Many working-age people assume that Medicare covers just about every kind of health care that an older person may need.

Many working-age people think that Medicare covers all types of health care that an older person may need. However, it doesn't.

US News' recent article entitled “Dental, Vision and Hearing Benefits for Medicare” says that some of the biggest gaps involve dental, vision and hearing services. Medicare doesn't cover dental cleanings or root canals, nor does it include everyday eyeglasses or hearing aids. A 2019 Kaiser Foundation report found that about two-thirds of Medicare recipients didn't have dental coverage, nearly 50% had not seen a dentist in the past year and about 1 in 7 had lost all their teeth.

However, Democrats in Congress are trying to make those benefits a regular part of Medicare under major legislation expected later this year to advance President Joe Biden's domestic spending agenda. Proponents of the bill say that expansion of the program is overdue.

Progressives want dental, vision and hearing coverage. Their aim is to provide a comprehensive benefit available to as many Medicare recipients as possible without delays, such as an extended phase-in period. However, adding more benefits to Medicare is expensive. This push will also have to compete with other priorities on Democrats' health care wish list.

Republicans are expected to oppose the far-reaching Biden agenda legislation into which Medicare benefits would get sprinkled. Democrats would have to pass the bill under special budget rules allowing a simple majority to clear the Senate.

The most expedient approach looks to be making dental, vision, and hearing coverage a part of Medicare Part B, which pays for outpatient care. Part B is voluntary, but most of Medicare's more than 60 million beneficiaries enroll in this service. Part B has a premium, and most people now pay $148.50 a month. It's thought to be a good deal because taxpayers cover 75% of the overall cost of the insurance. Premiums are expected to go up with comprehensive benefits, but the cost would be spread broadly.

Most of those with private Medicare Advantage plans already have some sort of dental coverage, but it can vary. If dental, vision and hearing benefits were made standard under Part B, the Medicare Advantage plans would also be required to provide them.

The comprehensive dental coverage would include regular preventive care, such as cleanings and X-rays, minor work, such as fillings and major work including root canals, crowns, and dentures. The vision coverage would include eyeglasses and contacts, required exams and fittings. Hearing coverage would include hearing aids and their maintenance, along with audiology services.

The coverage expansion was a component of a larger effort that would have empowered Medicare to negotiate prescription drug prices. Some of the savings from drug costs would have been invested back into the program.

Another major gap in coverage — retail pharmacy prescription drugs — wasn't included until 2003. It is also important to remember that long-term care isn't covered by Medicare.

Call an experience attorney with questions. Book a Call

Reference: US News (June 26, 2021) “Dental, Vision and Hearing Benefits for Medicare”