The budget reconciliation bill working its way through Congress includes a Medicare dental benefit. If a dental benefit makes it into the final budget legislation, what will it cover? Margot Sanger Katz reports on this new benefit for The New York Times, exposing how critical this benefit could be because millions of older Americans cannot afford dental care today.
Because of Medicare’s lack of dental benefits, older adults often lose their teeth. About 20 percent have no teeth. Almost half of them don’t see the dentist each year. Without teeth, malnutrition rises, physical health deteriorates, and mental health is at risk.
Even Medicaid does not always pay for dental services. Dental services are not a mandated benefit. So, a lot of states do not cover these services. Some states cover only emergency dental services.
It’s still not clear whether Congress will pass a Medicare dental benefit or what it will cover if it does. A comprehensive benefit would easily cost more than $50 billion a year. A partial benefit will be of little help to a lot of people with Medicare as they won’t be able to afford the out-of-pocket costs to take advantage of the benefit. And, some dentists are pushing back and suggesting that they do not support the benefit for fear of Medicare setting low rates for their services.
As it is, dentists have been successful at keeping dental therapists from performing basic and essential dental services. Dental therapists are trained to fill cavities, perform teeth cleanings and extract teeth. And, they charge lower rates for these services than dentists. But, most states do not allow dental therapists to practice except under the supervision of dentists.
People in Medicare Advantage often have a dental benefit. However, the benefit appears to be modest at best. The available data suggests that most enrollees can’t take advantage of the dental benefit because out-of-pocket costs are often so high. Medicare Advantage plans could benefit from a new infusion of capital if Congress pays them additional funds to offer richer dental benefits. But, that won’t help enrollees unless their costs are affordable.
If you need affordable dental care right now, contact your local federally qualified health center or check out these other options. These primary care facilities, which operate in thousands of sites across the country, often offer free or low-cost dental services.
Here’s more from Just Care:
Leave a Reply