Press ReleasesBLOG POST: Push grows to add dental, vision, hearing benefits to Medicare

Senate Majority Leader Chuck Schumer (D-N.Y.) has become the latest to lend his voice to a growing effort to add dental, vision and hearing coverage to Medicare.¹

Schumer expressed support for a preliminary budget outline being developed by Senate Budget Chairman Bernie Sanders (I-Vt.) that includes this coverage and would spend almost $1.6 trillion more over a decade than President Biden’s proposed spending plan. Biden’s plan, released last month, also proposed coverage for all three.²

While traditional Medicare does not cover dental and does not provide many vision or hearing services, many Medicare Advantage plans offer this coverage, although sometimes on a limited basis.³ For example, 43% of beneficiaries in plans with both preventive and more comprehensive dental benefits had annual spending caps, often of about $1,000.⁴

Adding coverage for these benefits would be costly, with the Congressional Budget Office estimating it would have increased Medicare spending by $358 billion between 2020 and 2029.⁴

Suggestions to offset these costs have included allowing Medicare to negotiate with pharmaceutical companies for lower-priced drugs, but these have met with some resistance.

For MA plans, the expanded coverage could bring financial benefits from better member health, as neglected dental, vision or hearing health can lead to much more expensive and serious health conditions for beneficiaries over time.

Oral health problems have been linked to higher rates of pulmonary infections, diabetes and cardiovascular disease.³ Meanwhile, vision and hearing problems can lead to depression, falls and cognitive impairment.⁴ This can mean higher rates of hospitalizations and costly treatments.

A significant portion of the MA population already has problems with either dental health, vision or hearing,⁴ and cost is a significant barrier for older Americans in getting these needs addressed.³

MA plans that bulk up their benefits in these areas will be ahead of the curve if efforts to include them in Medicare succeed. Plans are also likely to see better business outcomes in addition to health outcomes if payments rise accordingly.⁵

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References

1. Schnell, M. Schumer backing plan to add dental, vision and hearing coverage to Medicare. The Hill. June 21, 2021. https://thehill.com/homenews/senate/559356-schumer-now-backing-sanders-plan-to-add-dental-vision-and-hearing-coverage-to
2. A Look at What’s Inside Biden’s $6 Trillion Budget Request. The New York Times. May 28, 2021. https://www.nytimes.com/2021/05/28/us/politics/trillion-budget-plan-joe-biden.html
3. Willink, A. et al. Getting Medicare Beneficiaries the Dental, Vision, and Hearing Services They Need. The Commonwealth Fund. Feb. 4, 2020. https://www.commonwealthfund.org/publications/journal-article/2020/feb/dental-vision-hearing-services-medicare-beneficiaries
4. Miller, M. On Medicare and Need Dental Work? Beware a Big Bill. The New York Times. June 9, 2021. https://www.nytimes.com/2021/06/09/business/medicare-dental-work-bill.html
5. Freed, M. et al. Policy options for improving dental coverage for people on Medicare. KFF. Sept. 18, 2019. https://www.kff.org/medicare/issue-brief/policy-options-for-improving-dental-coverage-for-people-on-medicare/