009 and January 2011, and did not enroll in the VA health care during their five-year period of eligibility have an additional one year to enroll and receive care. The additional one-year eligibility period began February 12, 2015 with the signing of the Clay Hunt Suicide Prevention for America Veterans Act.Note: At the end of this enhanced enrollment priority group placement time period Veterans will be assigned to the highest Priority Group (PG) their unique eligibility status at that time qualifies for.*Note: While eligible for PG 6; until system changes are implemented you would be assigned to PG 7 or 8 depending on your income.*Note: While eligible for PG 6; due to system limitations, Veterans will be manually assigned to Priority Group 8c, yet eligible for the enhance benefitsPriority Group 7Veterans with gross household income below the geographically-adjusted income limits (GMT) for their resident location and who agree to pay copaysPriority Group 8Veterans with gross household income above the VA and the geographically-adjusted income limits for their resident location and who agrees to pay copaysVeterans eligible for enrollment:Noncompensable 0% service-connected:Subpriority a: Enrolled as of January 16, 2003, and who have remained enrolled since that date and/or placed in this sub priority due to changed eligibility statusSubpriority b: Enrolled on or after June 15, 2009 whose income exceeds the current VA or geographic income limits by 10% or lessNonservice-connected and:Subpriority c: Enrolled as of January 16, 2003, and who have remained enrolled since that date and/or placed in this sub priority due to changed eligibility statusSubpriority d: Enrolled on or after June 15, 2009, whose income exceeds the current VA or geographic income limits by 10% or lessVeterans not eligible for enrollment:Veterans not meeting the criteria above:Subpriority e: Noncompensable 0% service-connected (eligible for care of their SC condition only)Subpriority g: Nonservice-connected

What are some super practical actions one should take in their first 30 days as a Canadian resident?

Here are 31 things you should do, in no particular order:Get your OHIP (Ontario Health Insurance Plan) sorted out. Or the health plan of which ever province you are moving to. Note that it takes at least 3 months to get it so you may consider getting private insurance while you wait.Get your driving license. Hire a private driving instructor to train you, even if you have decades of experience. Road rules are different here (sometimes weird)Research the best schools in your city and enroll your kids. Fraser Institute is trusted with their annual school rankings report.Get a Presto card for commuting while you get your license sorted out. You can use it on local transit and GO trains and buses. Tap on and off you go.Understand how price matching at groceries works and start doing it. You will experience very quickly that customer service in Canada rocks! And it’s a shame to see how some people abuse it.Get a membership at COSTCO. Big savings on bulk grocery shopping. Helpful for big and small families. Just make sure you have cleared out some space for those massive jars and containers.Open up a bank account. RBC have a great newcomers deal where they patiently explain the whole process and new banking terminology to you (“Fixed Deposits” are called “Guaranteed Investment Certificates” for example). TD bank have a great app called My Spend which automatically tracks and categorizes your spending. Handy for the thrifty.When you get a credit card USE IT. Don’t use your debit card unless you have to. When you pay off your credit card on time it improves your credit score which will be important for you later when buying/renting homes and cars.If you have kids, apply for Child tax benefits to get generous income from the government to support your kids (O Canada!)Got big savings from your home country? Plan to save to a Registered Retirement Savings Plan (RRSP). You get a great tax return when you do this. But be careful as there is a limit as to how much you can put in here. When your limit is reached out the rest in a Tax Free Savings Account (TFSA). There is a retroactive limit on this as well from the year you landed. Careful you don’t crossover the limit on both RESPs or TFSAs else you will get a letter from the CRA that you owe extra taxes on it. Talk to your bank to be sure of your limits. The interest you generate from these savings is tax free so it’s definitely worth looking into.Want to save for your kids university education? Look into opening Registered Educations Savings Plan (RESP) to also get government grants to your child’s education.Staying at an AirBNB? Find a realtor to get you the best deals on a house to rent (for now). It doesn’t cost you anything. They will get their commission from the landlord.Too busy unpacking to cook? Register with Uber Eats or Skip The Dishes app to order in. It will help you scan restaurants in your area that suit your palette.Planning a direct flight back to your home country on Air Canada? Don’t forget to sign up for the Aeroplan rewards program to rack up those miles.Choose a car and find three dealerships that sell it. Bargain for the best deal. Don’t be fooled by “No interest loans”. There is no such thing as no interest. They build the interest into the price.Once you have a car, make sure you get road side assistance. CAA is popular, although my credit card also gets me access to my banks outsourced road side assistance service.Research on the best deals for your car insurance. Insurance depends on risk factors tied to your age but also where you stay. Brampton has the highest car insurance rates. Being a new driver in Canada will also pinch your pocket. TD bank have an app called TD My Advantage that tracks your driving habits and discounts your premiums with them, based on how you score in your driving.Buy winter tires. Recommended over all season tires. It’s a hassle to change on and off twice a year, but it’s worth it. Else you will discover how dangerous driving on the snow is the hard way. Find a local tire shop instead of the dealers to get a better price. If your car supports it, I’d recommend getting tire pressure sensors as well for the winters. Once again, the small tire shops will give you a better deal on the sensors. In Brampton, I use Tipples Tire Service & Sales. Great service.If possible, wait till Black Friday (End of Nov) or Boxing Day (Dec 26) to buy things like furniture and appliances. Super big massive sales at this time.Rogers, Bell and TELUS are the big telecom companies here. There are cheaper alternatives. I suggest going for quality and use them to supply your mobile, internet and TV needs if you want reliable services. You get what you pay for. It is generally known that telco is comparatively expensive in Canada.Start learning hockey, baseball and basketball. Else you will feel clueless and left out of many Canadian conversations.Buy a good winter jacket. Be prepared to spend a little extra here. Get the boots and gloves too. I love my Canada Goose jacket and Columbia boots.Join a local Facebook group that is linked to your area. Great source to get advice from real people. For example I stay in Brampton, and my wife is part of a group called “Brampton Moms”. Use the group to get advice and referrals on anything you need. And contribute as well. Give and take.Find and register with a family doctor. Use your Facebook group to ask for good doctors around.Find a good dentist. Dental is not covered by government health care so you must take care of those pearly whites. The dentist I go to schedules and consistently reminds me about my check ups. Get dental insurance (through your company or otherwise) and fix everything wrong with you and your family’s teeth NOW before it gets worse. Else you may end up spending 1000s over your private insurance limit. I personally know people who suffered this way.Register for an online CRA account so you can receive tax notifications digitally. Online self serve tax tools like Turbo tax can automatically pull your tax details from it, making filing your taxes a breeze.Watch out for fake messages from the CRA warning you that you owe money. “Click here or call back to fix your problem else you will owe a lot of money”. Those messages are all fake targeting innocent newcomers. Ignore any and all forms of messaging (sms/email/calls) where they ask you for money, bank details or SIN number.Setup your Interac e-transfer with your online banking mobile app. This allows you to send money to people by just using their email address. It’s a very popular way of transferring money between friends and even some small businesses.Moving to a house? Be sure to setup online accounts with Hydro (for electricity), Enbridge (for gas) and Regional Water and Wastewater (Water and Sewage). Or which every company is locally providing these utilities. Bills can be paid easily from your bank using online mobile banking.Keep your original confirmation of landing document that they stamp at the border safely. Don’t think that your PR card replaces it. You will need to show it for your citizenship test and ceremony.Make sure you get a good Carbon Monoxide detector. If you live in a house, your furnace is a source of CO, and a leak is silently fatal.What about your job?!?!?That’s a massive discussion on its own.Click this link to learn how you can get more job interviews in Canada without applying for 50 jobs a day. It’s how I got three job offers just two weeks after landing in Canada, without local experience, qualifications or a social network.You won’t get this advice at settlement services ;)So feel free to share this with someone you know is stressed out about moving to Canada. They’ll love you for it.

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