Oral health is essential to overall health and quality of life. Left untreated, dental diseases can result in severe pain and infection, an inability to perform daily activities, and in very rare cases, death. In California, Medi-Cal beneficiaries — especially children and pregnant women — face considerable obstacles in obtaining dental services, despite having dental coverage.
Denti-Cal, Medi-Cal's fee-for-service dental program, was the primary public financer of dental care for more than eight million low-income, elderly, and disabled Californians in 2007. In 2009, most of the Medi-Cal adult dental benefits were eliminated due to the state's budget deficit. Children's services, as required by federal law, continue to be delivered.
This CHCF Almanac presentation covers the organization of Medi-Cal's fee-for-service dental program in 2007, how it was funded, and the demographics of the population it served. It identifies the challenges the program faces in continuing to make dental care available to children, and the potential consequences of leaving a large segment of the adult Medi-Cal population with no care at all.
Key findings include:
- Just 25% of Medi-Cal beneficiaries reported a dental visit in 2007.
- Medi-Cal dental provider reimbursement rates are among the lowest in the nation and are significantly below the fees charged by most dentists.
- Because of these low rates, as well as the elimination of adult dental benefits, only 24% of California's private dentists accept Medi-Cal dental reimbursement, down from 40% in 2003.
- While research suggests that serious gum disease is associated with premature birth and low birth weight, only one in seven pregnant women with Medi-Cal coverage had a dental visit in 2007.
The complete presentation, along with supplemental data tables detailing beneficiary counts and expenditures by county, is available as a Document Download.