As U.S. Medicare enrollees choose their coverage for next year, dental benefit cuts and withdrawals from certain areas by some privately run plans are emerging as factors in their decisions.
Reporting on Medicare's annual enrollment period, which began on October 15, The Associated Press highlighted the possibility of reduced coverage in some plans. Enrollees have until December 7 to choose among Original Medicare, privately run Medicare Advantage plans, prescription drug coverage and other options. Changes made during this period take effect on January 1, 2027.
Some Plans Leave Certain Areas and Reduce Dental Coverage
David Lipschutz, co-director of the Center for Medicare Advocacy, said some Medicare Advantage plans are withdrawing from certain areas and reducing benefits such as dental coverage. He also mentioned the possibility of higher costs for enrollees.
This does not mean dental benefit cuts have been confirmed for every Medicare enrollee in the United States. The report concerns changes to some private plans and does not specify how many people will be affected in which areas, or the dollar value of reductions in dental coverage. It therefore provides no basis for calculating the nationwide scale of cuts or the additional costs for individual enrollees.
Prescription Drug Costs Will Also Change in 2027
Changes in next year's health care costs do not all move in the same direction. The annual out-of-pocket cap for Part D prescription drug coverage will rise from $2,100 this year to $2,400 next year. The standard deductible, which enrollees pay before their insurance begins covering costs, will also increase from $615 to $700. A temporary federal subsidy program that helped reduce premiums ends this year.
Meanwhile, new Medicare-negotiated prices for 15 drugs take effect next year. AP reported that the Centers for Medicare & Medicaid Services (CMS) expected these prices to reduce enrollees' prescription drug costs. With measures to lower drug prices alongside possible dental benefit cuts, it is difficult to characterize the insurance changes as an across-the-board expansion or reduction in benefits.
The Need to Compare Coverage Across Plans
Juliette Cubanski, director of the Medicare policy program at the health policy research organization KFF, described this enrollment period as an opportunity to assess whether alternatives could provide needed care at a lower cost. Alongside premiums, the scope of dental coverage, enrollees' share of costs and whether a plan will remain available where they live are distinct factors to compare.
In South Korea, the National Health Insurance Service (NHIS) provides guidance on eligibility and the number of dental implants covered for older adults. Insured people and their dependents aged 65 or older who still have some natural teeth may receive coverage for up to two implants over their lifetime. The patient share for those with standard health insurance is 30% of covered costs, and people with no remaining teeth are excluded from this implant benefit. These criteria are available in the NHIS coverage guide.
The U.S. developments concern privately run plans changing the benefits they will offer the following year. When comparing them with South Korea's implant coverage, readers should distinguish which treatments are covered and under what conditions, before focusing on the fact that both concern older adults.