Tag: American Dental Association

Medicare considers expanding dental benefits for certain medical conditions

By Susan Jaffe, KHN  | October 17, 2022 | This story also ran on

Proposed changes in Medicare rules could soon pave the way for a significant expansion in Medicare-covered dental services, while falling short of the comprehensive benefits that many Democratic lawmakers have advocated.

That’s because, under current law, Medicare can pay for limited dental care only if it is medically necessary to safely treat another covered medical condition. In July, officials proposed adding conditions that qualify and sought public comment. Any changes could be announced in November and take effect as soon as January. The review by the Centers for Medicare & Medicaid Services follows an unsuccessful effort by congressional Democrats to pass comprehensive Medicare dental coverage for all beneficiaries, a move that would require changes in federal law. As defeat appeared imminent, consumer and seniors’ advocacy groups along with dozens of lawmakers urged CMS to take independent action. [Continued on Kaiser Health News and CNN]

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Seeking Dental Care For Older Americans

Since Medicare doesn’t cover most dental care, seniors often go without treatment.

By SUSAN JAFFE  | Health Affairs | December 2016 | Volume 35, Number 12

The last time Evelyn Sell went to the dentist was nearly three years ago, when he told her his staff would no longer be able to lift her out of her wheelchair and into the dentist’s chair. “That really threw me for a loop,” said Sell, 87, a retired preschool teacher who lives in Kingsley Manor, a retirement community in Los Angeles. “I didn’t know what I was going to do about dental care.”

Care at home: During a recent visit to Kingsley Manor, a Los Angeles, California, senior living community, dental hygienist Maria Ladd uses an intraoral camera to take photos of resident Ruth Wilson’s teeth. (Photo: Susanna Castillo)

…Then earlier this year, she found the solution. A flyer in her mail informed her that the management of her assisted living facility had partnered with the Virtual Dental Home project run by Pacific Center for Special Care at the University of the Pacific in San Francisco. Sell could have a dental hygienist come to her home. She was one of the first residents to sign up.

The project is one of several innovative demonstrations that providers and researchers are developing to serve vulnerable uninsured or underinsured patients. Despite their promise, however, these efforts meet only a fraction of the need. A comprehensive solution would likely require federal legislation, but bills to broadly expand Medicare’s dental coverage have languished in Congress. So some advocates for older adults are working on a third front, seeking changes to Medicare coverage policy based on the idea that dental care can be an integral part of the medically necessary care Medicare covers. [Continued here] …