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Medicare – the health insurance program that most older Americans rely on – would cover dental care, vision and hearing under a budget deal announced Tuesday night by Senate Democrats.
The proposed expansion of coverage was included as part of a plan to spend $ 3.5 trillion over the next decade on climate change, health care and family services programs, which all part of President Joe Biden’s economic agenda. While there is no certainty that everything in the budget plan will go through the full process of Congress, Medicare advocates are hopeful that additional benefit coverage will materialize.
“This would be a very big deal for the Medicare program and Medicare beneficiaries,” said David Lipschutz, associate director and senior counsel for the Center for Medicare Advocacy.
“If Congress adds [those] benefits, this would fill some significant gaps in the program’s coverage since its inception, ”said Lipschutz.
About 62.7 million people are enrolled in Medicare, the majority of whom are 65 years of age and over and depend on it for their primary health insurance. The program was created by legislation of Congress in 1965 under President Lyndon Johnson and largely mirrored the health coverage standards of the time, which did not involve widespread coverage for dental, vision and hearing. Lipschutz said.
“But as the healthcare system has evolved, Medicare has often been slow to catch up,” he said.
Original Medicare consists of Part A (inpatient coverage) and Part B (outpatient care coverage). With limited exceptions, there is no coverage related to dental, vision or hearing care, which may cause beneficiaries to forgo care.
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“It would be a significant improvement [to provide coverage] for people who often go without needed care because they cannot afford it and for people who pay dearly for the care they need, ”said Tricia Neuman, Executive Director of the Kaiser Family Program Foundation on Medicare Policy.
Some beneficiaries have limited coverage for dental, vision and hearing if they choose to receive their Part A and B benefits through an Advantage (Part C) plan, which often includes these extras. About 40% of beneficiaries are enrolled in Advantage plans.
However, Lipschutz said, the additional coverage is usually not comprehensive. On the other hand, if extended benefits – no matter how generous – were required as part of the original health insurance, they would become the norm in an Advantage plan.
“We hope this will enrich the benefits for all beneficiaries,” Lipschutz said.
While no details have been released on how the expanded coverage would be funded, Biden has proposed to impose higher taxes on the wealthy and corporations.
The Senate Democrats’ announcement also provided few details on the proposed changes, although other efforts to expand Medicare coverage may offer some clues.
A House bill introduced last week by Representative Lloyd Doggett, D-Texas, would include items such as dentures, preventive and emergency dental care, refractive eye exams and glasses, as well than hearing aids and exams.
The expanded coverage was also included in a larger healthcare-related bill that authorized the House in 2019 but was not taken up by the Senate. Under this proposal, beneficiaries would have contributed the standard 20% for some dental coverage. Major treatments, ie bridges, crowns, root canals, would have cost more. Dentures would also have been covered, within certain limits. And routine eye and hearing exams, along with hearing aids, contact lenses, and glasses, were also reportedly included.