Can Medicare Take the Bite out of Senior Dental Insurance?
Advocacy When are we going to put the mouth back into the body and include for seniors a dental benefit in Medicare? Studies indicate that by not doing so, we’re losing more in the long run.
Baby boomers signing up for Medicare are surprised to find that it does not cover dental care—except in some Advantage and PACE recipients. The importance of the mouth to eating, speaking, socializing, immunity and sexuality are tied to oral health, yet many seniors do not have access to even basic dental services.
Access to dental care is linked to dental insurance. Among seniors aged 65 and over, 54 percent of adults with private health care coverage had visited a dental professional within the past six months, compared to 41 percent of adults who had Medicare (but no dental) and 25 percent who had Medicare plus Medicaid.
"Poor, underserved elders are more likely to lose teeth, have unfilled decay and gum disease."
Access to dental insurance and care also varies with age, education, income, employment, insurance, poverty, race and ethnicity. As seniors age, they are less likely to have dental insurance and thus less likely to have access to needed care.
Near poor and poor seniors are the least likely to have insurance; leading to problems staying healthy. Some states include dental benefits for poor seniors in Medicaid. But Medicaid dental coverage for adults and seniors varies from state to state. And in times of budget crunches, benefits vary from year to year. Thus, Medicaid benefits are, at best, inconsistent.
Feeling the urgency
Dental care is important for several reasons. Poor, underserved elders are more likely to lose teeth, have unfilled decay and gum disease.
National data showed that complete tooth loss in 65-plus-year-olds was more common in 75-plus-year-olds (25.8 percent) vs. 65-74 year olds (13.0 percent), and in non-Hispanic blacks (29.2 percent) and non-Hispanic Asians (24.2 percent) than in whites (16.9 percent) and Hispanics (14.9 percent).
Untreated tooth decay among seniors is highest among the poor (41 percent) and near poor (22 percent) vs. non-poor (15 percent). By race and ethnicity: 41 percent of non-Hispanic black elders and 27 percent of Hispanic and Asian elders had unfilled cavities vs. 16 percent in white elders.
In light of these numbers, however, work done by Optum for UnitedHealthcare on Medical-Dental Integration in 2013 suggests that in seniors with diabetes, heart diseases, lung diseases, asthma and kidney diseases, the savings in overall health care outweighed the costs of preventive dental care.