医疗保险受益人的牙科保险。

IF 2.1 Q2 HEALTH POLICY & SERVICES Policy, Politics, and Nursing Practice Pub Date : 2024-11-01 Epub Date: 2024-09-28 DOI:10.1177/15271544241283793
Gregory Wolownik, Sally S Cohen
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引用次数: 0

摘要

口腔健康状况不佳与各种全身性疾病(如心内膜炎、肺炎、心血管疾病和糖尿病)和生活质量下降有关。1965 年颁布的《医疗保险》不包括全面的牙科服务。截至 2023 年,医疗保险允许承保与特定医疗条件密不可分的有限牙科服务。许多医疗保险优势计划(医疗保险 C 部分)提供牙科保险。然而,在 2019 年,约有 2400 万联邦医疗保险受益人(占所有联邦医疗保险参保人的 47%)没有牙科保险。71%的传统医疗保险参保人(未加入医疗保险优势计划的人)表示,高昂的费用是他们没有获得牙科护理的主要原因。口腔健康对老年人的重要性一直是一个全国性跨专业联盟(其中包括几个全国性护理组织)一直在倡导立法扩大医疗保险的牙科保险范围的主要原因。美国牙科协会和许多共和党议员的激烈反对使该联盟的努力受挫。鉴于护士和高级执业护士在照顾全国老年人和残疾人方面发挥着至关重要的作用,在倡导将牙科福利纳入传统医疗保险方面,护士作为领导者的声音需要得到加强。
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Dental Coverage for Medicare Beneficiaries.

Poor oral health has been associated with various systemic diseases (e.g., endocarditis, pneumonia, cardiovascular disease, and diabetes) and decreased quality of life. When enacted in 1965, Medicare excluded coverage for comprehensive dental services. As of 2023, Medicare has allowed coverage of limited dental services inextricably linked to specific medical conditions. Many Medicare Advantage plans (Medicare Part C) offer dental coverage. Yet in 2019, approximately 24 million Medicare beneficiaries (47% of all Medicare enrollees), lacked dental coverage. Seventy-one percent of traditional Medicare enrollees (those not enrolled in a Medicare Advantage Plan) reported that high cost was the primary reason that they did not obtain dental care. The importance of oral health for the older adults has been the main reason that a national interprofessional consortium, which includes several national nursing organizations, has been advocating for legislation to expand Medicare to include dental coverage. The consortium's efforts have been thwarted by fierce opposition from the American Dental Association and many Republican legislators. Given the vital role that nurses and advanced practice nurses play in caring for the nation's older adults and disabled, nursing's voice needs to be strengthened as leaders in advocating for inclusion of dental benefits in traditional Medicare.

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来源期刊
Policy, Politics, and Nursing Practice
Policy, Politics, and Nursing Practice Nursing-Leadership and Management
CiteScore
3.30
自引率
5.60%
发文量
24
期刊介绍: Policy, Politics & Nursing Practice is a quarterly, peer-reviewed journal that explores the multiple relationships between nursing and health policy. It serves as a major source of data-based study, policy analysis and discussion on timely, relevant policy issues for nurses in a broad variety of roles and settings, and for others outside of nursing who are interested in nursing-related policy issues.
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