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Should Medicare Offer Basic Dental Coverage?

Nov 16, 2016

By Dean George

Oral health professionals have argued for years that Medicare should offer a bundle of preventive and diagnostic dental services for seniors since they have to pay more out-of-pocket for dental care than any other age group.

In 2012, seniors with traditional Medicare on average spent $737 out-of-pocket on dental care, but that figure is much higher for seniors needing major care, according to Tricia Neuman, director of the Program on Medicare Policy at the Kaiser Family Foundation.

“There are 250,000 people every month that are turning 65, and 30 percent of dentists say they could use more business,” said Beth Truett, president and CEO of Oral Health America. She added that those demographics constitute “a perfect storm” and make this a good time to revisit adding dental benefits to the Medicare program.

Many oral health professionals have been arguing for health plans to help seniors for years but the issue has been bumped repeatedly to the back of the waiting room because of other senior health needs.

In 2006 Medicare was expanded to include prescription drug coverage. In 2010 preventive services were added as part of the Affordable Care Act in an effort to treat health problems before they became life threatening and more expensive.

Is it finally time to address the needs of seniors struggling with oral health issues?

The American Dental Association (ADA) has reported that low-income seniors are especially struggling. According to an ADA analysis of federal data, more than one-third of low-income seniors below 200 percent of the federal poverty level (roughly $23,000) had untreated tooth decay between 2011 and 2014.

Seniors with limited incomes and no coverage are more likely to skip regular dental visits, even if they are having trouble biting and chewing their food. They are also more likely to avoid social interaction if they have missing or damaged teeth.

Medicaid, the state-federal program for low-income people, only provides limited dental care for adults. Eight states offer no adult dental benefits at all.

As previously reported in Dental Wire, mobile dentist offices and non-profit organizations do provide dental care for seniors in some geographical areas, but there remain large swaths of the country with limited or no access to dental care for seniors or others needing dental care.

That is why dental professionals like Dr. Judith Jones, a professor of dentistry at Boston University, and others are advocating for a Medicare expansion that will add a dental benefit to Medicare Part B.

Dr. Jones and countless others propose increasing Medicare Part B premiums and bundling diagnostic and preventive oral health services as part of Medicare’s basic health coverage. Those Medicare beneficiaries requiring major procedures like crowns, bridges and root canals would only be responsible for copayments on the more expensive restorative treatments.

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Copyright 2016, Bloom Insurance Agency, LLC 

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