The Effect of Dental Insurance on the Use of Dental Care for Older Adults: A Partial Identification Analysis

Abstract

We evaluate the impact of dental insurance on the use of dental services using a potential outcomes identification framework designed to handle uncertainty created by unknown counterfactuals – that is, the endogenous selection problem – as well as uncertainty about the reliability of self-reported insurance status. Using data from the Health and Retirement Study, we estimate that utilization rates of adults older than 50 would increase from 75% to around 80% under universal dental coverage.

Dental Care And Medicare Beneficiaries: Access Gaps, Cost Burdens, And Policy Options

“…Based on our analysis of the MCBS data, almost 12 percent of Medicare beneficiaries reported having some dental insurance-a share that is lower than that reported by other studies of dental insurance. 5,6 This may reflect the fact that many people are not aware that their insurance covers some dental services. 8,18 ▸ EXAMINATION OF POLICY ALTERNATIVES: For the purposes of modeling use of and spending on dental care for the total Medicare population, we assumed that average spending was likely to be higher among people with dental insurance, incomes high enough to rule out cost as a barrier, or both.…”

“…8,18 ▸ EXAMINATION OF POLICY ALTERNATIVES: For the purposes of modeling use of and spending on dental care for the total Medicare population, we assumed that average spending was likely to be higher among people with dental insurance, incomes high enough to rule out cost as a barrier, or both. 6 To estimate likely monthly premium costs of providing dental benefits, we therefore used the average total spending and use of higher-income beneficiaries (those with incomes of at least 200 percent of poverty) who had dental insurance.…”

“…4 Similarly, retirees who had dental as well as medical benefits while working and receive employer-sponsored insurance to supplement Medicare after they retire often find that dental benefits are not included. 5,6 The lack of coverage-combined with the fact that half of Medicare beneficiaries live on incomes below $23,000 a year 7 -puts older adults at risk for oral health problems that could be prevented or treated with timely dental care, including tooth decay, periodontal disease, and edentulism (having no natural teeth left). 3,8 Providing striking evidence of the consequences of barriers to access to dental care, physical exams conducted as part of the National Health and Examination Survey in 2011 and 2012 showed that 19 percent of adults ages sixty-five and older had untreated dental caries and nearly 19 percent had lost all their teeth-and the rates of untreated dental caries and edentulism were 2.6 times and 1.7 times higher, respectively, among non-Hispanic blacks in that age group than among non-Hispanic whites.…”

Demand and Burden of Dental Care in Canadian Households

“…Therefore, the issue of public dental insurance for basic primary dental care is worth debating and exploring. (Kreider, Manski, Moeller, & Pepper, 2014).…”

The Association Between Dental Coverage and Self-reported Health in Older Adults jGPHA

“…Studies that have examined dental insurance coverage among adults in the United States have provided evidence to support the provision of increased dental coverage to improve overall health of older adults (Kreider, Manski, Moeller, & Pepper, 2015;Willink et al, 2016). The aim of the present study was to examine the relationship between dental coverage and self-reported health over time in a national sample of older Americans.…”