RICHMOND, Va. (WRIC)- For the first time, thousands of low-income adults on Medicaid in Virginia are eligible for comprehensive dental benefits.
The new policy officially took effect on July 1, 2021.
The Virginia General Assembly initially allocated funding for the expansion in the 2020 session but the change was delayed due to the coronavirus pandemic. Since it was authorized in the two-year state budget, lawmakers will have to allocate more funding in the future to maintain this level of coverage.
However, advocates believe this is the start of a permanent shift.
“Once you’ve enabled access to comprehensive healthcare it’s pretty difficult to suddenly not prioritize that care,” said Virginia Health Catalyst CEO Sarah Holland. “This is a game changer.”
Holland has been pushing for the expansion for at least a decade. She said Virginia is the 20th state to take this step.
“Several years ago this was seen as a luxury,” Holland said. “But people die of dental disease all of the time. Often it is coded as something else.”
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 said children and pregnant women covered by Medicaid were already eligible for dental benefits in Virginia but this change 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.
Previously, Brickhouse said many adults on Medicaid could only access dental coverage for emergency extractions. Without benefits, she said many turned to emergency rooms as a last resort to deal with pain associated with 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.
Those looking to make an appointment should identify themselves as a Medicaid recipient and make sure the practice accepts Medicaid before booking.
According to Christina Nuckolos, communications director for the Virginia Department of Medical Assistance Services, about three-quarters of the nearly 2,000 dentists involved in the state’s Mediciad program have indicated they will 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 in an email.
Since Medicaid pays much less than private insurers for the same services, some are calling on state lawmakers to increase reimbursement rates to incentive more participation. That hasn’t been done in more than a decade, according to Brickhouse.