Dental & Vision Coming to Medicare–If Congress Approves

If you have Medicare, you probably already know that you aren’t covered for dental or vision under the program. That is unless you purchase additional coverage through Advantage or standalone policies.

medicare in congress building
Pay attention to the people we have in office. It’s important for our healthcare system.

There’s tentative good news coming; Congress might be allowing Medicare to negotiate prices for prescription drugs, and the pharmaceutical companies that produce them. With these talks, they’re seeking a cap for out-of-pocket expenses people have been expected to pay for with their medication.

Members of the House Ways & Means Committee passed three Medicare benefits expansion bills that would add dental, vision, and hearing care insurance benefits to the program. Although these committees passed the bills, they must be adopted and implemented. 

David Lipschutz, the Center for Medicare Advocacy’s associate director, says “There have been proposals over the years that would do this, but in the past, they haven’t gone anywhere. It looks like this time something could get passed in at least one chamber of Congress.”

The proposed bills are:

  1. H.R. 4650 (the Medicare Dental Act of 2019 bill): This bill would add preventive and screening coverage for basic and major dental services, such as coverage for bridges, crowns, root canals, and dental implants, to the definition of “medical and other health services” covered by Medicare, in Section 1862(s) of the Social Security Act of 1935. 
  2. H.R. 4665 (the Medicare Vision Act of 2019 bill): This bill would add coverage for routine eye exams to coverage through Part B, with beneficiaries paying 20% of the cost. It would provide coverage for eyeglasses, basic eyeglass frames and contact lenses to the Medicare definition of “medical and other health services.” 
  3. H.R. 4618 (the Medicare Hearing Act of 2019 bill): This bill would add coverage for hearing exams and hearing aids to the Medicare “medical and other health services” definition under Part B. Beneficiaries would have to contribute 20% as they would normally under Part B costs.

These bills include provisions for cost-sharing among the patients, and includes limits on the number of products and services, such as hearing aids, adding relief to those who couldn’t afford these services before.

person holding glasses paid for with Medicare
Both our eyes and teeth play important parts of health. We really need coverage to help take care of them.

Members of the House Energy and Commerce Committee have also approved the bills, but it still needs further support before it is fully implemented. There is no exact estimate as to how these bills would impact Medicare’s budget. 

While we’re not sure about the costs incurred from these changes, Medicare’s overall costs are expected to rise, and there is more work to be done if an accurate assessment is to be presented. But one thing is for sure, if Medicare offers hearing, dental, and vision, then it would make a lot of people’s lives a little easier. 

Senate GOP Planned on Getting Rid of Healthcare Mandate, With No Success

Republicans have been working to get rid of the individual mandate from the Affordable Care Act. The reason is to not only save the government money, but to “provide more tax relief to middle class families.” However, they have failed repeatedly to get the tax reform bill passed, leaving the mandate applicable, and the penalty that follows if it is disregarded.

The individual mandate is the requirement for people to buy health insurance or pay a fine. This was intended to have people buy coverage, especially those that are healthy, in order to keep insurance costs lower for everyone. When healthy people are part of the insurance pool, it helps fund the treatment costs of sicker people.

The Congressional Budget Office estimates that by repealing the mandate, the government will save about $330 billion over the next ten years. The money the government would save is the money spent on insurance premiums because people would drop their insurance or opt out of having one. The Congressional Office also estimates that there will be 13 million people uninsured in the following ten years. Without the mandate, fewer people will sign up for insurance, especially healthy people. What will then happen is the costs of treatment for the sicker people would sky rocket.

There have been many arguments as to whether the mandate encourages or discourages people from buying health insurance. Republicans argue that the mandate discourages people from buying insurance that costs just as much as the penalty they would receive if not being insured. But, studies have shown that more Americans over the years have been signing up for insurance because of the law. Paying a penalty that can cost more than paying for insurance is poor financing and illogical.

Republicans claim that repealing this mandate would mainly help the middle class. “Eighty percent of the people who pay the mandate tax make less than $50,000 a year, and a third of those who pay the tax make less than $25,000 a year,” said Sen. John Thune. However, the issue is that the ones who will suffer the most are the middle class. When premiums increase even more, only those who qualify for subsidies will be able to afford coverage. People who earn too much to qualify for a subsidy, and want to buy insurance will have a hard time with medical costs, because coverage will be too expensive.

There is some support behind the mandate repeal amongst Americans, while others think it’s a bad idea after hearing that many Americans will be uninsured, causing premiums to rise. Despite the support or lack of from the American people, the mandate is here to stay and you will be penalized if uninsured.

Get Help Making Sense Of All Of This

The Senate’s continuous failed attempts prove that this reform bill will not pass, leaving the individual mandate the current law. If you do not sign up for health insurance, you will pay a penalty up anywhere from $695 to $2,085. It is important that you teach an agent to find a plan as soon as possible. EZ.Insure’s agents are highly knowledgeable about all the plans in your region. You will be assigned your very own agent that can help you compare plans and pick which is best for you and your family at an affordable price. No bouncing from agent to agent. Contact one now at [email protected]. To get an instant quote, you can enter your zip code in the bar above. Do not wait and  end up having to pay a penalty that could cost more than monthly premiums.

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