Brief Examines Five Potential Ways to Improve Dental Coverage for People on Medicare

Medicare does not cover routine dental care, and two-thirds of the Medicare population have no dental coverage at all. With limited or no dental coverage, some incur high out-of-pocket costs, while others forgo need dental care because they can’t afford it. Policymakers in Washington and others are exploring ways to make dental care more affordable for the 60 million people on Medicare.

A new KFF brief examines five potential ways to make oral health care more available and affordable for the Medicare population, including two approaches that would add a new dental benefit under Medicare and others that would offer more limited help to people on Medicare, and have less of an impact on the federal budget. The five options include:

• Adding a dental benefit to Medicare Part B
• Creating a voluntary dental benefit under a new part of Medicare
• Permitting greater access to medically necessary dental services under Medicare
• Testing models for dental coverage
• Offering dental discount cards

The brief reviews the limits of dental coverage permitted under current Medicare law, then describes each of the policy options, with an analysis of likely implications for key stakeholders, including Medicare beneficiaries, taxpayers, insurers, and dental professionals. It also examines trade-offs for the options, including increases in federal spending. The brief, Policy Options for Improving Dental Coverage for People on Medicare, is intended to inform policy discussions focused on improving oral health care and coverage for the Medicare population.

A previously released brief, Drilling Down on Dental Coverage and Costs for Medicare Beneficiaries, reviews the state of oral health for people on Medicare, describing the consequences of foregoing dental care, current sources of dental insurance, use of dental services, and beneficiaries’ out-of-pocket spending.