Dr. Reitz: Your article on dental health and the link with physical disease was noteworthy. Most retirees lose their dental coverage when they retire. A lot of single premium dental plans are beyond the affordability of most Medicare people. Over the years I wrote to the politicians, Medicare, and the dental associations to ask them to add a simple yearly checkup and cleaning to the Medicare-covered expenses. It falls on deaf ears. One would think the Medicare system, which is fiscally in debt, would save hundreds of millions of dollars by preventing disease at the beginning, i.e., in the mouth, by providing this additional simple coverage. – George L.
Dear George: You are not alone in advocating for dental benefits under Medicare. Many consumer advocacy groups are pushing to have this on the presidential election agenda for 2020. I am not a Medicare expert, but here is what I found concerning dental coverage in Medicare.
Medicare Part B, largely financed through government revenue, covers physician visits (not dentists), outpatient and preventive services. Part B benefits are subject to a deductible ($166 in 2016), and most Part B benefits are subject to coinsurance of 20 percent. Medicare Advantage (Part C) is the supplemental insurance paid by the individual. Currently, over half of Medicare Advantage (Part C) plans include a dental benefit, and many others offer it as a voluntary buy-up option. In most cases, the dental benefits are limited to annual prophylaxis and X-rays.
The difference between Part B and Part C is that if dental were included in Part B, all senior citizens over the age of 65 would then be eligible for and receive government-funded dental care, because Medicare eligibility is not income dependent.
Although I believe all citizens should receive basic dental care, as a dentist my concern is how Medicare has treated physicians. The reimbursement rates are generally only 80 percent of what insurance considers usual and reasonable. The paperwork is overwhelming, and filing requirements are constantly changing, adding additional overhead for physicians.
Future retirees can control the cost of dental care after retirement if they maintain a healthy mouth while working.