- Include a range of services necessary to achieve and maintain oral health for beneficiaries whose income is up to 300% of the federal poverty level.
- Is sufficiently funded and efficiently administered to ensure access to care.
Applying Medicare Resources to Those Seniors Who Most Need Assistance
Proposals to expand Medicare should include a comprehensive dental benefit that meets the needs of those beneficiaries up to 300% of the federal poverty level (FPL). Estimates show that meeting the needs of beneficiaries up to 300% of the FPL covers about 47% of the older adult population. This would provide meaningful coverage to most seniors who presently do not visit a dentist because they cannot afford it.
The percent of Medicare eligible seniors who have experienced increased cost barriers to dental care steadily rose from 2009-2019. Seniors with incomes at or below 133% of the federal poverty level saw the largest increase in cost barriers from 10% in 2009 to 26% in 2019.
Creation of a New, Separate Program for Dental Benefits
The current Medicare program includes distinct “parts” recognizing the variability in delivery of health care services such as hospital care, physician services and prescription drugs. The dental care system is significantly different from the medical care delivery system and therefore merits a designated program recognizing those differences in the delivery of services if added to the Medicare program.
The ADA believes that any expansion of Medicare should include a separate new program dedicated to providing comprehensive dental care for low income seniors.
Caring for the oral health needs of seniors is complex. We hope that an innovative approach that is adequately funded and efficiently administered and which utilizes private, non-profit and government solutions will provide a workable solution and offer opportunities for improved oral health for whom the need for care is most critical – low income seniors.
Full text of the ADA’s official policy recommendations are available.
Editor’s Note: Reporters are invited to follow the ADA on Twitter @AmerDentalAssn