Nearly 220,000 adults will become eligible for expanded MaineCare dental coverage beginning Friday.
The state also is increasing MaineCare reimbursements for dental care providers, according to an announcement from Gov. Janet Mills’ administration.
The changes will cost an estimated $45 million and more than double the amount allocated for oral health care under the program. MaineCare is the state’s Medicaid program, which is partially funded by the federal government and provides free or low-cost insurance for Mainers who meet income and household composition requirements.
Expanded dental coverage for adults was part of the 2022-23 budget adopted in June 2021 and its implementation comes after a year of work on the program by the state’s Department of Health and Human Services, the governor’s office said.
About 217,000 adults covered by MaineCare will be automatically enrolled in the new dental benefit on Friday. The Mills administration said it is a key part of a broad effort to increase access to dental care in the state, particularly in rural areas.
Procedures that will now be covered include cleanings, fillings, root canals, dentures and other oral health services. Previously, adult dental care covered by MaineCare was limited to emergencies, such as tooth extractions.
Carolin Silvius of Portland said she plans to be one of the first to get dental care under the expanded program. She said she will need to contact MaineCare to find out which denture specialists in the area accept MaineCare patients.
“My bottoms (dentures) need to be relined, if not remade,” she said after the expansion was announced Wednesday. Silvius said she should have had the procedure to refit the dentures for greater comfort years ago, “but it would have been expensive. It was more than I could afford on Social Security.”
Dental coverage should already have been offered under MaineCare coverage, she said.
“We needed something done about this and I’m so glad it passed. This will be a huge improvement,” Silvius said
“Providing preventive and routine dental care will not only improve the health and wellness of hundreds of thousands of Maine people, but it will also save money in the long run by preventing the need for expensive emergency care,” Mills said in a statement.
MaineCare covers one in four people in the state, so the expansion in coverage will benefit hundreds of thousands of Mainers, said Jeanne Lambrew, the commissioner of the Department of Health and Human Services.
States have flexibility to determine what dental benefits are provided to adult Medicaid recipients. Maine is joining 19 other states that provide comprehensive dental care coverage, according to the Center for Health Care Strategies. Fifteen states provide limited coverage and 14 other states, in addition to Maine before Friday, provide only emergency dental coverage or no dental coverage at all.
Under the previous coverage, people had to go to the emergency room “when their teeth reached the point of no return, which was costing folks their dignity and health,” Maine House Speaker Ryan Fecteau said. He submitted the bill to expand MaineCare dental benefits and then shepherded the measure through the Legislature as part of the state budget.
DHHS, dental providers and oral health care leaders worked on the expansion of benefits for nearly a year and the department adopted an emergency rule that means the new reimbursement rates will go into effect on July 1. A permanent rule will be proposed by the department next month and DHHS also plans to reach out to dental providers around the state to explain the improved coverage.
When the measure was approved in 2021, the state said the coverage expansion alone would cost the state $4 million per year, with the federal government chipping in an additional $12 million annually. A 2012 study found that Maine spent $17 million on emergency room visits for dental care, and advocates predicted that spending will decline sharply after the expansion of routine preventive coverage.