Covered Calif. To Require Pediatric Dental Coverage Starting in 2015

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On Thursday, the Covered California board of directors voted to require all children's health plans offered through the exchange to include pediatric dental coverage as an essential health benefit beginning in 2015, the Sacramento Business Journal reports.

Background on Pediatric Dental Coverage

Currently, pediatric dental care is provided as a side benefit through Covered California (Robertson, Sacramento Business Journal, 1/24).

Six plans offer pediatric dental benefits through Covered California. They are:

  • Anthem Blue Cross;
  • Blue Shield of California;
  • Delta Dental;
  • Health Net;
  • Liberty Dental; and
  • Premier Access Dental.

All of the pediatric dental policies -- except those offered by Health Net -- are sold as stand-alone products, with premiums ranging from $9 to $44 per month (California Healthline, 6/26/13).

Details of Decision

The decision by Covered California's board to require children's health plans to cover pediatric dental care came after new data showed that only 27% of children who enrolled in health plans through the exchange also obtained dental coverage.

During the board meeting last week, Covered California Executive Director Peter Lee said he was surprised that "[t]he vast majority are not selecting dental coverage" (Sacramento Business Journal, 1/24).

However, he added, "A lot of folks are low income. They're thinking additional coverage versus food on the table."

The exchange said it might decide to offer additional dental coverage options for consumers who want to ensure they can keep their current dentist.

Reaction

Some dental insurers warned that the new policy could result in insurers partnering with less-expensive HMO dental plans that have more limited provider networks.

Meanwhile, dental health advocates applauded the change, saying that a lack of adequate pediatric dental care can lead to sleep deprivation and trouble paying attention in school.

Kathleen Hamilton of The Children's Partnership said her group is "very pleased, very excited by the 180 degree turn."

However, Hamilton added that the state Department of Health Care Services must work "to ensure that networks are adequate and that families have access to dentists in their communities ("State of Health," KQED, 1/24).

Broadcast Coverage

On Friday, KQED's "The California Report" reported on the exchange board's decision to require pediatric dental care in health plans ("The California Report," KQED, 1/24).

Linda Bergthold
Anthem offers pediatric dental coverage for $5.87 a month. Yes, it's an HMO & thus a restricted network, but preventive care is covered 100% and it's hard to argue that only 'your" dentist can do that. Should be a treatment any dentist can offer.

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