Dental Care And Medicare Beneficiaries: Access Gaps, Cost Burdens, And Policy Options

Abstract

Despite the wealth of evidence that oral health is related to physical health, Medicare explicitly excludes dental care from coverage, leaving beneficiaries at risk for tooth decay and periodontal disease and exposed to high out-of-pocket spending. To profile these risks, we examined access to dental care across income groups and types of insurance coverage in 2012. High-income beneficiaries were almost three times as likely to have received dental care in the previous twelve months, compared to low-income beneficiaries-74 percent of whom received no dental care. We also describe two illustrative policies that would expand access, in part by providing income-related subsidies. One would offer a voluntary, premium-financed benefit similar to those offered by Part D prescription drug plans, with an estimated premium of $29 per month. The other would cover basic dental care in core Medicare Part B benefits, financed in part by premiums ($7 or $15 per month, depending on whether premiums covered 25 percent or 50 percent of the cost) and in part by general revenues. The fact that beneficiaries are forgoing dental care and are exposed to significant costs if they seek care underscores the need for action. The policies offer pathways for improving health and financial independence for older adults.

Predictors of having a dentist among older adults in Iowa

“…Our findings did not identify income as a predictor of having a dentist, a finding that differs from some other studies . In a recent report using data from the Medicare Current Beneficiary Survey, high‐income Medicare beneficiaries were three times as likely to have received dental care in the previous year than low‐income beneficiaries .…”

“…Needing help with transportation was another predictor identified in our study, and transportation issues have also been cited as a significant barrier for older adults in accessing dental care . We also observed that having dental insurance was a strong predictor of having a dentist, and the way insurance coverage impacts access to dental care has been reported for the US older adult population and seems to be a worldwide trend …”

“…Nevertheless, to our knowledge this is the first study to evaluate possible predictors of having a dentist among older adults in the United States, and our findings shed light on the potential influence of certain activities of daily living, as well as dental insurance, on access to dental care. Increasing insurance coverage through including oral healthcare benefits in Medicare might help older adults to overcome financial‐related barriers . Future prospective studies are needed to further explore the complex relationships influencing barriers to care among older adults.…”

The Association Between Dental Coverage and Self-reported Health in Older Adults jGPHA

“…Studies that have examined dental insurance coverage among adults in the United States have provided evidence to support the provision of increased dental coverage to improve overall health of older adults (Kreider, Manski, Moeller, & Pepper, 2015;Willink et al, 2016). The aim of the present study was to examine the relationship between dental coverage and self-reported health over time in a national sample of older Americans.…”

“…Dental coverage for the elderly population in the United States is limited, with only 12% of adults aged 65 years and older having such coverage (Willink, Schoen, & Davis, 2016). The elderly have limited options for dental coverage, as the largest health insurance provider for adults 65 and older, Medicare, does not cover dental care unless it coincides with medical needs (US Centers for Medicare and Medicaid Services, 2017).…”