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Medicaid Adult Dental Benefit |
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Overall, Americans lose more than 164 million hours of work each year due to lack of treatment for dental ailments. These problems range from simple cavities to gum and periodontal disease, and can lead to further medical complications in both oral and overall health. In many cases, the onset of serious diseases follow prolonged periods of poor dental care. Even when fatal diseases are not the result, poor general oral hygiene will often lead to cavities that, if left untreated, eventually require extraction. In the District alone, over 20% of adults over 65 have had all their natural teeth extracted and over 40% have had at least 6 removed, many without being able to afford denture replacements. Without teeth, one cannot chew and one's nutrition and diet suffer accordingly.
While dentists, policy makers and patients recognize the need and benefit of regular dental visits, the bulk of uninsured citizens cannot afford access to basic dental services. Without access to regular preventive dental services, dental care is postponed until symptoms, such as toothache and facial abscess, become so acute that people end up in hospital emergency rooms that are not equipped to handle dental emergencies and can offer only temporary solutions such as antibiotics and painkillers. This frequent consequence of failed prevention wastes valuable health care system funds without addressing the underlying problem of access for the uninsured.
For the past three years, the Committee on Health has invested nearly $40 million in dental services for uninsured populations throughout the District. This effort has culminated in a new adult dental benefit for all adults in the Medicaid program. As of April 1, 2007 D.C. Medicaid (also known as D.C. Healthy Families) provides a comprehensive dental benefit for all adults in the Medicaid program. Participating dentists bill Medicaid directly and beneficiaries pay nothing for dental care. Now, over 60,000 adults will join children (up to 21), who have always had a dental benefit through Medicaid. The following is a summary of what is covered in the dental benefit:
- Two general dental examinations and routine maintenance cleanings per year
- Fillings
- Surgical services and extractions
- Reline or rebase of a removable denture
- Complete panoramic X-ray of the mouth
- Bitewing X-rays
- Removable partial and full dentures
- Root canal treatment limited to two molars per year
- Periodontal scaling and root planning
- Removal of impacted teeth
- Dentures once every five years with exceptions
- A removable partial prosthesis
To locate a Medicaid dentist, call (202) 698-2000. You may also contact the Medicaid Dental Hotline at (866) 758-6807.
Dental providers interested in participating in the Medicaid program can call the Medical Assistance Administration's Office on Children and Families at (202) 442-9373 for more information.
- Catania and Fenty Promote Medicaid Dental Benefit
- Investment in Dental Services FY 2006-2008
- Letter from MAA to Beneficiaries
- Letter from MAA to Dental Providers
- Dental Services Fee Schedule for Providers |
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Last Updated ( Friday, 21 November 2008 )
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