There are NO dental MEDICARE benefits available for Seniors and/or nursing home residents.
MEDICARE
Title 18 of the Social Security Act, is the federal health insurance for persons 65 years and older. It covers over 95% of America's elderly but pays for practically NO dental care. It does not pay for dental examinations, x-rays, dentures, fillings, or cleanings. Medicare will only pay for the setting of fractures of the jaw when performed in a hospital setting. It may also pay for the removal of teeth when completed in a hospital setting--but not their replacement.
MEDICAID does have benefits for adults in Missouri nursing homes and limited benefits in Kansas
Title 19 of the Social Security Act, is a federal/state program providing reimbursement for health care services for persons with very low incomes and little or no assets.
In order for a state to receive federal matching dollars, it must provide dental services for children. Unfortunately, this requirement does not extend to low-income adults, including the elderly. States can choose to provide dental care to their low-income adults as one of the "optional" services. Although some states choose to do so, most do NOT reimburse for basic oral health services needed by their adult population. Missouri and Kansas currently have no benefits for adults
PRIVATE INSURANCE
Of the 30 million persons 65 years and older in 1988, approximately 6% had dental insurance (Wolf SH, Kamerow DB, 1990, p. 817-823).
AARP has a dental insurance program: http://www.aarphealthcare.com/Products/Dental/
OUT OF POCKET EXPENSE
The vast majority of dental services received by older persons is paid for out of pocket. For some older people, this presents no financial problem, but for the many who live within 200% of the federal poverty guidelines, lack of third party reimbursement for dental services is a barrier to care.
Elderly people who live in nursing homes are at greater risk for oral health problems compared to elderly people who live independently.
As people age, medical complications and other factors can negatively affect oral health. Evidence shows that older Americans are at risk for greater oral health problems than other groups because of age and the inability to get to a dentists office due to an existing medical condition or lack of transportation.
"Oral health of frail elders residing in long-term care facilities is very poor. Most of the care at nursing homes is medical care and nursing care, and sometimes the oral health needs are overlooked.
Children or relatives should take an active role in the oral health needs of elderly people residing in nursing homes:
Assisting with:
All oral health problems, should be reported to the nursing staff for proper diagnosis and treatment.
Important questions to ask nursing home administrators:
Before choosing a nursing home for an elderly person, relatives and loved ones should inquire about the quality and consistency of dental care at the facility:
Does the home have on-call dentists?
Is nursing home staff trained in basic mouth care?
Is the nursing home staff trained to recognize oral pathology?
Does nursing home staff emphasize mouth care at least once a day?
If the staff or home administrator can't say 'yes' to each of these questions, then these areas need to be addressed before admitting your loved one into the care facility.
| 