Delaware dental insurance plan begins for low-income adults

Dental insurance plan - Dentist with Patient

October 1 marked the start of the additional coverage as a part of Medicaid across the state.

Starting yesterday, adults in Delaware who receive Medicaid will automatically receive a dental insurance plan as a part of their coverage.

Governor John Carney signed the legislation to make this possible back in August 2019.

The dental insurance plan was originally scheduled to be added to Delaware’s Medicaid in April 2020. However, the COVID-19 pandemic delayed things until October 1, instead. Therefore, as of yesterday, people aged 19 through 65 years old who are enrolled in a managed care Medicaid plan will also receive their dental coverage through that same plan. Their managed care organization will provide them with a list of providers.

Approximately 200,000 of the total 235,000 adult and child Medicaid clients are currently served by one of two different managed care organizations. The first is AmeriHealth Caritas Delaware. The second is Highmark Health Options Blue Cross Blue Shield Delaware. Adults in the state who are enrolled in fee-for-service (FFS) Medicaid will receive their services through that program. The Department of Health and Social Services’ Division of Medicaid and Medical Assistance has the list of providers for those consumers. To receive it, they must speak with the Delaware Health Benefits Manager.

The dental health insurance plan benefit will provide coverage for a wide variety of services.

Among the services to be covered by the benefit includes exams, cleanings, sedation, fillings and standard tooth extractions. It covers up to $1,000 in care per year, though a qualifying emergency or medically necessary supplemental care will include an additional $1,500 per year on top of that original amount.

Governor Carney issued an emergency order on September 25 which suspended the $3 per visit co-pay for adult dental services throughout the public health emergency caused by the pandemic. As a result, adult Medicaid patients will not be required to pay the co-pay until the state of emergency is no longer in effect. The Division of Medicaid and Medical Assistance will pay the full amount to providers on behalf of those with the Dental insurance plan - Dentist with PatientMedicaid dental insurance plan, who will not have to reduce their fees as a result of this regulation.

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