A Medicare surprise: Most dental care isn’t covered

If you plan to retire soon, add this item to your to-do list: a visit to the dentist before your dental insurance disappears.

Retirees transitioning to Medicare are often surprised to learn that the program does not cover routine dental care or more complex procedures.

Overall, 40 percent of the 65-plus population has some form of dental benefit, according to the National Association of Dental Plans. For seniors who use Medicare Advantage managed care plans, about half offer very limited coverage for cleanings and exams. A small percentage of seniors have dental insurance from a former employer, and Medicaid covers dental care for low-income residents in some states, although benefits vary. Some buy individual commercial plans or have coverage through an association such as AARP.

But most seniors just pay for dental care out of pocket – the mean expense for Americans age 65 and older was $870 in 2012, according to the Agency for Healthcare Research and Quality, a research arm of the U.S. Department of Health and Human Services.

The costs can be far higher for more complex procedures. The average cost of a crown in New York City is $2,500; a periodontal procedure in Los Angeles costs $1,700, according to Fairhealthconsumer.org, a service that tracks prices of healthcare and health insurance.

Those numbers help explain why 34 percent of seniors had not seen a dentist in two years in 2010, and 22 percent had gone without care for the past five years, according to the Kaiser Family Foundation.

Medicare celebrates its 50th anniversary later this month, and adding basic dental coverage is on the wish list of many health policy experts reflecting on the program’s future.

Research shows clear links between poor oral health, diabetes and heart disease. One out of four Medicare beneficiaries has edentulism – that is, they no longer have any of their natural teeth, according to KFF; that can cause other health issues, such as nutritional deficiencies and problems with speech. Learn more at Reuters Money.

 

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