Dentists approached Congress to include dental coverage in Medicare.
The panel of four dentists requested that the U.S. Senate Help, Education, Labor, and Pensions Committee consider changes to make dental care more accessible, especially for underserved communities.
Additionally, they emphasized the importance of educating people about how skipping dental checkups can affect their overall health negatively.
Dr. Lisa Simon, an associate physician at Brigham and Women’s Hospital and a member of the faculty at Harvard Medical School, said that the dental coverage provided by many Medicare Advantage plans isn’t enough.
These plans, which are offered by private companies, combine Part A and Part B coverage and sometimes also include prescription drug coverage.
“Fewer than half of Medicare beneficiaries see a dentist each year. When they do, they spend more than $1,000 out of pocket on their care.” Simon said.
She added, “Dental plans are often a draw for beneficiaries that choose Medicare Advantage,” “But my research has found that beneficiaries with Medicare Advantage have rates of dental access that are just as low and out-of-pocket costs that are just as high as traditional Medicare beneficiaries. Medicare Advantage is not the solution here.”
Dr. Myechia Minter-Jordan, president and CEO of CareQuest Institute for Oral Health in Boston, explained to the panel that many Medicare enrollees lack dental benefits because traditional Medicare doesn’t include dental coverage.
Jordan said, “Half of Medicare enrollees, nearly 25 million older Americans and people with disabilities, without dental benefits.”
“There is currently no financial support for adults to purchase dental insurance through the Health Insurance Marketplace,” she added. “And adult dental coverage is optional under state Medicaid programs, which means that coverage varies widely from extensive benefits to none at all.”
Dr. Brian Jeffrey Swann, who practices dentistry in Tennessee and serves on the board of directors for Remote Area Medical, told the committee that the nonprofit organization offers pop-up dental and vision clinics for underinsured and uninsured individuals.
He also noted that the National Dental Association has long insisted on adding dental coverage under Medicare.
Swann said, “The people that come to RAM for assistance often drive across two or three state lines, sleeping in their cars, wrapped in blankets to stay warm. Many people come days before the clinic just to ensure that they get a ticket,”
He added, “Patients suffer from cavities and gum disease,” “And this is concerning due to the interplay of gum disease and diabetes.”
The dentists’ recommendations to Congress highlighted a clash between Chairman Bernie Sanders and Senator Bill Cassidy on the issue of Medicare changes. Where Sanders thinks it’s crucial to include dental care in Medicare because many people struggle to afford it.
He adds, “70% of older Americans have some sort of periodontal disease, which can lead to rheumatoid arthritis and cardiovascular disease,” “And many of them cannot afford dentures, which can cost many thousands of dollars.”
Cassidy, a doctor, on the other hand, said most people have dental coverage through Medicare Advantage plans. He expressed his thought that adding dental coverage to Medicare could make it harder to manage financially.
“98% of Medicare Advantage plans offer dental benefits and more than half of Medicare beneficiaries are enrolled in an MA plan,” Cassidy said. “The reimbursement rate under Medicaid is so lousy that frankly, it’s the illusion of coverage without the power of access,” he added. “If you’re losing money on every patient you see who’s covered by Medicaid, you can’t make it up.”
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