Medicare Is Eyeing Dental Coverage Again—Don't Get Excited Yet

Medicare is eyeing dental. Again. The headlines sound good. The details are broken. Don't get excited yet.

What's on the table: Several 2025 proposals have floated dental benefits into Medicare. The framing: seniors deserve preventive care access. The reality: preventive-only coverage. A cleaning. An exam. Nothing else. Root canals, crowns, implants, extractions remain uncovered.

Why this looks good on paper and fails in practice: Half of seniors need restorative care, not cleaning. And under the current UCR model, Medicare would pay 30-40 percent below what you're accepting from private insurance. You'd be treating Medicare patients at a loss just for the "prevalence." Plus, the administrative burden of new coding, new documentation, new appeal processes would eat 10+ hours per month in your office.

The honest version: Dental in Medicare isn't about patient access. It's about congressional optics. "We expanded benefits" is a press release. Actual impact on your practice is negative. Lower reimbursement, higher overhead, minimal patient volume from the Medicare cohort that can actually afford treatment.

Action: Don't lobby for this. Don't hold your breath. Focus on privately insured patients with real benefits. That's where the actual money is.