Dental, visual and auditory benefits for Medicare


In this photo from the April 28, 2021 file, President Joe Biden greets Sen. Bernie Sanders, I-Vt., As Biden arrives to speak at a joint session of Congress in the U.S. House of Representatives in Washington. Many people of working age assume that Medicare covers virtually every type of health care an elderly person may need. But it doesn’t. Some of the most important gaps are dental, vision and hearing services. Democrats are now trying to turn those benefits into a standard part of Medicare under the massive legislation that is expected to advance on President Joe Biden’s national agenda later this year. Vermont Independent Senator Bernie Sanders and other progressives are leading the push. Credit: AP Photo / Andrew Harnik, pool

Many people of working age assume it Medicare it covers virtually any type of health care that an elderly person may need.

It doesn’t.

Some of the most important gaps are dental, vision and hearing services. Medicare does not cover dental cleanings or root canals. It does not cover glasses and contact lenses daily. It does not cover hearing aids.

Democrats are now trying to turn those benefits into a standard part of Medicare under the massive, multifaceted legislation expected later this year to advance President Joe Biden’s ambitious national agenda.

Many feel that the expansion of the program is over. But that doesn’t mean it’s easy.


Senator Bernie Sanders, I-Vt., And other progressives lead drive for dental vision and hearing . Its goal is to provide a comprehensive benefit available to as many Medicare beneficiaries as possible without delay, such as an extended phasing-in period.

But adding more benefits to Medicare is expensive and the idea will have to compete with other priorities on the Democrats ’health care wish list.

Republicans are expected to join in opposition to the powerful legislation on the Biden agenda in which Medicare benefits will be applied. Democrats should pass the bill in accordance with special budget rules that would allow a simple majority to clean up the Senate.

“It’s too early to lower the odds,” said Tricia Neuman, a non-partisan Kaiser Family Foundation Medicare expert.


The simplest approach seems to involve dental, visual, and auditory coverage being a component of Medicare Part B, which pays for outpatient care.

Part B is voluntary, but the vast majority of the more than 60 million Medicare beneficiaries enroll. There is a premium and now most people pay $ 148.50 a month. While not cheap, it is actually considered good business because taxpayers cover 75% of the overall cost of insurance. Premiums were expected to increase with richer profits, but the cost would be broadly shared.

On the other hand, most people with private Medicare Advantage plans now have some level of dental coverage, but that can vary greatly. If dental, visual, and auditory benefits were standard in Part B, Medicare Advantage plans should also provide them.


While the details will take some time to materialize, full dental coverage will include periodic preventive care such as cleaning and X-rays, minor work like fillings, and major work, including root canals, crowns, and dentures.

Vision coverage would include glasses and contacts, in addition to the necessary exams and accessories. Hearing coverage would include hearing aids and their maintenance, as well as audiology services.


Again, this is unclear because no key details have been determined, such as the scope of benefits and cost sharing by Medicare beneficiaries.

But a 2019 bill from House Speaker Nancy Pelosi, D-California, was priced at nearly $ 360 billion in ten years.

Of that, $ 238 billion would have been paid for dental care, $ 30 billion would have been paid for vision care, and $ 89 billion would have been paid for hearing services, according to the Congressional Budget Office.

Expanding coverage was part of broader legislation that would have allowed Medicare to negotiate the prices of prescription drugs. Some of the savings from drug costs would have been returned to the program.

Pelosi’s bill passed the House, but went nowhere in the Senate. Democrats continue to use this approach as a template.


Dentistry, vision and hearing are considered integral to good health.

An elderly person with hearing problems who cannot afford it aid can be found in a state of isolation that can aggravate depression. Dental infections can spread through the bloodstream to other parts of the body.

But a 2019 Kaiser Foundation report found that nearly 2 in three Medicare recipients had no dental coverage and nearly half had not seen a dentist in the past year. About 1 in 7 had lost all their teeth.

Black and Hispanic enrollees were much less likely to have visited a dentist in the past year.

“Obviously it’s a big open hole in the Medicare program,” said David Certner, AARP’s legislative director.


Experts say the reason probably dates back to 1965, when the program was created.

It was modeled on the most common types of private health insurance at the time. And they were built around hospitalization and visits to the doctor’s office.

Another major gap in coverage, prescription drugs from retail pharmacies, was not resolved until 2003.


Long-term care.

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