MEDI-CAL DENTAL BENEFITS RESTORED

Medi-Cal Dental Benefits for Adults

On April 29, California Department of Health Care Services received Medicare approval to restore certain optional adult dental benefits for members 21 years of age and older under the Medi-Cal program, effective May 1.  The partial restoration of dental services includes examinations and x-rays, dental cleanings with fluoride treatments, silver and tooth-colored fillings, and root canals and crowns on front teeth.  Complete dentures are also being restored.

For a complete list of services being restored, please see Provider Bulletin Volume 29, Number 14 (August 2013).  Dental providers will determine which medically necessary services will be provided, and the existing benefits for children will not change.  When the elimination of the optional Medi-Cal dental benefit for adults began in July 2009, due to the state’s severe budget issues, there were several exemptions that allowed some members to continue receiving services.  They included members who were residents of nursing homes and skilled nursing facilities, pregnant women, and some others.

This partial restoration of the benefit is not a component of the Affordable Care Act (ACA).  Most of the costs are for individuals who are already eligible for Medi-Cal.  Any ACA funding would be used for services to those who qualify for Medi-Cal only because of the ACA’s expanded eligibility.

If a member needs help finding a dentist, please see the Provider Referral Tool on the Denti-Cal website or call Denti-Cal at 1-800-322-6384.

MEDI-CAL DENTAL COVERAGE PARTIALLY RESTORED

Legislative leaders and Gov. Jerry Brown (D) have  agreed on a budget plan that restores partial funding for dental services in Medi-Cal, California’s Medicaid program.

Oral HealthNorthern California legislators and dental providers have been at the forefront of a campaign over the past four years to get dental coverage for Medi-Cal adults restored. For many advocates and stakeholders, this week’s budget news was considered a partial victory. Although not the complete restoration of $131 million sought, the state plans to spend about $16.9 million this fiscal year and $77 million next year on dental coverage. The money will provide preventive care, dental restorations and full dentures for adult beneficiaries of Medi-Cal.

denticalRestoring adult coverage in Denti-Cal was considered a priority for California Senate President Pro Tempore Darrell Steinberg (D-Sacramento).

“Dental care is so essential to physical health and employability,” Steinberg said. “The current alternatives are gum disease and use of hospital emergency rooms at the expense of taxpayers, which is unacceptable.”

Lindsey Robinson, a pediatric dentist in Grass Valley and president of the California Dental Association, called the agreement “a significant achievement in the effort to restore all adult Denti-Cal services and a step in the right direction to address the oral health care crisis facing millions of Californians.”

by Mari Edlin, California Healthline Regional Correspondent

Read the rest of the article at http://www.californiahealthline.org/features/2013/medical-dental-coverage-partially-restored.aspx#ixzz2Wt8niGJz