Report: Adding dental coverage to Medicare Part B could save enrollees $500+

Medicare enrollees could save $500+ per year in out-of-pocket spending if federal lawmakers expand parts of the program to include dental services, according to a report released Tuesday.

The Urban Institute analysis—aided by funding from the Robert Wood Johnson Foundation—examined the implications of expanding Medicare Part B, which covers medically necessary and preventive services, to include dental care. The proposed coverage would be subject to Part B deductibles and 20% cost-sharing, and it could lower out-of-pocket expenses by 80%, or $530 per person annually, the report found.

Katherine Hempstead, a Robert Wood Johnson Foundation senior policy advisor, said the proposed expansion is “an opportunity to increase equity and close long-standing gaps in access to dental services.” Low-income adults currently “bear the brunt” of Medicare’s lack of dental coverage, she added.

Anuj Gangopadhyaya, a Loyola University Chicago assistant professor of economics who previously worked as a senior research associate at the Urban Institute’s Health Policy Center, agreed that adding a dental benefit to Part B would improve Medicare enrollees’ use of those services. But “differences in dental spending by enrollee racial and ethnic background and by income group that existed before adding a dental benefit would persist under this policy,” he said in a statement.

The report estimated that dental spending under the proposal would increase by more than 70% for people with incomes below the federal poverty level (FPL), or $14,580 for individuals or $19,720 for a family of two in 2023. Enrollees with incomes 400% above the FPL would only see a 20% increase in Medicare spending.

Black and Latino/Hispanic enrollees would see the largest percentage increase in dental spending (44% and 45%, respectively), while white enrollees would see the largest increase by dollar amount (a per capita spending increase of $1,032, compared to $530 for Latino/Hispanic enrollees, and $356 for Black enrollees), the report found.

Total spending on dental care would further rise by an estimated 34%, or $19.4 billion, according to the analysis. Meanwhile, per capita dental services spending would increase to $1,129 from $841.

Pending legislation

In March, Democratic Senators Bob Casey of Pennsylvania and Ben Cardin of Maryland unveiled the proposed Medicare and Medicaid Dental, Vision, and Hearing Benefit Act. The bill would end an exclusion that currently prevents Medicare from covering services in those three areas, and it would also increase federal matching rates for Medicaid coverage of those services.

The existing restrictions, the sponsors argued, have led some enrollees to rely on “stopgap, short-term” insurance plans for those medical services or face high out-of-pocket costs due to the lack of coverage.

“Congress has an opportunity to ensure that serious health conditions can be avoided or caught early enough to prevent complications or more costly treatments, regardless of where someone lives or their income,” Cardin said in a March statement. “Our legislation will make a real difference in so many lives.”

The Senate Finance Committee is reviewing the bill, which has yet to pass in either chamber.