Medicare Part B Offers a Way Forward for Dental Coverage

In July, Families USA joined the American Dental Association, Oral Health America, Center for Medicare Advocacy, Justice in Aging, DentaQuest Foundation, Santa Fe Group and other industry leaders, in releasing An Oral Health Benefit in Medicare Part B: It’s Time to Include Oral Health in Health Care, a white paper on the need for Medicare to include dental coverage.

59 million seniors and people with disabilities rely on Medicare for their health care, but it doesn’t cover part of the body that causes all kinds of health problems—the mouth. Medicare currently excludes dental care from its coverage, leaving millions without access to oral health care. Oral health is a vital part of overall health, but it’s not covered and treated in the same way as other health issues.

Medicare dental coverage would keep seniors and people with disabilities healthier and more financially stable 

Without dental coverage, many people on Medicare simply cannot afford oral health care.  They are forced to forego dental treatment due to cost, and their health suffers as a result. Pain, nutrition problems, chronic conditions, and recurring infections are all problems that older adults and people with disabilities face. Many of these can be caused or made worse by a person’s lack of oral health care and resulting poor oral health.

Through Families USA’s Story Telling Initiative, we’ve heard many personal stories about how lack of oral health care impacts people’s lives. Recently, we shared Cheryl’s story, a Medicare recipient in Olympia, Washington. Living on a fixed income and without dental coverage, Cheryl cannot afford the root canals and other oral health care she desperately needs. Her overall health, from mouth pain to heart problems, is worse for it.

Cheryl is not alone. Millions of other seniors and people with disabilities face similar consequences without oral health coverage.

There is a path: Medicare Part B offers a way forward for dental coverage 

This new white paper shows that oral health coverage can be provided as a Part B Medicare benefit for the millions of seniors and people with disabilities that currently go without.  This coverage could be funded through general revenues and monthly premiums, just like other services under Part B. The modelling in this paper shows that premiums are estimated to be just $11.45 to $14.50 per person each month for comprehensive dental coverage.

This paper also shows that this sort of coverage would cost significantly less than other programs recently added to Medicare, like the Part D prescription drug benefit. Under the structure laid out above, the annual cost for coverage is estimated to be $24.8 billion to $31.4 billion annually. Not factored into this cost, though, are the huge savings that this coverage would generate in other healthcare costs. Studies show that oral health care can reduce expensive emergency visits to the ER for dental pain, improve chronic disease outcomes, and prevent some hospital acquired infections.

Medicare dental coverage is a needed, wise, and popular investment 

Medicare dental coverage would help millions of people in this country live happier, healthier lives. It would help reduce healthcare costs that could be avoided by treating disease that starts in the mouth. It is also incredibly popular with the American people—polling shows that 96 percent of likely voters support adding dental coverage to Medicare. Adding dental coverage to Medicare is a clear solution.

Now, with this newly released white paper, there is a path laid out on what policy could look like to get us there. Yet, this issue is not currently on the political policymaking agenda in a significant way. That must change.