Congress has proposed the expansion of Medicare benefits for seniors to include a dental, hearing and vision benefit in the 2022 Budget Resolution. While the American Dental Association (ADA) and New York State Dental Association (NYSDA) support a senior dental benefit, we do not support the expansion in its current form.
The projected expansion, likely to fall under Medicare Part B, is projected to be underfunded and not designed for efficient administration by dental providers. ADA lobbyists have been meeting on Capitol Hill to discuss the ADA policy on financing oral health care for adults aged 65 and older.
The ADA position is that if any dental benefit is added to Medicare, it should focus on low-income seniors with incomes up to 300% of the federal poverty level. This would cover approximately 47% of the older adult population who currently do not visit the dentist because they cannot afford it. In addition, the policy, adopted by the 2020 ADA House of Delegates, insists that the program be sufficiently funded to ensure adequate reimbursement for dentists with reduced administrative burden. It must also allow freedom of choice for patients to seek care from any dentist, while continuing to receive the full program benefit. The policy also recommends the creation of a distinct and separate program within Medicare geared towards dentistry, and not Part B, which is designed for the delivery of healthcare by physicians. There is little understanding on Capitol Hill of the vast differences between a dental benefit and a medical health plan.
Now is the time for Congress to hear from you on how to design a new dental benefit in Medicare and how it could best work for dentists and Medicare patients. Just saying "no" is not an option in this high-profile political debate.
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- The ADA has created a FAQ to explain its response to the proposed expansion.
- ADA News: ADA Advocates for Medicare Dental Benefits to Focus on Low-Income Seniors
- ADA Advocacy website: Medicare
- ADA Webinar 8/19/21: Congress Considers a Medicare Dental Benefit