Medicare has excluded dental coverage for 60 years, devastating seniors' oral health

When Medicare was created in 1965, dental care was explicitly excluded from covered services. Sixty years later, this exclusion remains intact. Approximately 47 million Medicare beneficiaries — nearly all Americans over 65 — have no dental coverage through their primary health insurance. Medicare Advantage plans sometimes include limited dental benefits, but these are typically capped at $1,000-$2,000 per year, with extensive restrictions and narrow provider networks. The impact on seniors is severe and measurable. One in five adults over 65 has untreated tooth decay. Edentulism (complete tooth loss) affects 13% of seniors aged 65-74 and rises sharply after that. Seniors without teeth struggle to eat nutritious foods, leading to malnutrition that worsens chronic conditions like diabetes and heart disease. The inability to chew properly is directly linked to cognitive decline. A 2023 meta-analysis found that tooth loss was associated with a 48% increased risk of cognitive impairment. Seniors are literally losing their minds in part because they cannot afford to keep their teeth. The exclusion persists because adding dental to Medicare is expensive — the CBO estimated it would cost $238 billion over 10 years in the most recent Build Back Better proposal. Every time Congress considers adding dental to Medicare, the price tag kills the effort. Dental industry groups have mixed positions: some support expanded coverage because it would bring paying patients, while others oppose government rate-setting. The result is legislative paralysis. Seniors who worked their entire lives and paid into Medicare discover at 65 that the health insurance they earned considers their mouth a separate, uncovered organ.