Stepped up dental insurance means more seniors get treatment

Posted on : 2016-10-16 13:59 KST Modified on : 2019-10-19 20:29 KST
Increase in hospital visits since coverage was expanded indicates many elderly folks had been ignoring dental problems
People 70 and older could have implants covered by their health insurance
People 70 and older could have implants covered by their health insurance

Mr. Lee, 72, lost one of his bottom right molars a few years ago. He didn’t experience any immediate problems eating, and he had heard dental implants were very expensive, so he simply got by without it. When he went for a free National Health Insurance check-up every two years, he was told to go see a dentist, but he kept putting it off. Late last year, he finally went to a nearby dentist after hearing people 70 and older could have implants covered by their health insurance.

“The dentist gave me an implant for the missing tooth and told me to get treated for several other teeth that had cavities or gum disease,” he said.

Lee ended up receiving two rounds of implant treatment, two crowns for teeth with cavities, and treatment for gum disease. It was all of the treatment he had been putting off - and it cost him a total of just over 3 million won (US$2,670).

Mr. Kim, 75, suffered a 5-cm laceration to his face when he tripped and fell on the road in January. He also suffered severe damage to two molars. After receiving stitches, he went to the dentist, who told him he had to receive implants for both teeth. The hospital advised him that all treatment would be covered by health insurance - meaning he could receive it at one-third what the previous cost.

“Before I injured my teeth, I had had almost no dental treatment in my life,” Kim said. “It’s much easier to eat now that I have the two implants, and I’ve been getting implant treatment for other teeth recently.”

Analyses have shown dental treatment costs continuing to skyrocket in recent years, with senior citizens leading the trend. Denture treatment is expensive enough, but implants in particular mean a large financial burden that leads many seniors to shy away from treatment.

But gradual expansions in health insurance coverage for denture and implant treatment for seniors over the past few years have resulted in more and more visiting the dentist - and having treatment for other dental problems performed as well.

Indeed, a report on 2015 treatment cost statistical indicators published in September by the Health Insurance Review & Assessment Service showed dental hospitals experiencing the large rise from 2014 in health insurance-covered treatment costs by medical institution type. Dental clinics ranked second. Total health insurance-covered treatment costs for all institutions stood at 44.922 trillion won (US$39.9 billion) last year, up 6.9% from 42.27 trillion won (US$37.6 billion) in 2014. But for dental hospitals, the amount rose 25% from 138.2 billion won (US$122.9 million) to 172.8 billion won (US$153.6 million) over the same period; for dental clinics, it rose 18.2% from 2.2884 trillion won (US$2.0 billion) to 2.7055 trillion won (US$2.4 billion). Among common outpatient ailments, gum disease had the largest rate of increase for health insurance-covered costs, climbing 10.9% from 906.6 billion won (US$806 million) in 2014 to 1.0056 trillion won (US$894 million) in 2015.

Health insurance coverage for implants - which includes up to two per person, with patients bearing only half the cost - was introduced in July 2014 for seniors 75 and older. In July 2015, it was expanded to those 70 and older. As of July 2016, the age limit was lowered to 65. Implants typically cost between one and two million won (US$890-1,780) apiece, but a senior receiving health insurance coverage would only have to pay 620,000 won (US$550) of the 1.24 million won (US$1,100) cost. Dentures received coverage slightly earlier, with health insurance applied for a full set for those aged 75 and older as of July 2012. That system has also been expanded: as of July 2016, seniors 65 and older receive benefits for partial and full sets. Once again, they are only responsible for half the treatment cost. In the case of a full set of dentures, they would pay 540,000 won (US$480) per row (top and bottom) for resin or 620,000 won (US$550) for metal; for a partial set, the cost would be around 650,000 won (US$580) per row.

With an aging trend resulting in seniors accounting for a growing percentage of the South Korean population and lifespans increasing, health insurance authorities predicted an increase in demand for dental treatment and expected a large jump in dentist visits once health insurance coverage for implants and other expensive treatment went into effect. It’s an example of the changing hospital landscape in an aging society.

“The fact that dental treatment costs increased so much after health insurance was introduced for implants means that a lot of seniors couldn’t go to the dentist in the past because of the cost burden,” explained a National Health Insurance Service source.

“Now that the age for health insurance eligibility for implants has been lowered since July to 65 and over, it’s looking like dental treatment costs this year will increase even more from last year,” the source added.

By Kim Yang-joong, medical correspondent

Please direct questions or comments to [english@hani.co.kr]

 

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