8, 9 In addition to reflecting underlying disease, poor oral health can exacerbate general health issues and systemic diseases. 7 Oral health examinations can identify nutritional deficiencies, HIV, certain microbial infections, and some cancers. 5, 6 Oral health is often a reflection of the overall health of the body. Numerous studies confirm the direct connection between oral health and overall health. The Health and Economic Consequences of Unmet Need Almost one in five Medicare beneficiaries (19%) who used dental services spent more than $1,000 out-of-pocket on dental care in 2016.Almost half of all Medicare beneficiaries did not have a dental visit within the past year (49%), with higher rates among those who are black (71%) or Hispanic (65%), have low incomes (70%), and are living in rural areas (59%), as of 2016.Almost two-thirds of Medicare beneficiaries (65%), or nearly 37 million people, do not have dental coverage (Figure 1).įigure 1: Most people on Medicare do not have dental coverage, and many go without needed care.It describes the consequences of foregoing dental care, current sources of dental coverage, use of dental services, and related out-of-pocket spending. This brief reviews the state of oral health for people on Medicare. Limited or no dental insurance coverage can result in relatively high out-of-pocket costs for some and foregone oral health care for others. Medicare, the national health insurance program for about 60 million older adults and younger beneficiaries with disabilities, does not cover routine dental care, and the majority of people on Medicare have no dental coverage at all. ![]() 3 Lack of routine dental care can also delay diagnosis of conditions, which can lead to potentially preventable complications, high-cost emergency department visits, and adverse outcomes. 2 Untreated caries (cavities) and periodontal (gum) disease can exacerbate certain diseases, such as diabetes and cardiovascular disease, and lead to chronic pain, infections, and loss of teeth. Having no natural teeth can cause nutritional deficiencies and related health problems. 1 Untreated oral health problems can lead to serious health complications. Oral health is an integral part of overall health, but its importance to overall health and well-being often goes unrecognized. Please see the methodology here for more information. Due to this and other methodological changes in our analysis, estimates of the number of people on Medicare with dental insurance cannot be trended using our 2016 estimate. It is not possible to calculate a correct estimate for that year due to the MCBS data collection issue. As a result, the estimate of how many beneficiaries lack dental coverage (65%) should not be used. Due to a data collection and processing issue identified by CMS, the estimates for private dental coverage derived from the 2016 Medicare Current Beneficiary Survey (MCBS) were lower than they should have been by an unknown magnitude. OCC is also responsible for functions that support these service lines such as administration, planning, oversight and stakeholder relations.NOTE: A newer version of this analysis is available here. ![]() Here’s more information on emergency care.Ībout the author: VA’s Office of Community Care (OCC) operates two main service lines, Delivery Operations and Revenue Operations, that support medical care delivery and services for Veterans and their families. ![]()
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