Medicare May Expand Access to Dental Benefits, But Not All Dentists and Insurers Agree

WASHINGTON — A hearing held by the U.S. Senate Special Committee on Aging centered around whether to expand Medicare to cover eyes, ears, and teeth, a proposal from Senate Democrats that could possibly cost over $359 billion over a decade. 

“While these programs recognize the value of dental, hearing, and vision in keeping people healthier longer, their coverage is inconsistent, and not nearly robust enough. In order to achieve the best possible health outcomes, and the greatest value, Medicare should cover the entire person, from head to toe,” said Joanne Grossi, president of the American Association of Retired Persons.

A recently released Kaiser Family Foundation report analyzes dental coverage and costs for people with Medicare, showing that many people enrolled in Medicare go without dental care, especially beneficiaries of color. 

According to the data, almost half of all Medicare beneficiaries had not visited a dentist within the past year, with higher rates among those who are Black, or Hispanic. Rates were also higher among those who have low incomes or who are in fair or poor health.

One reason Medicare beneficiaries do not seek care is a lack of insurance, as nearly half of all people with Medicare( 47%) do not have dental coverage. 

Twenty-nine percent of those who do have coverage get it through Medicare Advantage, 16% through private insurance and 8% through Medicaid.

“Medicare should cover dental care, vision care, including eyeglasses, and hearing care, including hearing aids. Medicare beneficiaries want, need and deserve these services and are often surprised when they learn Medicare doesn’t cover them. It is time for Congress to take action to add in these essential benefits,” said Grossi. 

Key members from the American Dental Association seem to have a different plan in mind, as they would rather Medicare services be expanded under a separate new program for low-income seniors, and available only to those whose income is up to 300% of the federal poverty level, according to a letter from the ADA President Dr. Daniel Klemmedson. 

However, estimates from the Kaiser Family Foundation show this would cover only 47% of the older adult population.

The America’s Health Insurance Plans, a trade association of health insurance companies known for certification of Medicare Advantage and other health plans governed by CMS, issued a statement that benefits such as free transportation or over-the-counter drugs could be limited by any expansion.

Congress will continue to consider in the coming months whether creating a benefit standard for dental, hearing, and vision under Medicare should be included under the $3.5 trillion budget reconciliation package.