Covered California Picks Six Insurers To Offer Pediatric Dental Policies
On Tuesday, Covered California selected six insurers to offer pediatric dental coverage through the state's health insurance exchange beginning in October, the Sacramento Bee's "Capitol Alert" reports (Sanders, "Capitol Alert," Sacramento Bee, 6/25).
Background
Covered California primarily will serve individuals and small businesses.
Supporters hope that the exchange will function similarly to websites like Amazon and Expedia so that users will be able to choose among various health plans through an easily navigable online store.
The exchange is expected to open for registration in October, and an estimated five million people will purchase plans through the exchange in 2014 (California Healthline, 6/19).
Details of Dental Policies
The health plans that will offer pediatric dental benefits through Covered California 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 -- will be sold as stand-alone products, with premiums ranging from $9 to $44 per month ("Capitol Alert," Sacramento Bee, 6/25).
Three policy types will be available:
- HMOs;
- PPOs; and
- Exclusive provider organization plans (Robertson, Sacramento Business Journal, 6/25).
The policies will cover several services, including:
- X-rays;
- Dental exams;
- Teeth cleanings;
- Crowns;
- Prosthetics; and
- Oral surgeries.
The policies will be offered at two levels:
- About 85% coverage of the total average cost of benefits; and
- About 70% coverage of the cumulative cost of benefits ("Capitol Alert," Sacramento Bee, 6/25).
Reaction
Following the announcement, Paul Reggiardo -- spokesperson for the American Association of Pediatric Dentistry -- said the group supports the inclusion of the policies but hopes that California will go further by making pediatric dental coverage mandatory.
Robert Hanlon -- an endodontist and former president of the San Diego County Dental Association -- said, "Dental disease is the number one reason why children miss school. Dental disease is also the number one most preventable disease in the country, so we applaud anything that increases access."
However, Neil Crosby -- vice president of public affairs for the California Association of Health Underwriters --Â noted that the premium rates announced on Tuesday are for a single child only.
He said, "[T]he rates may be comparable if you have one dependent, but if you have multiple children, then you are going to end up paying more" (Sisson, U-T San Diego, 6/25).
Broadcast Coverage
On Tuesday, KPCC's "KPCC News" reported on the selection of the policies (O'Neill, "KPCC News," KPCC, 6/25).
Low-Income Kids Least Likely To Receive Dental Care
In related news, California is one of 10 states where children in low-income families are least likely to receive dental care, according to a study by the Pew Charitable Trusts.
Jane Koppelman -- co-author of the study and research director for Pew's Children's Dental Campaign -- said that nearly 60% of children covered by Medi-Cal -- California's Medicaid program -- did not receive dental care in 2011.
The number of children covered by Medi-Cal who did not receive dental care increased from 57.7% in 2010 to 58.6% in 2011, according to the study.
Koppelman said many dentists do not accept Medi-Cal beneficiaries because of low reimbursement rates and extensive paperwork requirements (Dornhelm, "State of Health," KQED, 6/25). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.