Hoping For ACA Help With Dentistry?

Posted on May 12, 2014 by William J. Claiborne, DDS MS

Although many Americans are hopeful that the Affordable Care Act (or ‘Obamacare’) may help with dental care, there are no signs that the ACA will provide much help.

In some states, dental care for children is being incorporated into supplemental Medicare coverage for low income families. For others, individual health care plans offer dental coverage as a separate option. Added dental coverage, in many cases, has a conservative maximum coverage, such as $2,000 a year. This may cover fees for two 6-month check-ups and cleanings and one or two crowns. For those who need extensive work, relying on dental insurance or Medicare supplements will likely fall short of providing the dentistry needed to restore good oral health.

Some states have increased Medicare funding for low-income families who have purchased insurance through the Affordable Care Act. However, the number of physicians, dentists, and dental specialists who accept Medicare is limited. Caregivers often avoid being a Medicare provider because of the low reimbursement level and extended time it takes for reimbursement.

Although Medicare has the most frustrating track record for the dental profession, HMO and PPO dental coverages can also leave dentists in challenging positions. While reimbursement is slightly better than Medicare, lag time between insurance filing and reimbursement is traditionally slow.

Resolving the nation’s health care issues will likely take years. In the meantime, don’t assume that ample dental coverages will emerge any time soon. While it may be a challenge to pay for quality dental care, it is an investment well worth the commitment. Your smile is a major part of your appearance, self-confidence and digestive system as well as an aid in lowering overall health risks. Research has linked the bacteria of periodontal (gum) disease to heart disease, stroke, diabetes, arthritis, preterm babies and more.

Americans spend thousands on automobiles and wide screen televisions with access to hundreds of sports and entertainment channels while dental health ranks poorly on their budget’s priority list, regardless of insurance coverage. Until dentistry is deemed a necessity rather than an elective option, insurance coverage or supplemental plans will mean little in providing a confident smile that lasts your lifetime. That’s up to you.