June 17, 2024 8:49 am
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Delta Dental Would Begin Medicaid Dental Benefits for Adults Under $33.5 Million Contract

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by Annmarie Timmins, New Hampshire Bulletin

Adults insured by Medicaid may be a step closer to having their dental care covered. On Wednesday, the Executive Council will consider a $33.5 million contract with the Delta Dental Plan of New Hampshire to provide not only oral care but also oral education and transportation to appointments when needed.

The company would have until April to begin providing dental coverage to nearly 88,000 adults on Medicaid and expanded Medicaid under the 15-month contract. The state, which covers oral health care for children on Medicaid, was one of fewer than a dozen that did not also cover adults until legislation passed this year. Only emergency services were covered.

Lawmakers who have tried for more than a decade to expand benefits to adults overcame cost concerns this year by using nearly $21 million in settlement money, secured by the state against a company hired to manage Medicaid pharmacy benefits, to cover the first three years.

The next challenge will be recruiting more dentists to take Medicaid; currently fewer than 20 percent do, in part because of low reimbursement rates, tedious paperwork, and challenges caring for a population with significant health issues and difficulty showing for appointments.

Six companies submitted bids, according to documents provided to the council by the Medicaid division within the Department of Health and Human Services. The team that reviewed the bids scored Delta Dental and the other finalist, MCNA Dental, similarly on a number of program requirements, according to the documents. Delta Dental scored higher on cost savings, quality management, relevant experience, and having an adequate provider network. 

Tom Raffio, president and CEO of Northeast Delta Dental, told the Bulletin in August the company would likely submit a bid and highlight its existing relationship with nearly 851 New Hampshire dentists, 93 percent of all dentists in the state.

The new benefits would have no cap on benefits or copays for preventive services. Other dental care would be capped at $1,500 a year and require a 10 percent copay for those with household incomes above 100 percent of the federal poverty level, which is $27,750 for a family of four.

Coverage for dentures would be provided only for Medicaid recipients with developmental disabilities, acquired brain disorders, people in nursing homes, and those in the Choices for Independence program, which includes the elderly and people with chronic illness or disabilities.

This story was written by Annmarie Timmins, a reporter at the New Hampshire Bulletin, where this story first appeared.

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