The Potential Impact of Expanding Medicare Coverage to Include Dental and Vision

iQuanti: Since Medicare's inception in 1965, relatively few changes have been made. But a recently introduced Democratic bill is seeking to expand Medicare coverage by adding dental, hearing, and vision insurance to the existing benefits. Here's what you need to know about how this change could affect enrollees.

What Medicare Currently Covers

Medicare has long since provided Americans over 65 with hospital and medical insurance coverage. This "Original Medicare" consists of:

• Part A (Hospital) which covers services like home health care, hospice, and inpatient care.
• Part B (Medical) which covers services like preventive care, mental health services, and durable medical equipment (DME).

There is also an optional prescription coverage (Medicare Part D). But for extras like dental, vision, or hearing care, enrollees have had to look to private companies selling Medicare Advantage plans.

Medicare Advantage Plans, known as Medicare Part C, typically covers all services from Parts A and B, Medicare Part D, and additional coverage options for dental, vision, hearing, wellness plans, daycare services, and more, depending on the plan. As a result, Medicare enrollees in need of these additional services have looked to Medicare Advantage plans to provide them with a more comprehensive healthcare experience.

Proposed Changes to Medicare

Democrats are looking to expand Original Medicare coverage as part of the passage of a $3.5 trillion Build Back Better agenda. Of that total bill, Medicare changes are a line item as part of a $1 billion investment in the Committee on Finance.

One of the main changes proposed by the bill is that it would expand Medicare to cover dental, vision, and hearing. And it would also lower the eligibility age (presumably from 65 to 60 as was one of Biden's campaign promises). But at the moment, passing this bill would require nearly all Democrats to vote in favor of the entire budget for the proposed changes to become law.

The Impact of Medicare Expansion

The implications of adding supplemental coverage would be vast, not to mention costly. Participants, many of who are already responsible for paying premiums for Part B, could face an increase in their monthly out-of-pocket costs. But it's also critical to weigh that cost against the obvious benefit of improvements in health for millions of Medicare enrollees.

The expansion could also negatively impact the Medicare Advantage industry. Private companies have long since used supplemental benefits as a selling point for Medicare Advantage plans. Pulling these benefits into traditional Medicare could cause a significant shift in membership from Medicare Advantage back to Original Medicare plans.

The Bottom Line

While the legislation to expand Medicare coverage could be put to a vote as early as fall 2021, Medicare enrollees shouldn't bank on coverage expansion any time soon. Instead, Medicare participants should still look to Medicare Advantage plans, or plan to pay out-of-pocket for dental, vision, and hearing services for the foreseeable future.