Adults may wait months for Medicaid dental benefits
CHAMPAIGN — Illinois will restore dental benefits for adults in the Medicaid system come July 1, but it could be months before a local dental clinic serving needy patients might be able to add more appointments.
As part of Medicaid reform legislation signed by Gov. Pat Quinn Monday, the state is restoring the dental coverage for adults that was removed in 2012 under the state's SMART (Save Medicaid Access and Resources Together) Act.
Since that action two years ago, dental benefits for adults in the Medicaid system have been reduced to emergency extractions only.
It was decided that removing those benefits didn't make good financial sense in the long run, and it could wind up having a negative impact peoples' health, said health care spokesman Mike Claffey.
Restoring the benefits will help the dental center at Frances Nelson Health Center in Champaign "quite a bit, because about 65 percent of our patients don't have any coverage," said Nancy Greenwalt, executive director of the center's parent organization, Promise Healthcare.
"It will move a ton of adults into coverage," she said.
But the dental center's practice is fairly full so this won't mean a lot of new openings right away, Greenwalt said.
The Promise Healthcare board will be looking into adding another dentist, but that won't likely happen until the fall, after getting a chance to see how the new benefits and reimbursement from the state are working, she said.
Greenwalt also said adults in the Medicaid system are gaining benefits for restorative work such as fillings, but still won't have coverage for preventive work, such as cleanings.
Greg Johnson, executive director of the Illinois State Dental Society, looks for bringing back adult dental benefits to help "quite a bit" in terms of increasing access to care. It should also help relieve pressure on hospital emergency rooms, where people in pain without dental coverage have tended to go, he said.
There are about 800 dentists in the state who have continued to treat children in the Medicaid system, and others who do some Medicaid business, who will hopefully add adults on Medicaid to their practice, he said.
While there is a large backlog in processing new Medicaid applications, Illinois has been paying dentists treating Medicaid patient fairly promptly, within about two months, Johnson said.
"I don't think they're very far behind," he added.
Under a new Affordable Care Act category, Illinois opened Medicaid to all income-eligible adults between ages 19 and 64 and was hit with a large surge in applications this past spring. About 350,000 people have been enrolled under the Medicaid expansion.
The state is still working its way through about 250,000 more Medicaid applications, Claffey said.