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New Law Increases Coverage for Medicaid Adults Needing Upper and Lower Dentures

(Anchorage, AK) —A bill signed into law recently by Governor Sean Parnell allows eligible Medicaid recipients to access two years worth of adult dental Medicaid benefits when they need an upper and lower denture at the same time.

The annual limit for adult dental services is $1,150.  Two years worth of benefits are typically needed to get a full set of dentures. Former regulations meant Medicaid recipients and dentists had to time any construction and placement of matching upper and lower dentures to overlap two state fiscal years. The new regulations allow patients to get upper and lower dentures at the same time.

Medicaid-eligible adults utilizing the two-year combined coverage for dentures would be eligible for emergency dental services only the following year. 

“While the annual limit is adequate for Medicaid-eligible adults needing an upper or lower denture, the coverage limits have been problematic for adults needing a set of dentures,” said Dr. Brad Whistler, a dentist with the state’s Division of Public Health. “Besides improving the quality of life for eligible recipients needing a set of dentures, the changes support how dentists typically provide these denture services.”

The Department of Health and Social Services is developing regulations related to the change in the annual limit provisions in relation to dentures and anticipates implementing this change in October 2010.

“I would encourage Medicaid-eligible adults needing a set of dentures to discuss the situation with their dentist, however they may want to wait until October for the new regulations to take effect before starting the process to get the dentures,” said Whistler.

For more information on Medicaid adult dental services go to: http://www.hss.state.ak.us/dhcs/medicaid_medicare/dental_medicaid/default.htm

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