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Which State Offers Dental Benefits to Low-Income Adults on Medicaid?

Virginia’s new policy making low-income adults on Medicaid eligible for dental benefits took effect on July 1, 2021.

8 News’ recent article entitled “Virginia is offering dental benefits to all adults on Medicaid for the first time” reports that the Virginia General Assembly first allocated funding for the expansion in the 2020 session. However, the change was delayed due to the pandemic. Since it was authorized in the two-year state budget, state legislators will have to allocate more funding in the future to maintain this level of coverage.

Dr. Tegwyn Brickhouse, chair of VCU’s Department of Dental Public Health and Policy, explained oral health is inseparable from overall health.

“It can help control chronic diseases, such as diabetes and cardiovascular disease. We also know there’s a link between oral health and pre-term birth,” Brickhouse said.

Brickhouse remarked that children and pregnant women covered by Medicaid were already eligible for dental benefits in Virginia. However, the move is making those services accessible to more than 750,000 other adults. In addition to routine cleanings and preventative care, the program will pay for x-rays, examinations, fillings, dentures, root canals, gum-related treatments, oral surgeries and more.

In the past, Brickhouse said many adults on Medicaid could only access dental coverage for emergency extractions. Without benefits, Brickhouse said many turned to emergency rooms as a last resort to find relief from the pain of other oral health conditions.

“Dentistry is not typically provided in emergency room settings, so you end up maybe getting an opioid but never really getting the tooth fixed. So, providing dental care will provide hundreds of thousands of dollars in savings from emergency room visits,” Brickhouse said.

Christina Nuckolos, communications director for the Virginia Department of Medical Assistance Services, says that roughly 75% of the nearly 2,000 dentists involved in the state’s Medicaid program have said that they’ll serve adult members.

“Governor Ralph Northam wrote a letter to the state’s dentists urging them to participate or to increase the number of Medicaid members they serve. The Virginia Dental Association distributed the Governor’s letter to their 3,900 members, and we are pleased that it has been well-received,” Nuckolos said.

Because Medicaid pays much less than private insurers for the same services, proponents are asking state lawmakers to up reimbursement rates to incentivize more participation. That hasn’t been done in more than 10 years, Brickhouse said.

Reference: 8 News (July 6, 2021) “Virginia is offering dental benefits to all adults on Medicaid for the first time”

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