Abstract:

In health economics, the allocation of scarce resources is not always fair or just. Typically, senior citizens, even with Medicare insurance, must pay deductibles and copays toward their medical and prescription costs. However, the system of application for “supplemental” or “advantage” plans is complex – replete with small print and disclaimers written in complicated lawyers’ language. The senior is often recruited into these health insurance plans offering a PPO (Preferred Provider Organization) instead of maintaining straight Medicare insurance. The applicant is in for a surprise when she or he follows the complex journey to a Medicare PPO but finds out they are not always covered for doctors’ visits or prescriptions. For example, some outpatient hospital programs do not accept the Medicare PPO, accepting instead only straight Medicare. Furthermore, a second surprise may come at the pharmacy when the senior finds that many needed medications are not covered (i.e., they are not in the plan formulary). The senior citizen, often cognitively impaired due to age, must make these decisions based on very little evidence or literature except that given by the plan provider. This paper focuses on the problem of oral health disparities affecting seniors in the United States – centering on defining existing problems and posing education and prevention as approaches to future solutions.