Posts Tagged "dental care"

Medicare to Cover 3 New Dental Procedures

“Is it medically necessary for a person to be able to chew?” Dr. Lisa Simon, a physician and dentist at the Harvard School of Dental Medicine, asks.

This is a serious question for older Americans in fragile health. I know a 93-year-old man whose teeth problems make it extremely difficult for him to eat meat and many other foods on the dinner table.

Two-thirds of retirees do not have dental insurance, which means they may decide to forgo getting expensive dental care. The importance of dental care to nutrition and health is also an equity issue for older Blacks and low-income retirees, who are more likely to be missing all of their teeth.

Medicare has historically paid for very few dental procedures. But the Centers for Medicare and Medicaid Services has expanded its existing, limited coverage to include treating patients who have oral infections prior to an organ transplant and patients who need a cardiac procedure or treatment of head and neck cancers.

Simon, who advocates for integrating dental care into overall medical care, argues in the journal Health Affairs that Medicare’s expansion of coverage for medically necessary procedures does not go far enough.

“These provisions are an overly narrow interpretation of what makes a health care service          ‘necessary,’ ” Simon writes.

She lists several examples of medically necessary conditions that don’t seem to fit Medicare’s updated definition. They include cancer patients who have oral inflammation during chemotherapy, diabetes patients with periodontal disease, and elderly women being treated for osteoporosis with injections that put them at risk of painful jaw deterioration. …Learn More

What if Medicare Paid Your Dentist?

Bar chart showing why retirees over 65 haven't seen a dentist in the last yearTwo out of three U.S. retirees do not have dental insurance. Their basic choice is paying their dentist bills directly or, if they can’t afford it, forgoing care.

A new report analyzes the pros and cons of one potential solution to this pervasive problem: adding dental coverage to Medicare. Several bills that have circulated in Congress, including the Seniors Have Eyes, Ears, and Teeth Act of 2019, would do just that.

This approach recognizes that teeth and gums have everything to do with one’s health, said Meredith Freed, a policy analyst for the Kaiser Family Foundation’s Medicare policy program. Elderly people with loose or missing teeth have difficulty eating nutritious but hard-to-chew foods. Gum disease, left untreated, increases the risk of cardiovascular disease, and diabetes, which is increasingly prevalent, makes people far more prone to gum disease.

Oral health care “has a significant impact on people’s happiness and financial well-being,” Freed said. Dental coverage under Medicare would “improve their quality of life.”

But a proposal to do this would face an uphill climb in Congress. Medicare is already under-funded. Dental care would only add to the program’s rising costs. Retirees do have another option: about two-thirds of the Medicare Advantage plans sold by insurance companies offer dental benefits. …Learn More