Proposed coverage for dental, visual and hearing care in Medicare


From the NYTimes

Poor oral health is associated with higher rates of diabetes, cardiovascular disease and pulmonary infections. Federal data shows that 19 percent of older adults have untreated tooth decay and another 19 percent have complete tooth loss.

Two-thirds of all people on Medicare don’t have dental coverage. Coverage for dental, visual and hearing care has moved to the front burner in 2021 as part of a broader discussion about Medicare expansion in Washington. Adding coverage for all three was proposed as part of the federal budget. Currently, 43 percent of patients in Medicare Advantage dental plans face annual dollar caps, typically around $1,000. 

Commercial dental care plans also have limitations, for example, a 66-year-old resident of New York City could choose between a basic ($24 per month) or premium ($48 per month) Delta Dental P.P.O. plan, both with a $50 annual deductible. The basic plan pays a maximum of $1,000 per year in care and the premium plan $1,500.

“The expense lies in restorative care, which is why plans are imposing an annual dollar cap on coverage.” For example, the median cost across the United States last year for a root canal and crown, extraction of four teeth and a partial upper denture was $4,800. The median cost for a patient needing periodontal treatment, three fillings and two crowns was $4,360.

Only 27 percent of low-income Medicare beneficiaries had visited a dentist in the previous 12 months, compared with 73 percent of high-income beneficiaries. In 2016, 71 percent of Black Medicare beneficiaries did not visit a dentist in the previous year; nor did 65 percent of Latinos.

References:

https://www.nytimes.com/2021/06/09/business/medicare-dental-work-bill.html