Only 12 percent of older Americans have some form of dental insurance and fewer than half visited a dentist in the previous year, suggests new Johns Hopkins Bloomberg School of Public Health research on Medicare beneficiaries.
Insurance status appeared to be the biggest predictor of whether a person received oral health care: For those with incomes just over the federal poverty level, 27 percent of those without dental insurance had a dental visit in the previous year, compared to 65 percent with dental insurance, according to an analysis of 2012 Medicare data.
Income also played a role: High-income beneficiaries were almost three times as likely to have received dental care in the previous 12 months as compared to low-income beneficiaries, 74 percent of whom reported receiving no dental care. Many high-income beneficiaries – even those with dental insurance – paid a sizable portion of their bills out of pocket.
The findings, published in the December issue of the journal Health Affairs, suggest an enormous unmet need for dental insurance among those 65 and older in the United States, putting older adults at risk for oral health problems that could be prevented or treated with timely dental care, including tooth decay, gum disease and loss of teeth. It also highlights the financial burden associated with dental visits, among both the insured and uninsured.
“Medicare is focused specifically on physical health needs and not oral health needs and, as a result, a staggering 49 million Medicare beneficiaries in this country do not have dental insurance,” says study author Amber Willink, PhD, an assistant scientist in the Department of Health Policy and Management at the Bloomberg School. “With fewer and fewer retiree health plans covering dental benefits, we are ushering in a population of people with less coverage and who are less likely to routinely see a dentist. We need to think about cost-effective solutions to this problem.”
Eighty percent of Americans under the age of 65 are covered by employer-sponsored programs that offer dental insurance, which covers routine cleanings and cost-sharing on fillings and other dental work. Many of them lose that coverage when they retire or go on Medicare. The vast majority of Medicare beneficiaries who have dental insurance are those who are still covered by employer-sponsored insurance, either because they are still working or because they are part of an ever-dwindling group of people with very generous retiree medical and dental benefits.