MaineCare is scheduled Friday to begin covering preventative dental services for adults in a move expected to cost an estimated $45 million, Gov. Janet Mills’ office announced Wednesday.
Adult and pediatric dental providers who accept MaineCare will also see an increase in reimbursement rates beginning Friday.
MaineCare members who are 21 or older will be enrolled automatically in the new benefits, according to the governor’s office.
Expanded dental coverage for adults was part of the 2022-23 state budget adopted in June 2021.
Under the expanded program, an estimated 217,000 Maine adults will be eligible to receive coverage for diagnostic and preventative dental care, including cleanings and fillings.
MaineCare previously covered only emergency dental services for adults and already offers comprehensive dental coverage for Mainers younger than 21, according to the announcement.
More than 345,000 Mainers are enrolled in MaineCare, which provides health care coverage for the state’s children and adults who are elderly or disabled or who have low incomes. It is partially funded by the federal government and provides free or low-cost insurance for Mainers who meet income and household composition requirements.
Coleen Elias, CEO of Lewiston-based Community Clinical Services, said Wednesday the organization is “thrilled” MaineCare will cover more than dental emergencies, such as tooth extractions, for adults.
“Oral health is health, and the restriction in coverage has meant a restriction in access to these services throughout the state,” Elias wrote in an email to the Sun Journal.
The federally qualified health center operates a pediatric dental clinic on Second Street in Auburn, where it serves more than 2,500 children per year, according to Elias.
“Like other organizations, we have been inhibited by a lack of funding and reimbursement to be able to provide dental care services for adults,” Elias said. “While we are excited about this important expansion of coverage, we are also very mindful of the uphill challenges ahead in meeting the pent-up demand for services that have never been available for a significant portion of the population.”
Those challenges include workforce shortages, increasing costs and “a small percentage of dentists that will accept MaineCare due to historically lower rates of reimbursement,” she said.
Elias said Community Clinical Services is working to expand dental services to adults and “today’s announcement brings us one step closer to making that possible.”
The expansion is part of a broader effort to increase access to dental services, particularly in rural parts of Maine, according to Mills’ office.
A majority of participating MaineCare providers in western Maine are federally qualified rural health centers.
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