Adult dental Medicaid funding was restored for thousands of adults on January 1. For three years, a comprehensive Medicaid benefit has only provided to 38,000 of the states nearly 500,000 Medicaid-eligible adults. During this time, most Medicaid-eligible adults only had access to emergent care.
Restoration of adult dental Medicaid funding will have a very positive impact on the state’s community health centers, dental residency programs, and the University of Washington School of Dentistry. Medicaid funding is a significant source of revenue which allows these programs to provide dental access to many of the state’s most vulnerable populations. Before January, dental treatment provided by these programs to Medicaid-eligible adults was done without compensation or on a sliding fee schedule based on a patient’s ability to pay.
January also marks the implementation of Medicaid expansion in Washington state. Under the Affordable Care Act, states had the option to expand Medicaid eligibility to all adults who earn less than 138 percent of the federal poverty level. Initially, the federal government will pay 100 percent of the cost of Medicaid benefits for this expansion population. The federal match eventually drops to a 90 percent match in a few years. Restoring a comprehensive dental benefit for the existing Medicaid-eligible adults allowed the state to also provide a comprehensive dental benefit for adults who are newly eligible for Medicaid under Medicaid expansion.
WSDA is committed to helping member dentists navigate Medicaid's billing and administrative processes. The following are useful links that should help dental providers:
- Click here of a list of Medicaid's fee schedule (scroll down to "Dental Program")
- Click here for Dental Medicaid Provider guide
- Dental offices that need help with billing or registration issues can email firstname.lastname@example.org
Provider questions can also be referred to Emily Lovell, WSDA's Public Policy Coordinator, at email@example.com or by calling 800-448-3368.