This week, economist Austin Frakt outlined the economic and health impacts associated with Medicaid’s lack of dental coverage for adults in many states. These associations range from an increased risk of cancer and heart disease, to complications for pregnancy, to social stigma and difficulty finding work.
While Medicaid requires dental coverage for children, coverage for adults is optional. Currently, there are 17 states that offer comprehensive adult dental benefits.
Medicaid’s lack of a comprehensive adult dental benefit in most states makes the health and well-being of people with Medicaid less robust. But Medicaid’s sparse dental coverage is still superior to the coverage Medicare offers most beneficiaries.
Traditional Medicare only pays for a limited number of dental services, and only under a limited number of circumstances. For example, Medicare might cover dental services if a beneficiary has oral cancer and needs services in preparation for radiation treatment. But dental services outside of these narrow coverage lanes is not available in traditional Medicare. The program is permitted to cover “medically necessary” care but has chosen not to do so.
Medicare Advantage, the form of the program that can be accessed through private insurance plans, can include dental coverage at the discretion of the plan sponsor. It is unclear how many beneficiaries have access to comprehensive dental services through their Medicare Advantage plans.
The lack of a comprehensive dental benefit in Medicare is one of the gaps in the program that must be addressed, especially as lawmakers consider extending Medicare eligibility beyond older adults and people with disabilities. Medicare Rights has long advocated for dental benefits to be included fully in both traditional Medicare and Medicare Advantage plans. No time like the present to better support and protect our nation’s health!