New Medicare expansion would add vision, dental and hearing — could Biden do more?

Three of the biggest holes in traditional Medicare will finally be patched up if President Joe Biden succeeds in selling his $3.5 trillion budget bill.

Last week, a group of Democratic senators agreed on a spending plan that would — among many other things — make vision, hearing and dental coverage a standard part of Medicare.

The move would be a massive relief for anyone worried about affording health care later in life, but it’s also not the most ambitious proposal on the table.

Here’s what could be in the works and what you can do now to ensure you have the coverage you need.

Biden's big wish list

The multifaceted budget bill hopes to check off numerous items on Biden’s agenda and other measures championed by Sen. Bernie Sanders and Senate Majority Leader Chuck Schumer.

That includes national paid family leave, universal preschool, an extension of the expanded child tax credit, free community college, support for affordable housing projects and what could be the biggest expansion in the history of Medicare.

In addition to making vision, hearing and dental coverage more accessible, the bill would also give the federal government the ability to negotiate for lower prescription drug prices for Medicare users.

“We are very proud of this plan,” Schumer told reporters last week. "We know we have a long road to go. We're going to get this done for the sake of making average Americans' lives a whole lot better."

Missing from the plan is one mammoth measure that Biden, Sanders and Schumer have all fought for over the years: lowering the qualifying age for Medicare to 60 or even lower. Nearly two in three Americans back the idea, a Kaiser Family Foundation poll found in 2019, including about half of Republicans.

For now, even the most progressive members of Biden’s team have tempered their ambitions to try to get the bill passed. Sanders had initially sought a $6 trillion package but said the $3.5 trillion compromise still represents “a very pivotal moment in American history.”

The holes in traditional Medicare

Americans who haven’t yet hit age 65 may not realize just how many needs aren’t covered by "original" or "traditional" Medicare — that is, Parts A and B.

Some of the most glaring omissions include long-term care, prescription drugs and — yes — vision, dental and hearing care. That means there’s no coverage for glasses, eye exams, root canals, teeth cleanings or hearing aids.

Many retirees without substantial savings are unable to handle the out-of-pocket expenses.

Nearly two-thirds of Medicare recipients have no dental coverage, according to a Kaiser Family Foundation report from 2019. Nearly half haven’t been to the dentist in over a year, and about one in seven have lost all their teeth.

If Biden and his allies succeed, Medicare users won’t have to hunt for affordable insurance elsewhere or go without coverage and risk falling into debt.

Expansion faces a fight ahead

For the most part, the American public strongly supports expanding Medicare, especially when it comes to adding dental benefits. More than three-quarters support the idea — and that number rises to 82% in 2022 Senate battleground states, according to a recent YouGov survey.

However, Washington is divided. Republicans control half the Senate and largely oppose the health proposals, saying the expansion would cost hundreds of billions and make funding Medicare a nightmare down the line.

The Democrats behind the bill hope to use a budget process called “reconciliation,” which would allow them to pass the spending with a simple majority vote. Yet Biden would need the support of all the Democrats in the Senate to pull it off, and moderate members like Sen. Joe Manchin of West Virginia are only lukewarm.

“Dental is a very important part of a person’s health,” Manchin told reporters. “But we have to pay for all this.”

The bill’s supporters say it is fully paid for — but with numerous details still up in the air, it’s unclear exactly how much the Medicare proposals would cost or whether users would suffer higher premiums. Most people signed up for Medicare Part B currently pay $148.50 a month.

A similar plan by House Speaker Nancy Pelosi in 2019 carried a price tag of almost $360 billion over 10 years, though some of that money would have come from the ability to negotiate lower drug prices.

How else to get this essential coverage

If the plan doesn’t succeed, or you need comprehensive coverage now, Americans 65 and up can look into a Medicare Advantage plan — otherwise known as Part C. These plans are offered by private companies but follow rules set by the Medicare program.

Some Medicare Advantage policies offer vision, hearing and dental coverage, but you’ll want to check exactly what’s included. When you're enrolled in Medicare Advantage, you're still responsible for paying traditional Medicare costs and potentially an additional monthly premium.

If you’re not old enough to qualify for Medicare, you have a few options to lower your health insurance costs so you can afford to include vision and dental coverage.

First, shopping around and comparing prices is the single best way to save. The Insurance Information Institute recommends comparing at least three quotes to ensure you’re not severely overpaying. While that sounds like a lot of work, some quote comparison sites make it as simple as answering a few questions and reviewing your options.

If you still need to make more room in your budget, use the same approach to slash your other insurance premiums. Switching to a different auto insurance policy might reduce your costs by up to $1,000 a year. You could save a similar amount on your homeowners insurance, as well.

Finally, use your remaining time before retirement to invest. It’s OK if you don’t have a lot of money to spare: Try a popular app that turns your “spare change” from everyday purchases into a diversified portfolio.