Dental, Vision, and Hearing Services: Access, Expenses, and Coverage for Medicare Beneficiaries

Among Medicare beneficiaries, dental, vision, and hearing services could be characterized as having high need, high cost, and low utilization. Although Medicare does not cover most of these services, coverage has recently increased due to changes in state Medicaid programs and increased enrollment in Medicare Advantage (MA) plans, many of which offer these services as additional benefits. Using data from the 2016 Medicare Current Beneficiary Survey, this analysis shows that PA plans fill a significant gap in dental, vision, and hearing coverage, especially among low- and middle-income beneficiaries. . In 2016, only 21% of traditional health insurance beneficiaries had purchased a stand-alone dental plan, while 62% of MA enrollees were in plans with a dental benefit. Among Medicare beneficiaries with comprehensive coverage, out-of-pocket expenses still accounted for 70% of dental expenses, 62% of vision expenses, and 79% of hearing expenses. Although Medicare beneficiaries enroll in private coverage options, they do not have adequate financial protection. This article examines these findings in the context of recent congressional proposals to expand Medicare coverage for dental, vision, and hearing services.

Michael A. May