Adult Medicaid recipients in Illinois can now receive coverage for preventive dental services, which include regular exams and teeth cleanings.
Coverage for these services were part of the new state budget that took effect on July 1.
While most of the 1.7 million adults in the state’s Medicaid program receive coverage for preventive care through managed care organizations that voluntarily pay for it, nearly half a million Medicaid recipients who are in the traditional “fee-for-service” Medicaid program were left without such coverage.
Nancy Greenwalt leads Promise Healthcare, which runs the Smile Healthy dental clinic in Champaign. The federally subsidized clinic serves a majority of low-income patients on Medicaid.
Greenwalt said a hygiene appointment does far more than provide a teeth cleaning.
“There's actually really important education that happens there,” she said. “The hygienist… can talk to you about your diet, your habits that may be affecting your oral health.”
SmileHealthy offers preventive services for a reduced fee of $20 for patients with financial need, which is a fraction of the cost a patient would pay out of pocket elsewhere. But she said even that can be a barrier for people.
“We work with a lot of patients who've gone too long before getting treatment,” Greenwalt said. And waiting too long can lead to serious oral health issues that make maintaining good oral health even harder.
This is the first time preventive dental care for adults has been added to Illinois’ Medicaid program as a covered service. It’s expected to cost the state an additional $8 million to $12 million per year, half of which will be reimbursed by the federal government, according to The State Journal-Register.
But the sponsors of the measure said those costs will be more than offset by the expected savings from avoiding costly treatment and ER visits for severe dental problems.
Greenwalt said she expects the added coverage for preventive care will draw more adults on Medicaid to the clinic. She hopes to eventually expand the clinic’s services to meet the need.
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