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How Medicare Could Provide Dental, Vision, and Hearing Care for Beneficiaries

January 1, 2018

The Medicare program specifically excludes coverage of dental, vision, and hearing services. As a result, many beneficiaries do not receive necessary care. Those that do are subject to high out-of-pocket costs. This report examines gaps in access to dental, vision, and hearing services for Medicare beneficiaries and design a voluntary dental, vision, and hearing benefit plan with cost estimates.

Medicare Beneficiaries' High Out-of-Pocket Costs: Cost Burdens by Income and Health Status

May 12, 2017

Issue: Fifty-six million people—17 percent of the U.S. population—rely on Medicare. Yet, its benefits exclude dental, vision, hearing, and long-term services, and it contains no ceiling on out-of-pocket costs for covered services, exposing beneficiaries to high costs.Goal: To inform discussion of possible changes to Medicare, this issue brief looks at beneficiaries' out-of-pocket costs by income and health status.Methods: Spending estimates based on the Medicare Current Beneficiary Survey.Findings and Conclusion: More than one-fourth of all Medicare beneficiaries—15 million people—spend 20 percent or more of their incomes on premiums plus medical care, including cost-sharing and uncovered services. Beneficiaries with incomes below 200 percent of the poverty level (just under $24,000 for a single person) and those with multiple chronic conditions or functional limitations are at significant financial risk. Overall, beneficiaries spent an average of $3,024 per year on out-of-pocket costs. Financial burdens and access gaps highlight the need to approach reform with caution. Already-high burdens suggest restructuring cost-sharing to ensure affordability and to provide relief for low-income beneficiaries.