When I became eligible for Medicare, I was surprised to learn that dental coverage is not included in Part B. Medicare doesn’t cover dental treatment as a result of medical treatments or illnesses, including chemo and radiation, and medications causing dry mouth. People needing organ transplants, heart surgery and leukemia treatment often require dental clearance first; these clearance visits are not covered by Medicare.
Recently published pre-COVID data shows that 47 percent of Medicare eligible seniors had not seen a dentist in the previous year. The rate is higher for low-income seniors (73 percent), those reporting fair to poor health (63 percent), and those who are Hispanic (61 percent) or Black (68 percent). Poor oral health is associated with health conditions such as heart disease, pneumonia, diabetes, osteoporosis and Alzheimer’s disease.
The American Dental Association is lobbying against expanding Medicare B plans to include dental health. Their reasoning? Dentists don’t have the billing, recordkeeping and claims structures that Medicare requires, and the reimbursement rates are lower than dentists currently charge. Instead, the ADA proposes to provide a “range of services necessary to achieve and maintain oral health” to seniors with income at or below 300 percent of the federal poverty level.
The original intent of Medicare was to provide insurance to all seniors 65 and older. There are now different rates people pay for premiums based on annual income, but all people get the same basic services. And while dentistry may not use electronic records, procedure codes, and claims submissions in the same form as physicians, this does not seem to be a reasonable objection to including dental care as a basic benefit. Medicare B includes services such as physical and occupational therapy, durable medical goods, emergency ambulance care and laboratory tests. Surely each of these services required changes in their protocols to be compliant with Medicare guidelines.
Just as the hip bone’s connected to the thigh bone, the circulatory, digestive and respiratory systems all involve the mouth, and carry good germs and worrisome bacteria throughout the organs they visit. A comprehensive health insurance program that promotes prevention and treatment to all systems of the body ensures a better quality of life throughout the aging process. We don’t need a separate dental program for some seniors. Let your representatives in Congress know that dental care is vital to overall health and should be covered by Medicare for all seniors.