Why Medicare won’t pay for your dental care, and what you can do instead
That demographic reality presents a number of challenges to the Pine Tree State, but among them is providing access to dental care for an aging population of baby boomers and seniors, many of whom live on low or fixed incomes. This problem is especially pronounced when considering the high prices of dental procedures and the fact that federal Medicare coverage doesn't include dental benefits.
"We see a tremendous unmet need here," said Dr.
"We have people who drive two hours to get to this facility," Eisenbarth said. "The financial component is a real roadblock."
The need for healthy, pain-free teeth is as basic as being able to chew your food and as complex as supporting the management of chronic illness like diabetes and heart disease. And yet, basic preventive care and disease treatment are out of reach for many older Mainers.
A pricey necessity
For those who can afford it, private dental insurance typically covers preventive care such as cleanings and X-rays but is of little value for restorative work such as fillings, crowns and bridges. MaineCare,
Medicare, the public health plan for Americans aged 65 and older, considers only a few dental procedures "medically necessary," although some privately managed -- and more expensive -- Medicare Advantage plans provide a more generous dental benefit.
The retail cost of dental and oral health care services varies widely, from practice to practice and from one geographic region to another. But according to one consumer website, a standard cleaning typically costs between
The importance of dental care as we age is huge. Healthy teeth and gums are critical for enjoying the the kind of healthy, high-fiber diet we should all be eating. They're also important for communicating clearly and for looking and feeling our best.
Untreated tooth decay and periodontal disease is not just painful and unsightly. It is also linked to serious systemic illness, including heart disease, diabetes, dementia and stroke. In addition, oral disease can delay or even prevent treatment for other conditions, such as organ transplant, chemotherapy, heart valve replacement and orthopedic joint replacement.
According to a 2013 report from the
In 1965, when Medicare was passed into law, the average life expectancy for American men was about 67. For women, it was 74. Dentistry was an emerging science then, says one
"Over half of the people Medicare was designed to benefit were already edentulous, and people were living not very long past the age of enrollment," said Dr.
Now, though, more than 50 years later, much has changed. Dentistry has evolved into a sophisticated specialty practice dedicated to preserving the health and function of teeth, gums and other oral structures across the lifespan.
Importantly, Shenkin said, medical science now recognizes the impact of good dental care and oral hygiene on overall health, particularly as we age. That growing body of evidence could provide the impetus to add a dental benefit to taxpayer-funded Medicare, he said, and interest is growing nationwide in doing just that.
Promoting a Medicare dental benefit
Led by the nonprofit, nonpartisan
Among the groups endorsing the proposal is the senior advocacy organization
"This has been our policy for many years now," said
The group also supports adding Medicare coverage for eyeglasses, hearing aids and related medical care.
Scholnick said work must focus on identifying an expanded definition of medical necessity and determining reimbursement rates that will make participating as a Medicare provider an attractive option for dental professionals. In addition, he said, the group aims to raise awareness and build support among policymakers and the general public.
"The lack of oral care is a big problem for millions of older Americans," Scholnick said. But, he added, "there is no hard and fast timeline" for making a change.
While advocates and policymakers in
-- Check out the nearest publicly funded community health clinic, several of which, like PCHC in
-- The nonprofit Community Dental clinics operate in
-- Inexpensive dental cleanings and disease screening are available in
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