The Kaiser Family Foundation (KFF) recently released a report examining Medicare beneficiary access to dental care, including the share of Medicare beneficiaries with dental coverage, the share with a dental visit in the past 12 months, and their out-of-pocket spending on dental care. 

Troublingly, they found that nearly half of all people with Medicare had no dental coverage in 2019. That same share did not have a dental visit in the past year, with higher percentages among Black (68%), Hispanic (61%), and low-income beneficiaries (71%). Most who obtained care (88%) paid out of pocket. They spent $874, on average, with 1-in-5 spending more than $1,000. 

While most Medicare Advantage (MA) plans offer some dental coverage, it is often limited. As KFF notes, in 2021 88% of MA enrollees are in plans that have frequency limits on dental services, and 78% are in plans that have a cap on care. More than half (59%) are in plans with a maximum benefit of $1,000 or less, and the most common coinsurance for non-preventative services is 50%. For enrollees who pay a separate premium for their MA dental coverage, those amounts average $270 per year, but range from about $108 to $692.

Lack of dental care can exacerbate chronic medical conditions, contribute to the delayed diagnosis of serious medical conditions, lead to preventable complications, or delay or complicate needed services or surgeries. Limited coverage and cost controls can contribute to beneficiaries foregoing routine and other dental procedures. 

This report is particularly important and timely because policymakers are now discussing options to make dental care more affordable by broadening coverage for people on Medicare. 

President Biden’s FY 2022 budget request includes “improving access to dental, hearing, and vision coverage in Medicare” as a priority. The budget resolution recently passed by Senate Democrats directs the Senate Finance Committee to explore adding dental, vision, and hearing coverage to Medicare through the reconciliation process. In 2019, the House of Representatives passed the Elijah E. Cummings Lower Drug Costs Now Act (H.R.3) that would add a dental benefit to Medicare Part B, along with a vision and hearing benefit. Earlier this year, Representative Doggett, joined by 76 members of the House of Representatives, introduced the Medicare Dental, Vision, and Hearing Benefit Act (H.R. 4311) which would cover these services under Medicare Part B.

Medicare Rights strongly supports these legislative efforts. Congress must act immediately to fill this harmful gap in Medicare coverage. But they need to hear from you! Learn more and make your voice heard today.

Read the full report.