April 07, 2020

The disconnect between Maine dentists and Medicaid patients was no mystery. The reimbursement level was so low that few dentists felt they could afford to regularly treat these patients, putting more pressure on the minority of dentists who did. The doubling or more of many Medicaid dental rates is good news for both dentist and patient.

Medicaid dental care regularly covers children and young adults to age 21, with adults receiving coverage for emergencies only. But until Friday, Medicaid paid, for instance, a mere $19.75 for pulling a tooth. Ouch. Now it will pay $55 for the procedure, the same rate as Delta Dental, a private insurance company. Other procedures with increased rates included oral exams, up from $7.75 to $13 and panoramic X-rays, which goes to $43 from $21.50.

The change is important for the 80,000 to 90,000 Maine residents who qualify for the Medicaid program. It means they wil be far more likely to get regular checkups and to get small problems taken care of earlier, before they turn into major operations. An additional good idea for getting young people in for regular checkups is a bill being crafted by Rep. J. Elizabeth Mitchell of Portland that would establish a toll-free referral system to help parents find dentists willing to take Medicaid patients.

There should be more of those soon. The increased rates should fill a hole in statewide dental coverage. Medicaid patients wanting even routine care told of long waits and long drives to get care from a dentist willing to accept the low reimbursement levels. Too many children simply went without adequate care, setting themselves up for serious problems later.

The cost of increasing the reimbursement level is approximately $1.5 million a year, to be paid, at least for now, from the state surplus. Effective preventive care should reduce that cost over the long term — and will save a lot of tootheaches among Maine’s kids.

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