Most people know to get hospital, medical and prescription coverage when signing up for Medicare, but a dental plan isn’t always an option.
According to Kaiser Family Foundation: “Dental benefits are not generally covered by Medicare, except under limited circumstances, and many people on Medicare do not have any dental coverage at all. Some Medicare beneficiaries have access to dental coverage through other sources, such as Medicare Advantage plans, but the scope of dental benefits, when covered, varies widely and is often quite limited, which can result in high out-of-pocket costs among those with serious dental needs or unmet need.”
President Joe Biden has included dental, hearing and vision coverage in his FY 2022 budget request, and Rep. Lloyd Doggett (D-Texas) earlier this year introduced the Medicare Dental, Vision, and Hearing Benefit Act (H.R. 4311), which would cover these benefits under Medicare Part B.
But even if these aren’t available during the upcoming Medicare open enrollment — which begins Friday and runs through December 7 — here are three reasons you should consider getting dental coverage.
Oral health important to overall health
Good oral health is important to your overall well-being, experts say.
“Like other areas of the body, your mouth teems with bacteria — mostly harmless,” according to the Mayo Clinic. “But your mouth is the entry point to your digestive and respiratory tracts, and some of these bacteria can cause disease.”
Brushing and flossing usually keep these bacteria under control, but “without proper oral hygiene, bacteria can reach levels that might lead to oral infections, such as tooth decay and gum disease,” Mayo Clinic wrote.
Here is how the clinic says poor oral health might contribute to various diseases and conditions:
- Endocarditis: This infection of the inner lining of your heart chambers or valves (endocardium) typically occurs when bacteria or other germs from another part of your body, such as your mouth, spread through your bloodstream and attach to certain areas in your heart.
- Cardiovascular disease: Although the connection is not fully understood, some research suggests that heart disease, clogged arteries and stroke might be linked to the inflammation and infections that oral bacteria can cause.
- Pneumonia: Certain bacteria in your mouth can be pulled into your lungs, causing pneumonia and other respiratory diseases.
- Alzheimer’s: A 2019 study in Science Advances linked gingivitis (gum disease) to Alzheimer’s, finding the bacteria Porphyromonas gingivalis can move from the mouth to the brain. Once in the brain, the bacteria release enzymes called gingipains that can destroy nerve cells, which in turn can lead to memory loss and, eventually, Alzheimer’s.
Conditions, medications can affect oral health
Some medications — such as decongestants, antihistamines, painkillers and antidepressants — can reduce the amount of saliva in your mouth, lowering your protection from microbes that multiply and lead to disease.
In addition, osteoporosis and Alzheimer’s disease, both associated with aging, might affect your oral health.
Osteoporosis can lead to bone loss, including teeth and the jaw bone. Certain drugs used to treat osteoporosis also carry a small risk of damage to the bones of the jaw, according to the Mayo Clinic.
People suffering from Alzheimer’s often have trouble keeping up with their oral hygiene, which can lead to infections and other complications.
Dental care is expensive
Medicare Advantage plans’ cost sharing — the amount you pay out of pocket — for dental benefits varies by plan and by service category, Kaiser Family Foundation reported. Some plans have no cost sharing (primarily for preventive services), while others charge coinsurance and/or a flat copayment.
A July survey by KFF found:
Preventive services: Nearly two-thirds of enrollees (64%) in plans with access to oral exams, cleanings and/or X-rays do not pay cost sharing for those services, although the majority of these enrollees are in plans that have annual limits on covered preventive services.
More extensive dental services: For plans that offer more extensive benefits and require cost sharing, coinsurance is more common than copayments, and the most common coinsurance amount is 50% across the more extensive service categories, including restorative services, extractions, endodontics, periodontics, prosthodontics, nonroutine services and diagnostic services.
Finding the best Medicare Advantage plan for your dental needs will take research, but valuepenguin.com recommends these three: AARP Medicare plans from United Healthcare; Aetna; and Highmark. At each website, just put in your ZIP code, and you can see what plans are available in your area, what they include and how much they cost.
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