Advocacy group urges CMS to expand Medicare dental plan coverage – Home Care Daily News

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The Center for Medicare Advocacy is pushing the Centers for Medicare & Medicaid Services and Congress to expand Medicare dental coverage.

Currently, the federal health care program does not pay for services related to the care, treatment, filling, extraction or replacement of teeth or structures supporting teeth, said Wey-Wey Kwok, senior counsel for the center who spoke during a webinar. Wednesday. She noted that a myth persists that Medicare covers dental procedures if they are performed in a hospital. Only Medicare Part A will cover part of the hospital stay.

What does health insurance cover in the oral health service?

“Not much,” Kwok noted.

Some 65% of Medicare beneficiaries, or 37 million people, do not have dental coverage, Kwok pointed out during the webinar. Additionally, 49% of Medicare beneficiaries have not seen a dentist in the past year, with a high percentage of black, Hispanic, non-elderly, and low-income people with disabilities taking a pass, the Kaiser reported. Family Foundation in 2019. A total of 89% of the dental services used resulted in an average of $ 922 in out-of-pocket expenses, according to Kaiser.

The problem of lack of coverage has serious consequences, including persistent pain, infections and inflammation; expensive emergency room visits and hospitalizations; and social isolation, which can affect cognitive health, Kwok said.

The Center for Medicare Advocacy, a nonprofit that works to advance access to comprehensive Medicare coverage for the elderly and people with disabilities, wants CMS to expand the reach of medically necessary coverage. This includes when a medical procedure or covered treatment cannot take place or will be adversely affected unless the patient’s dental / oral problem is treated or resolved.

Additionally, the center is advocating for legislation to add a full oral benefit to Medicare Part B. That benefit would likely be associated with benefits for vision and hearing, Kwok said.


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