By Judith Stein, Executive Director, Center for Medicare Advocacy
When Medicare was enacted in 1965, over half of people over 65 had no health insurance. The fact that Medicare provided affordable, basic health insurance was a huge boon for older Americans and their families. (People with disabilities were added to the program in 1972.) However, certain coverage gaps were not filled.
Missing coverage components included routine dental, eye, and hearing care – including glasses and hearing aids – prescription drugs and preventive services. While major inroads have been made in providing coverage for medications and preventive services, eye care, hearing aids, and dental care – no matter how extreme the need – are still not covered by Medicare. These are all key to health and well-being, particularly for older people and people with disabilities, who are often more vulnerable to infection, malnutrition, and serious illness.
Unfortunately. Medicare contractors regularly deny coverage for pretty much any care that has to do with the jaw or mouth. This was not the intent of the law. The Center for Medicare Advocacy frequently hears from beneficiaries with urgent health issues who cannot obtain extraordinarily complex dental and oral health services due to inappropriately broad Medicare denials. Here is an example of a message recently received from a Medicare beneficiary:
I'm in desperate need of dental treatment. I was just talking to an advocate for Sjogrens Disease in Washington State about what a shame it is that I can't get needed implants for my mouth. I ended up having to get all my teeth pulled and get dentures that have failed miserably. I haven't been able to eat a solid meal for months.
To truly honor Medicare’s 50th Anniversary, coverage should be provided for these critically needed health services.
For more information on dental care, and other non-covered services, see https://www.medicareadvocacy.org/medicare-info/medicare-part-b/#non-covered.