Medicare Advantage Dental Plans Fall Short on Coverage
A recent study reveals that only 8.4% of Medicare Advantage plans offer comprehensive dental benefits, leaving millions of beneficiaries without adequate coverage. This gap may contribute to low dental visit rates, even among those with nominal dental benefits.
Medicare Advantage, the privatized version of Medicare, has surged in popularity due to its expanded benefits, including dental coverage. However, a new analysis, published in the Journal of the American Medical Association, shows that the quality of these dental plans is alarmingly low. Despite 94% of Medicare Advantage enrollees having access to a dental benefit, only 4.1% are enrolled in plans that meet high-quality standards.
Researchers evaluated more than 6,300 Medicare Advantage plans with over 27 million enrollees, analyzing features such as annual maximums, co-pays, and premium requirements. The findings highlight that most plans fail to provide comprehensive dental benefits comparable to those in employer-sponsored plans. Key shortcomings include limited coverage for essential procedures such as fillings and crowns and restrictive cost-sharing models that burden patients.
These deficiencies may explain why only about half of Medicare Advantage beneficiaries visit the dentist annually — a rate similar to traditional Medicare enrollees, who lack significant dental coverage altogether. For dental professionals, this underscores the need to advocate for policy reforms that standardize dental benefits across Medicare Advantage plans, ensuring patients have access to the care they need. Click here to read more.
