A 2020 study published in Health Affairs found that proper oral, vision, and hearing care are essential for overall health for seniors. According to findings from the study, poor oral health is associated with higher rates of diabetes, cardiovascular disease, and pulmonary infections; vision loss can lead to a higher risk of falls; and hearing loss can cause depression and cognitive impairment. But original Medicare coverage doesn’t pay for most routine dental or vision care. Usually, it only pays for dental care needed to diagnose or treat an illness— not cleanings, X-rays, bridges, and crowns. And it will pay for vision exams or eyewear related to health conditions like diabetes or cataracts, but not for preventive checkups or glasses. It doesn’t pay for any hearing devices. To avoid paying for these things themselves, many seniors are skipping preventive care— and are sometimes going without being able to see, hear, or even chew.
But thanks to current discussions in congress, that could soon change. President Biden has included Expanded Medicare Benefits For Seniors in his 2022 budget proposal; and if it passes, Medicare’s 60 million beneficiaries may become eligible to receive dental, vision, and hearing coverage.
The current cost of Medicare coverage for seniors
Some seniors opt to purchase supplemental or private insurance plans that include dental or vision care. Anthem offers Medicare supplements to cover the cost of routine dental and vision care, with premiums around $148.50 a month. A basic plan with Delta Dental costs $24 per month and pays a maximum of $1,000 per year, while a premium plan is $48 per month and pays for up to $1,500 per year. But according to a survey by the American Dental Association’s Health Policy Institute; the average cost for a patient needing periodontal treatment, three fillings, and two crowns was $4,360. That leaves a lot of money left for a senior to pay on their own— which is really hard on a fixed budget. Not surprisingly, a 2019 Kaiser Foundation report found that about one out of seven Medicare recipients have lost all their teeth.
According to VSP Vision Care, seniors without insurance can expect to pay $576 for an eye exam, glasses, and frames. Not every elderly person has that kind of cash available to spend.
And with the National Institute of Health estimating that one-third of those aged 65 to 74 have hearing loss, and half of those older than 75, you’d think that more elderly people would have hearing aids. But those can cost thousands of dollars, and Medicare doesn’t currently cover the expense.
The goal for expanding Medicare coverage
Exact details of this $3.5 trillion plan are still being discussed, but if the bill passes, seniors can expect to see the following coverage under Medicare Part B:
- Comprehensive dental coverage including regular preventive care such as cleanings and X-rays, minor work such as fillings; and major work including root canals, crowns, and dentures.
- Vision coverage including preventive exams, fittings, eyeglasses, and contacts.
- Hearing coverage including audiology services as well as the purchase and maintenance of hearing aids.
How can I get dental and vision coverage in the meantime?
It could still be quite some time until a decision is made regarding the expansion plan. If you or your loved one doesn’t currently have dental or vision coverage, ask your local Medicare representative about adding Medicare Advantage (Part C) to your original plan. This will allow you to get coverage for dental and vision health items as well as some hearing and prescription drug coverage— all of which are essential to an overall healthy life for seniors.