Noteworthy Medicare coverage gap: Sjögren's syndrome

August 3, 2015

There are advocates who say Medicare needs to increase the type of coverage it provides for beneficiaries.

MurphyThere are advocates who say Medicare needs to increase the type of coverage it provides for beneficiaries. One of those advocates is Margaret Murphy, associate director of the Willimantic, Connecticut-based Center for Medicare Advocacy. Her organization’s "wish list" for things Medicare should cover includes extreme dental care.

She points to the experience of people who suffer from horrible health conditions that affect oral health. "Medicare generally doesn’t cover dental care," says Murphy. "For example, people with a disease called Sjögren's syndrome, which causes your mucus membranes to dry up. If you have Sjögren's and your teeth are cracking off at the roots and becoming infected, Medicare generally doesn’t pay for that treatment. People are going to emergency rooms or having these systemic life-threatening infections."

As Murphy sees it, this is "clearly a medical program," and points to findings by the National Institutes of Health that lack of dental care coverage for the poor is a serious problem. Coverage for extreme dental care, a certain amount of routine dental care, hearing aids and related services, and dementia-particularly for safety and health reasons- are other areas where she would like to see Medicare provide coverage.