Network Health of Cambridge, which provides health insurance for 72,000 low-income people through the state Medicaid program (MassHealth), is adding a no-cost dental benefit for adult members. After eight months with the plan, adult members will be eligible for free annual dental checkups, cleanings, and X-rays services, which the plan said would cost almost $250 if paid out of pocket.
In 2002, facing a budget crunch, the state eliminated numerous Medicaid benefits, including most adult dental benefits coverage and eyeglasses. Children continue to be covered for dental care.
MassHealth is administered by the state and four private companies. Network Health is the third-largest of the private plans, and serves members primarily in central and western Massachusetts; Cambridge, Somerville and East Boston; Lawrence and Lowell; and Cape Ann.
"This is an enormous benefit," said Michael Doonan, a Brandeis University professor who also heads the Massachusetts Health Policy Forum. "Even when Medicaid provided dental benefits in the state, there weren't a lot of dentists who would take Medicaid reimbursement. One of the best things that could come out of this is some of the other plans might have to add this too, to keep up with the Joneses."
Dr. Allan Kornberg, chief executive of Network Health said offering the additional benefit will encourage members to stay with his plan, enabling him to spend less on marketing while helping to improve the health of members. "It's a good use of dollars and has some public health benefits," he said. "We'd like to see our competitors follow suit." A company spokeswoman, Phyllis D. Giller, said the new dental coverage is expected to cost $2 per member per year, or a total of about $150,000. "The cost is real but not huge to us," said Kornberg.
Restoring dental benefits for all adults covered by MassHealth (about 550,000 people under 65) would require action by the Legislature, according to advocates.
But Phyllis Peters, deputy assistant secretary for the Office of Acute and Ambulatory Care in the Executive Office of Health and Human Services, said there are "more and more discussions about the importance of dental benefits."
-Adapted from "Medicaid Provider Will Add Dental" By Jeffrey Krasner, The Boston Globe, 10/21/2005.10/05