LAKELAND, Fla. — John DeRosa lives alone in his intimate mobile home in Lakeland’s Lake Deeson Village. A native Brooklynite and Vietnam veteran, he’s got a major health care issue — his teeth.
“I have 14 (more) teeth that have to come out,” DeRosa told Spectrum News last Friday, a day after he had one tooth removed that was giving him considerable pain. “This dentist gave me a bill which is sitting over there of $6,000 and something. That’s with my benefits for insurance, and I guess that’s it.”
What You Need To Know
- Congress is considering a plan to expand Medicare to include dental, vision and hearing benefits
- Less than 30% of people 65 years and older have dental insurance, according to a 2017 CDC study
- American Dental Association opposes the proposal, and has offered an alternative approach that would provide Medicare benefits for low-income seniors
DeRosa, 76, can’t afford to do what is necessary to take care of himself right now. Between his monthly pension and Social Security checks, he takes home about $2,500 a month.
His plight is not unique, and in some ways he has it better than other seniors. While his medical insurance offers only limited dental benefits, at least he has some coverage. Less than 30% of people 65 years and older do have dental insurance, according to a Centers for Disease Control and Prevention study from 2017.
That could change if a proposal that would expand Medicare to begin covering dental, vision and hearing gets included in President Joe Biden’s budget reconciliation bill.
Medicare Advantage, a health insurance plan that provides Medicare benefits through a private-sector health insurer, does offer plans which include dental, hearing and vision benefits, but original Medicare does not.
The American Dental Association opposes the proposal, but has offered an alternative approach that would include offering more dental services for beneficiaries with incomes up to 300% of the federal poverty level.
That would be a form of means-testing, something that Medicare has never done, said Meredith Freed, a policy analyst with the Kaiser Family Foundation’s program on Medicare policy.
“There’s only one program, which is called the Low-Income Subsidy program, that provides cost sharing and premium assistance for drug costs, but that’s helping people with their drug costs. It’s not a specific benefit,” she said. “That’s only limited to a certain population. So this would definitely set a new precedent for Medicare.”
The Congressional Budget Office estimated in 2019 that adding dental, vision and hearing coverage to Medicare would cost about $358 billion over a 10 year period (2020 to 2029). Of that amount, $238 billion would pay for dental care, $30 billion would go to vision and $89 billion would go to hearing.
Freed says that dental issues can lead to chronic pain and nutritional deficiencies for people who aren’t able to eat food like fruits and vegetables that are packed with nutrients. She says it can affect a person’s quality of life — such as not smiling because of embarrassment about missing teeth.
DeRosa says that he doesn’t know where he’ll turn to next. Though he served in the military, he’s not received any satisfaction in dealing with the VA or going through other outlets.
“I’ve tried dental schools — they will not pull any teeth,” he said. “I tried the county health department. They’ll give me $125. What’s that going to cover? Nothing.”
Friends of DeRosa have set up a GoFundMe page to help out on his dental expenses.
As far as the negotiations to expand Medicare in Congress, DeRosa says simply that if the measure isn’t part of the ultimate reconciliation budget bill, it will show that Washington-based lawmakers “don’t give a damn about us.”
Some media outlets have reported that the Democrats hope to come up with a final package that they can vote on by the end of the week.
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