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Oral Health Assessment by Lay Personnel for Older Adults

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Published on: February 2, 2020

Dental Coverage for Medicare Beneficiaries.

Gregory Wolownik¹, Sally S Cohen²

¹Mount Sinai Health System, New York, NY, USA.

Policy, Politics & Nursing Practice

|September 28, 2024

Summary

Millions of Medicare beneficiaries lack dental coverage due to cost, impacting oral and overall health. Expanding Medicare benefits to include comprehensive dental care is crucial for older adults.

Keywords:

Medicare dental care health care policy health services accessibility nursing oral health

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Area of Science:

Public Health
Health Policy
Gerontology

Background:

Poor oral health is linked to systemic diseases and reduced quality of life.
Medicare, established in 1965, historically excluded comprehensive dental services.
Limited dental coverage exists for specific medical conditions, and Medicare Advantage plans may offer some benefits.

Purpose of the Study:

To highlight the significant gap in dental coverage for Medicare beneficiaries.
To examine the barriers preventing access to dental care, primarily cost.
To advocate for the inclusion of comprehensive dental benefits in traditional Medicare.

Main Methods:

Analysis of Medicare coverage policies and enrollment data.
Review of reasons cited by beneficiaries for lacking dental care.
Examination of advocacy efforts by nursing organizations and opposition faced.

Main Results:

In 2019, 24 million Medicare beneficiaries (47%) lacked dental coverage.
High cost was the primary barrier for 71% of traditional Medicare enrollees without dental care.
Advocacy for expanded Medicare dental benefits faces significant opposition.

Conclusions:

A substantial number of older adults are without essential dental coverage, impacting their health.
Expanding Medicare to include comprehensive dental benefits is vital for improving the well-being of the elderly population.
Strengthening nursing leadership in advocacy is essential to overcome legislative hurdles and achieve policy change.