The fiscal year 2022 budget resolution proposes to expand Medicare coverage to include dental, vision, and hearing services. To better understand the context around a new proposed dental benefit, we examine dental care utilization and spending overall and for the Medicare population using two national databases. We first show that the highest total and out of pocket spending levels, aside from those in teenage years, occur at ages 65 to 79. Traditional Medicare excludes dental coverage, but beneficiaries can access such coverage through employer plans, Medigap coverage, Medicaid, or Medicare Advantage (MA) plans. Still, only about 27 percent of Medicare enrollees’ total dental expenditures are paid by an insurer. We also find substantial differences in dental utilization and spending by race, ethnicity, and income. Most enrollees who use any dental services use preventive services, but those with the highest expenditures have greater utilization of extensive procedures (e.g., fillings and extractions). These findings suggest Medicare enrollees could benefit substantially from policies that would expand dental coverage.
Patterns of Dental Care Spending and Use