Is a Dental Benefit Needed in Medicare?

Patterns of dental care spending and use

A dentist examines a patient's mouth.

As Congress considers expanding Medicare coverage to include dental, vision, and hearing services, a new analysis shows dental needs and spending increase with age.

 

The Issue

Traditional Medicare coverage excludes dental coverage despite research that shows the necessity of dental care increasing with age. Among adults, spending on dental services reaches its highest levels between the ages of 65 and 79. While some Medicare enrollees have supplemental dental coverage, only about 27 percent of Medicare enrollees' total dental costs are currently covered by insurance.

Key Findings

  • Individuals age 65 and older pay 58 to 75 percent of their total dental care costs out of pocket, a higher share than younger age groups.

  • Medicare enrollees with low incomes are less likely to see a dentist than those with high incomes—28.7 percent of individuals with incomes below the federal poverty level accessed dental care, compared to 69.7 percent of individuals with incomes 4x the federal poverty level.

  • Utilization of dental care is lower among Medicare enrollees who are Black, Hispanic, and of other races (35–40%) compared to White enrollees (52.2%).

Conclusion

Dental health impacts overall health and Medicare enrollees could substantially benefit from expanding coverage to dental services.

About the Urban Institute

The nonprofit Urban Institute is dedicated to elevating the debate on social and economic policy. For nearly five decades, Urban scholars have conducted research and offered evidence-based solutions that improve lives and strengthen communities across a rapidly urbanizing world. Their objective research helps expand opportunities for all, reduce hardship among the most vulnerable, and strengthen the effectiveness of the public sector. Visit the Urban Institute’s Health Policy Center for more information specific to its staff and its recent research.