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Movement Grows to Add Dental Coverage to Medicare

December 19, 2019 By Barry Crimmins

Medicare does not offer much in the way of dental benefits. To get dental coverage, you need to purchase separate and often costly dental insurance or sign up for a Medicare Advantage plan that includes dental care. Advocates for Medicare beneficiaries are arguing for a change. 

Common dental procedures or supplies, such as cleanings, fillings, tooth extractions, dentures, dental plates, or other devices are currently not covered. Medicare Part A, the insurance for inpatient hospitalizations, will cover certain emergency or necessary dental procedures that are received in the hospital. For example, if you are hospitalized after an accident and require jaw reconstruction, Medicare Part A will pay for the dental work required as part of that procedure. In addition, Medicare Part A specifically covers oral examinations for patients who are in the hospital to receive a comprehensive workup for a kidney transplant or heart valve replacement.

Many Medicare Advantage plans offer dental coverage, but Medicare Advantage plans vary widely in what is covered and how much it costs. In addition, because Medicare Advantage is managed care, only certain providers are covered under each plan, and beneficiaries may need prior approval before receiving care. 

According to the Kaiser Family Foundation, most Medicare beneficiaries do not have dental coverage and go without care even though studies show there is a link between good oral health and good overall health. To take just one example, many infections can enter the body due to ongoing inflammation in the mouth and lead to more inflammation in other parts of the body like the heart. Kaiser also found that among Medicare beneficiaries who used dental services, the average annual out-of-pocket spending on dental care was $922.

The lack of coverage for oral health has prompted some groups to advocate for improving dental coverage for Medicare beneficiaries. Justice in Aging, a legal advocacy group fighting senior poverty, argues that adding oral health coverage to Medicare Part B would be the simplest and most cost-effective way to give all seniors dental benefits. The U.S. House of Representatives has passed a bill that would do just that, but it is unlikely to be taken up by the current Senate. Another possibility would be to add a separate optional dental benefit under Medicare, like the prescription drug benefit. 

For more information about the different options for improving dental coverage, click here.

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Elder Law News, October 2023

Getting older comes with opportunities and challenges, but fear not, we have your back! Are you concerned about Alzheimer’s? While there’s no known cure, proactive steps can help with prevention. Meanwhile, guess what? Signing up for Medicare Savings Programs just got simpler! The Feds have streamlined the process, making it easier to tap into helpful benefits.

Elder Law News, July 2023

Looping our readers in on the issues that impact the senior community is always a priority. And this month, there’s much to share.

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Elder Law News, June 2023

As a trusted counsel for all things relating to eldercare in Massachusetts, I wanted to share pressing topics impacting our beloved seniors.

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Elder Law News, March 2023

As the generation of Baby Boomers ages, many are finding their adult children aren’t in the financial position to provide support if long-term care is needed.

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As the generation of Baby Boomers ages, many are finding their adult children aren’t in the financial position to provide support if long-term care is needed.

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