The Burden of Out-of-Pocket Expenditures for Dental Care on Medicare-Enrolled Elderly and Disabled

Published 02/19/2020

A report from CareQuest Institute, the third in a three-part series addressing utilization of dental services and out-of-pocket costs for dental care, focuses on patients on Medicare. It compares costs associated with different types of Medicare coverage and reveals a high burden of out-of-pocket spending for Medicare enrollees.  

Key findings from the report: 

  • Among all Medicare or Medicare Advantage recipients, at least 75% of total dental costs were paid for out-of-pocket.  
  • Only four percent of those covered by traditional Medicare had dental costs covered by Medicare.  
  • The lack of a mandated dental benefit in Medicare significantly contributes to poor health among America’s elderly and disabled populations. 

The lack of a dental benefit within Medicare can also contribute to other health problems, increasing costs for patients and for Medicare. Including oral health services within value-based programs could provide incentives for payers and providers to improve individual and population health.  

Read the Additional Research Reports in this Series  

Part 1 of 3 Poor Families Spend 10 Times More of Their Income on Dental Care Than Wealthier Families analyzes oral health needs and financial implications for Americans of different income levels. 

Part 2 of 3 Medicaid Adult Dental Benefits Increase Access and Reduce Out-of-Pocket Expenditures compares the experience of adults enrolled in Medicaid to adults with private coverage and to those who lack coverage.