Medicaid

Project Homeless Connect returns May 7

The Pierce County Dental Society, along with other Pierce County Oral Health Coalition partners, will provide dental assessments and treatment triage at the Project Homeless Connect / Puyallup event on May 7, 2014. The upcoming activity will be held at the Washington State Fairgrounds. Please share the event information with community members as appropriate.

Welcome to Dental Services!

Deadline approaches for enrolling through state insurance exchange

For individuals seeking to enroll for health and dental insurance through the state-run insurance exchange called Washington Healthplanfinder, the deadline is March 31. (Questions about dental coverage under the Affordable Care Act for persons 18 years of age and younger and the expansion of state Medicaid to cover adults can be found on the coalition’s page here.)

According to the exchange’s web site, plans purchased by 11:59 p.m. on March 31, will be effective May 1, 2014. The next open enrollment period will be Nov. 15, 2014, to Feb. 15, 2015.

Those who qualify for Medicaid, also known as Apple Health in Washingtion state, may continue to enroll throughout the year.

An FAQ page has been published by Healthplanfinder to answer questions the public, providers, and others may have about the deadlines, exceptions, and situations for persons not sure about their applications’ status.

 

Oral health benefits under health care reform

Pierce County community and oral health coalition members, representing 28 agencies and provider offices, gathered at PCOHC’s Feb. 12 meeting to learn more about health care reform’s impact on oral health benefits. (Two CE credits were offered.)

Dianne Baum of the Washington Health Care Authority highlights adult dental Medicaid benefits during her presentation to the PCOHC.

Dianne Baum of the Washington State Health Care Authority highlights adult dental Medicaid benefits during her presentation to the Pierce County Oral Health Coalition (PCOHC). More than 40 attendees, representing more than two dozen organizations, attended the PCOHC-organized event.

Presentations were made by representatives from the Washington State Health Care Authority (HCA) and the state’s insurance marketplace known as the Washington Health Benefit Exchange (HBE).

Adult Dental Benefits (Medicaid)

Dianne Baum, dental program manager at the HCA, provided a comprehensive summary of the Washington Apple Health (Medicaid) Adult Dental benefits that the state legislature restored, and in some cases enhanced, effective Jan. 1, 2014.

Baum’s presentation addressed the following topics:

  • Eligibility parameters
  • Covered dental services, limitations and exclusions
  • Answers to commonly asked questions and resources for additional Medicaid dental information
  • Current and prospective Medicaid provider support: Baum emphasized the availability of the HCA’s Medicaid dental experts to provide one-on-one assistance to prospective providers as well as support those providers who currently serve Medicaid-covered patients.
  • Claim Review and Pre-authorization: HCA’s dental staff consists of professional, licensed dental practitioners and benefit professionals who assist with and oversee Medicaid claim documentation, review and authorization of dental treatment plans.

The Washington State HCA Medicaid Provider Guide for Dental-Related Services effective January 1, 2014, may be found here.

Pediatric Dental Benefits

Christine Gibert, senior policy analyst for Washington’s insurance marketplace, the HBE, outlined the history and current status of the new pediatric dental benefit offered through the HBE.

Gibert’s presentation touched on the following topics:

  • The mandatory purchase of pediatric dental benefits for any eligible child for whom a medical plan is purchased on the HBE,
  • Dental plan premiums, and
  • Coverage limits and deductibles that remain separate and distinct from medical plans.

Gibert said the HBE Board recognized the current dental-purchasing experience remained challenging for HBE consumers and providers alike.

While Washington’s lawmakers were currently considering legislation to allow embedding  pediatric dental benefits into medical plans, she said that 2016 was realistically the earliest implementation date for other changes to the HBE’s pediatric dental benefit.

Gibert said the HBE’s Dental Technical Advisory Committee (DTAC) provided an avenue for community input and information.

Ed. Note: The PCOHC thanks Baum and Gibert for their presentations, as well as Evergreen State College-Tacoma Campus for the use of its facility.

Oral health coverage and health care reform

The Pierce County Oral Health Coalition is proud to organize a presentation on Feb. 12, on oral health coverage issues and health care reform. Continuing education (CE) credits are available.

  • Restoration of adult dental Medicaid benefits in Washington State.  Presentation by Dianne Baum, Dental Program Administrator, Washington Health Care Authority, 1-2 p.m.
  • Pediatric dental benefits on the Washington Health Benefit Exchange (HBE). Presentation by Christine Gibert, HBE Senior Policy Analyst, 2-3 p.m.

The first presentation by Baum begins at 1 p.m., followed by Gibert at 2 p.m. Both presentations will take place at Evergreen State College-Tacoma Campus, located at 1201 6th Street, Tacoma, WA 98405. For a map, please go here.

The event is recommended for oral health professionals and providers and individuals and groups who work with populations who may eligible for these new benefits made possible through health care reform at the state and federal level.

Lunch will be provided; please RSVP by Feb. 6 at pcohc@pcdentists.org, or use our contact page.  Space may be limited. A copy of the flyer for the event can be found here.

Note: Gibert’s presentation was recently confirmed, and those who have already sent an RSVP for Baum’s presentation do not need to reply again.

Upcoming community events … dental and more

Pierce County residents have many opportunities in January and February to connect with health, oral health, and personal care resources. Please spread the word about these wonderful PCOHC-member sponsored events:

  • Project Homeless ConnectSpanaway: Health care enrollment, dental, medical and other personal care services, Jan. 25, 9 a.m. to 3 p.m., at Spanaway Middle School, 15701 B Street E.
  • Children’s Dental Health Day - Puyallup South Hill Mall: Free dental screenings, mobile dental van, community resources, and much more, Feb. 22, 10:30 a.m. to 2:30 p.m.

 

Oral health procedures to be covered by adult dental Medicaid starting in January

State health officials have released additional information concerning dental procedures that will be covered for Medicaid-eligible adults in Washington state, starting on Jan. 1, 2014.

An update on those procedures was recently shared at November meeting of the Washington Coalition on Medicaid Outreach by Dianne Baum, dental program manager for the Washington State Health Care Authority (HCA). The covered procedures include exams, X-rays, cleanings, fluoride varnish, fillings, periodontal care, root canals, dentures, extractions, and emergency services. Crowns will not be covered.

See the presentation for more details and the HCA’s news release from Oct. 10, 2013.

Starting in January, the Washington Medicaid Program will resume covering dental services for all adults with Medicaid. This includes residents who already have Medicaid and people who are eligible for “expanded Medicaid,” made possible by federal health care reform.