Capital News Service
LANSING – With Medicaid coverage of adult dental care restored as of Oct. 1, Upper Peninsula dentists who accept Medicaid are thankful but haven’t seen an influx of patients yet.
Michigan eliminated dental coverage for people 21 and older in July 2009 for budget reasons and patients are slowly finding out that their care is covered once again, said Donna Jaksic, executive director of the Upper Peninsula Association of Rural Health Services in Marquette.
The rural health association is a federally funded nonprofit community health center that serves rural areas throughout the U.P. Dental care is available at its clinics in Ewen, Spalding, Crystal Falls, Menominee, Engadine and Gwinn, some of which offer medical services, too.
“We expected calls Oct. 2 like mad, but people are just realizing now,” Jaksic said. “It really surprised us, but we’re extremely grateful it’s back.”
Jaksic said some private dentists accept Medicaid patients, but the region is considered underserved because not all of them do.
The legislature approved $19.7 million for the adult dental program, according to the Department of Community Health.
Statewide, 20 percent of dentists accept Medicaid, said Tom Kochheiser, director of public information for the Michigan Dental Association.
“I’m surprised to hear the news hasn’t traveled,” he said. “It had a big impact because without that safety net, some clinics and providers were taken out of the grid.”
Sandy Cittadino of the Michigan Community Dental Clinic in Marquette said once Medicaid coverage was eliminated, the clinic reduced its operation from five days a week to four.
“We didn’t have as much patient load,” she said. “The word is starting to get out there.”
To make patients aware of the change, her clinic plans to put up fliers in physicians’ offices and emergency rooms.
Before dental coverage was eliminated, an average of 25 to 50 percent of the association’s patients were uninsured. When coverage was disapproved, up to 75 percent were uninsured, Jaksic said.
To aid the uninsured, the association used a $930,000 federal grant to run a sliding fee program that adjusted charges for uninsured patients, depending on their financial status.
“It’s an expensive item no matter how you do it. Those who don’t have insurance often put off coming,” Jaksic said.
Now that Medicaid coverage is available, the association wants patients to schedule appointments and pick up where they left off.
Also, coverage restoration allows the health system’s clinics to offer denture work again.
“If we had tried to do full-range service, we’d have run out of money. We don’t do anything for the insured that we don’t do for the uninsured,” Jaksic said, noting that the clinic still offered emergency work, cleanings and fillings.
Lois Abramson, the manager of its medical clinic in Ewen, said many of the area’s Medicaid-covered patients still don’t know their benefits were restored and many need extensive work.
“It’s really a mess now. Their dental work is even worse. A lot of people just let their teeth go and now need extractions,” she said.
Abramson said that neglected dental work impairs patients’ overall health, which can lead to medical, and sometimes emergency, care. To prepare for the return of Medicaid patients, she is cross-training staff to do both medical and dental work.
“I hope that patients get taken care of. A lot of people are really suffering,” she said.
Barb Taylor, an assistant and part-time dentist at the clinic in Engadine, said she just learned that Medicaid coverage was restored.
“There’s been a little bit of traffic,” she said of Medicaid patients aware of the change.
The association is opening a Hancock location in the next few months and is looking to expand to Marquette.
Jaksic said additional clinics will reduce the driving time for many patients who seek Medicaid coverage, who sometimes travel up to 70 miles for dental care and are “desperately asking when the clinics will open.”
© 2010, Capital News Service, Michigan State University School of Journalism. Not to be reproduced without permission.