Health

Medicare patients could benefit from expanded dental coverage but lawmakers clash over adding benefits

Dental care needs increase with age, a new analysis suggests, finding Medicare enrollees could significantly benefit from expanded coverage.

The analysis, which was overseen by the Urban Institute, a nonprofit research organization, used its own Medicare policy simulation model, which projects Medicare enrollment and spending estimates, as well as 2015 to 2018 data from the Medical Expenditure Panel Survey on dental use and spending. The analysis received funding from the Robert Wood Johnson Foundation.

Researchers found that doctor visits, as well as dental visits specifically, increase with age, though utilization begins to decline with older adults over 80. The number of dental visits doubles by age 60. The analysis noted that a substantial share of the population has not had a dental visit in the past year despite medical recommendations to go in at least annually. 

“Dental health impacts overall health, and Medicare’s lack of dental coverage keeps many people out of the dentist’s office,” said Katherine Hempstead, senior policy adviser at the Robert Wood Johnson Foundation, in a press release. “Medicare’s coverage of dental care would allow many older adults to access the preventive services they need to live a healthier life.”   

RELATED: Experts say adding dental coverage to Medicare won’t trigger major shift away from Medicare Advantage

Spending on dental care also increases with age, reaching $532 on average per person for people between the ages of 70 and 75 from 2015 to 2018. Spending drops off after the age of 80. 

Only about 27% of Medicare enrollees’ total dental costs, however, are covered by insurance. As a result, patients 65 years and older pay between 58% and 75% of their dental costs out of pocket, a higher share than younger groups. The analysis estimated that nearly 10% of enrollees paid more than $1,000 out-of-pocket in one year. Moreover, those with low incomes, as well as patients of color, access dental care less. 

“This analysis suggests Medicare enrollees could substantially benefit from policies to expand dental coverage,” said Adele Shartzer, senior research associate at the Urban Institute, in the press release. “Providing basic coverage for preventive services can benefit many Medicare beneficiaries who do not currently use dental care – but these policies won’t provide financial relief for high-cost dental procedures.” 

While most Medicare Advantage enrollees have access to dental coverage, not everyone is in MA. The report comes amid a Congressional battle over whether to add such Medicare benefits. Republicans object to the spending, while some Democrats argue that excluding these benefits is a disservice to seniors in America who rely on the program.

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