By NextBestFitCover dental, vision, and hearing fully
Include in the standard benefit.
Matches the cost model: adult dental, glasses, and hearing aids covered; only cosmetic dental, orthodontics, and premium eyewear stay out of pocket.
To review: Dentist capacity is limited; the model assumes 35% more dental use. Basic-only coverage is the cheaper fallback.
Review ledgerHow this path connects
Concrete changes if chosen
What would actually have to change in law, agencies, payment rules, or systems.
- Add dental, vision, and hearing to the standard benefit
Effects
Each effect has its own page: the evidence, the case that it is or isn't a real cost, and whom it affects.
- Dental, vision, and hearing are mostly uncovered
Including dental care in the standard benefit closes a major coverage gap for care that affects overall health.
- Longer waits if demand grows faster than capacity
Dentist capacity is limited, so covering dental care in the standard benefit is likely to create waits for dentists.
12 paths soften this
Legal wait-time guaranteesLonger waits if demand grows faster than capacityChosenBuild capacity before demand risesLonger waits if demand grows faster than capacityChosenPay for activity on top of budgetsLonger waits if demand grows faster than capacityChosenFund more residency slotsPhysician shortage, especially in primary careChosenFull practice authority for NPs, PAs, pharmacists, dental therapistsScope-of-practice limits waste capacityChosenTeam-based care with physician oversightScope-of-practice limits waste capacityRejectedFee-for-service at public fee scheduleU.S. prices are far higher than in other countriesChosenKeep means testing, but expand home careLong-term care requires spending down to povertyChosenAllow private insurance for covered servicesTwo-tier care: a private fast lane for those who can payRejectedBudgets adjust automatically for population, age, and volumeFixed budgets can ration careChosenBase budget plus activity paymentsFixed budgets can ration careChosenWaiting-time guarantees as a backstopFixed budgets can ration careChosen - Raises spending or loosens control over it
Including dental care in the standard benefit is expensive.
Who's affected
- Older adults
- Dental, vision, and hearing are mostly uncovered: Coverage gaps and costs lead them to skip dental and other excluded care.
- Low- and middle-income households
- Dental, vision, and hearing are mostly uncovered: Coverage gaps and costs lead them to skip dental and other excluded care.
- Health insurers, brokers, and their shareholders
- Dental, vision, and hearing are mostly uncovered: Private Medicare plans market extra benefits missing from traditional coverage.
- Cash-pay and private care practices
- Dental, vision, and hearing are mostly uncovered: Coverage gaps support cash-pay care.
- People with employer coverage
- Longer waits if demand grows faster than capacity: They are seen fastest today and would share one queue with everyone.
- People with ongoing or specialist care needs
- Longer waits if demand grows faster than capacity: They need specialists and procedures most often.
- Taxpayers and public budgets
- Raises spending or loosens control over it: Public budgets pay the added spending.
Where it has been tried
- Nordic countries for children: In Denmark, dental care is free through age 19 (expanding to 21 in 2025); municipal school-based delivery achieves a participation rate of nearly 100%, including free orthodontic care (2024).