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Insurance Providers Fund Dental Coverage for Low-Income Hawai‘i Residents

October 1, 2018, 2:39 PM HST (Updated October 2, 2018, 8:31 AM)
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AlohaCare and ‘Ohana Health Plan will offer basic adult dental care coverage through each company’s expanded Medicaid offering beginning Jan. 1, 2019.

Since 2009, dental care coverage for adults enrolled in the state’s Medicaid program has been limited to emergency care. Hawai‘i has approximately 364,000 residents enrolled in Medicaid, a healthcare program funded by the state and federal government to provide accessibility to healthcare for individuals with limited resources. There are approximately 75,300 Medicaid beneficiaries on the Big Island.

According to a 2015 report called, Hawai‘i Oral Health: Key Findings by the Hawai‘i Department of Health, many residents face dental health disparities—particularly among low-income residents who are less likely to see a dentist each year. The report also found many residents seek care for dental problems at hospital emergency departments, but these services are generally not available in these settings.

In an effort to promote better oral health among Hawai‘i residents, AlohaCare and ‘Ohana Health Plan will now cover the cost of basic dental for adults who have Medicaid as their sole source of medical insurance coverage. Members will have the benefit of an annual exam, fluoride treatment, a cleaning every six months, one set of bitewing X-rays per year and either a non-emergent tooth extraction or filling. Members with dual coverage (Medicaid and Medicare) will not qualify.

“Oral health is critical to good health and overall well-being,” said Scott Sivik, state president of ‘Ohana Health Plan. “The mouth is the gateway to the rest of the body and provides clues about overall health and larger health issues such as diabetes, heart disease and cancer. At ‘Ohana Health Plan, we believe maintaining a healthy community means providing quality dental care to those who need it the most.”

“We are excited to address a major coverage disparity for adults covered by Medicaid in Hawai‘i,” said Laura Esslinger, chief executive officer of AlohaCare. “At last, adults who have QUEST Integration coverage will have access to oral healthcare to better integrate care and improve overall health and well-being.”

“We applaud ‘Ohana Health Plan and AlohaCare for recognizing that oral health is an integral part of a person’s well-being and for launching this important Medicaid dental initiative,” said Sheila Beckham, chief executive officer of Waikīkī Health. “Waikīkī Health currently has over 5,000 patients on Medicaid who have been struggling to get basic dental benefits since 2009.”

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LIBERTY Dental Plan currently contracts with local dentists and will manage the dental network for both health plans. “LIBERTY looks forward to our partnership with the local dental providers,” said Amir Neshat, DDS, founder and chief executive officer of LIBERTY Dental Plan. “We look forward to providing this valuable adult dental benefit as it will improve overall health.”

Medicaid beneficiaries who meet the requirements mentioned above and are not members of ʻOhana Health Plan or AlohaCare but wish to access these companies’ basic adult dental care coverage can enroll with AlohaCare or ‘Ohana Health Plan during Annual Plan Change from Oct. 1 through 31, 2018.

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