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本文引用的文献

1
Benefit Design and Access to Dental Care Among Seniors With Medicare Advantage Dental Benefits.享受医疗保险优势牙科福利的老年人的福利设计与牙科护理可及性
JAMA Health Forum. 2025 Jan 3;6(1):e245123. doi: 10.1001/jamahealthforum.2024.5123.
2
Use and Costs of Supplemental Benefits in Medicare Advantage, 2017-2021.2017 - 2021年医疗保险优势计划中补充福利的使用情况及成本
JAMA Netw Open. 2025 Jan 2;8(1):e2454699. doi: 10.1001/jamanetworkopen.2024.54699.
3
Availability of Dental Benefits Within Medicare Advantage Plans by Enrollment and County.医疗保险优势计划中按参保情况和县域划分的牙科福利可及性
JAMA. 2025 Feb 11;333(6):534-535. doi: 10.1001/jama.2024.24814.
4
Cost-Associated Unmet Dental, Vision, And Hearing Needs Among Low-Income Medicare Advantage Beneficiaries.低收入医疗保险优势计划受益人的与费用相关的未满足的牙科、视力和听力需求。
Health Aff (Millwood). 2024 Oct;43(10):1392-1399. doi: 10.1377/hlthaff.2024.00210.
5
Oral frailty: a concept analysis.口腔脆弱:概念分析。
BMC Oral Health. 2024 May 22;24(1):594. doi: 10.1186/s12903-024-04376-6.
6
Restrictiveness of Medicare Advantage provider networks across physician specialties.医疗保险优势计划提供商网络在各医学专业的限制情况。
Health Serv Res. 2024 Aug;59(4):e14308. doi: 10.1111/1475-6773.14308. Epub 2024 Apr 9.
7
Dental Use and Spending in Medicare Advantage and Traditional Medicare, 2010-2021.2010 - 2021年医疗保险优势计划和传统医疗保险中的牙科使用情况及支出
JAMA Netw Open. 2024 Feb 5;7(2):e240401. doi: 10.1001/jamanetworkopen.2024.0401.
8
Disparities in Enrollment in Medicare Advantage Plans With Dental Benefits.参加有牙科福利的医疗保险优势计划的差异。
JAMA Netw Open. 2024 Feb 5;7(2):e2356095. doi: 10.1001/jamanetworkopen.2023.56095.
9
Enrollment Patterns of Medicare Advantage Beneficiaries by Dental, Vision, and Hearing Benefits.医疗保险优势计划受益人的牙科、视力和听力福利的参保模式。
JAMA Health Forum. 2024 Jan 5;5(1):e234936. doi: 10.1001/jamahealthforum.2023.4936.
10
Medicare Advantage in rural areas: implications for hospital sustainability.农村地区的医疗保险优势:对医院可持续性的影响。
Am J Manag Care. 2023 Nov;29(11):594-600. doi: 10.37765/ajmc.2023.89455.

医疗保险优势牙科福利:美国不到半数的县提供全面覆盖。

Medicare Advantage Dental Benefits: Comprehensive Coverage Available In Fewer Than Half Of US Counties.

作者信息

Simon Lisa, Vujicic Marko, Nasseh Kamyar

机构信息

Lisa Simon (

Marko Vujicic, American Dental Association, Chicago, Illinois.

出版信息

Health Aff (Millwood). 2025 Jun;44(6):693-701. doi: 10.1377/hlthaff.2024.01478.

DOI:10.1377/hlthaff.2024.01478
PMID:40456029
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12243001/
Abstract

Medicare Advantage (MA) plans may offer dental coverage, a supplemental benefit excluded from traditional Medicare despite the importance of oral health to overall health. This study examined the availability of MA dental coverage by county and the characteristics associated with plan availability in 2023. Using public data collected by the Centers for Medicare and Medicaid Services describing MA supplemental benefits, we found that beneficiaries could choose from an average of 34.9 plans offering a benefit but only 1.7 plans offering a comprehensive dental benefit. Nationally, 39.9 percent of counties offered at least one comprehensive dental plan. Using Poisson regression accounting for county-level characteristics, we found that a larger population, higher MA market penetration, and lower MA insurer concentration had the strongest associations with dental benefit availability. Policy makers should consider quality benchmarks for MA dental plans and further evaluate the appropriate role of these benefits in incentivizing MA plan enrollment.

摘要

医疗保险优势(MA)计划可能提供牙科保险,这是一种补充福利,尽管口腔健康对整体健康很重要,但传统医疗保险并不涵盖此项福利。本研究调查了2023年各县MA牙科保险的可获得性以及与计划可获得性相关的特征。利用医疗保险和医疗补助服务中心收集的描述MA补充福利的公共数据,我们发现受益人平均可以从34.9个提供福利的计划中进行选择,但只有1.7个计划提供全面的牙科福利。在全国范围内,39.9%的县至少提供一项全面的牙科计划。使用考虑县级特征的泊松回归分析,我们发现人口较多、MA市场渗透率较高以及MA保险公司集中度较低与牙科福利可获得性的关联最为紧密。政策制定者应考虑MA牙科计划的质量基准,并进一步评估这些福利在激励MA计划参保方面的适当作用。