http://www.commonwealthfund.org/publications/in-the-literature/2016/dec/dental-care-and-medicare-beneficiaries?omnicid=EALERT1137219&mid=henrykotula@yahoo.com

Synopsis

In 2012, more than half of Medicare beneficiaries reported they went without a dental visit in the past 12 months, with lower-income beneficiaries much less likely than higher-income ones to have received dental care. Overall, only 12 percent of beneficiaries reported having any kind of dental insurance. To expand access to care and reduce out-of-pocket exposure for older adults, the authors propose two policy options for adding dental benefits to Medicare’s benefit package.

The Issue

Despite evidence of a strong connection between oral health and physical health, Medicare explicitly excludes dental care from covered benefits. This leaves beneficiaries at risk for tooth decay and disease and exposed to high out-of-pocket costs. Moreover, the lack of regular preventive dental exams means missed opportunities for detecting the onset of certain diseases, including some cancers. A new Commonwealth Fund–supported study in Health Affairs looks at older adults’ access to dental care and their out-of-pocket expenses for dental services. The authors also suggest two policies for expanding dental care for seniors, along with cost estimates.

Key Findings on Use of Dental Services and Out-of-Pocket Spending

• In 2012, less than half of all Medicare beneficiaries had any dental visits in the past 12 months.

  “Until dental care is appropriately considered to be part of one’s medical care, and financially covered as such, poor oral health will continue to be the ‘silent epidemic’ that impedes improving the quality of life for older adults.”

• Use of services was sharply related to income. Only 26 percent of beneficiaries with incomes below 100 percent of the federal poverty level had a dental visit, compared with 73 percent of beneficiaries with incomes at or above 400 percent of poverty.
• Only 12 percent of beneficiaries (6.6 million out of 56.1 million people) reported having at least some dental insurance to help pay bills. In contrast, around 80 percent of Americans under age 65 who were covered by employer-based health insurance had dental benefits.
• Medicare beneficiaries reported spending an average of $427 on dental care in the past 12 months, of which $329 was spent out of pocket. About 7 percent of beneficiaries spent more than $1,500 in that period.