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Dental Benefits Reign Supreme for Duals

By: Emily Dykstra

Duals are Medicare members who receive both Medicare and Medicaid benefits due to low-income status. Often Duals have unique needs compared to general Medicare members, which is why Deft has done a deep dive into their importance and the preferences they have for supplemental benefits available in Medicare Advantage plans.

Supplemental Benefits Tested

  1. Non-Medical Transportation
  2. Hearing Benefits
  3. Non-Emergency Medical Transportation
  4. Member Support Services
  5. Flexible Allowance
  6. Dental
  7. Member Support Services
  8. Vision Benefits

Out of the eight supplemental benefits, dental benefits emerged as the most important benefit for Duals and low-income non-Duals (LINDs). This group also had high levels of dental needs, with full and partial Duals reporting higher levels of current dental issues than Senior LINDs, and only one-third of all respondents reporting no dental issues.

 

Despite the high needs, Duals are not visiting the dentist on a regular basis, with over half of Duals indicating they had seen a dentist in the past 12 months.

Since Duals are by definition lower income, it is likely that cost and coverage are a large barrier for these individuals.

Dental benefits remained top of mind for Duals during a conjoint exercise. Click here to find out more about how conjoint analyses work.

Dental coverage explained the largest proportion of why Duals and LINDs alike preferred one plan over another in the conjoint exercise. Further, Duals and senior LINDs are much more likely to choose a plan that includes dental coverage over one that doesn’t, even if the plan without dental coverage had major enhancements to the other supplemental benefits offered.

When carriers are looking to design D-SNP coverage or better serve their low-income members, dental benefits should be a top consideration. While dental benefits are always rated highly by Medicare members, Duals and senior LINDs put a much higher emphasis on this benefit compared to other popular supplemental benefits, such as flexible spending allowances or vision coverage.

To learn how to purchase the 2024 National Dual Eligible Benefit Design Study or to get access to the 2024 Simulator Click here.

References

https://www.cms.gov/medicare-medicaid-coordination/medicare-and-medicaid-coordination/medicare-medicaid-coordination-office/downloads/mmco_factsheet.pdf