By
Anne Swerlick
|
February 15, 2021

Updating Florida Medicaid's Adult Dental Benefit Would Improve Beneficiaries' Overall Health and Save State Dollars

This post was last updated on September 10, 2021. As new policies are announced, FPI will update this page.

As Florida’s response to COVID-19 takes front and center, concern grows for low-income families who struggle to take precautions against the spread of the virus. Although Congress has passed the Families First Coronavirus Response Act to address, at least in part,  the public health crisis and economic fallout from COVID-19, many barriers continue to keep struggling families from accessing the assistance they need during the pandemic. As Florida initiates policies implementing the Act and addressing other barriers to the safety net, FPI will update this form. When available, hyperlinks are provided to agency documents or statements that provide greater detail  about the new policy.
On March 22, 2020, FPI and 44 other organizations sent a letter to Governor DeSantis, leadership in the Legislature and agency heads to urge action on 47 specific policy changes to reduce unnecessary barriers for Florida’s safety net programs in response to the COVID-19 pandemic. See the letter here.

Executive Summary

Florida Medicaid provides coverage for essential health services to over 4 million Floridians with low income, including people with disabilities, the elderly, children, parents, and pregnant women. However, state Medicaid law limits the adult dental benefit to just coverage of dentures and emergency services. This falls far short of meeting beneficiaries' needs. 

A substantial body of research shows that oral health is essential to overall health. Poor oral health can worsen chronic conditions, such as diabetes and heart disease, lead to pregnancy complications, and contribute to increased emergency department visits.

Medicaid prepaid dental health plans responsible for providing dental care to most beneficiaries have opted to offer some additional services as “expanded benefits.”  However, this coverage is not required under state law. As such, the provision of these additional services — while beneficial — is left solely to the discretion of the dental plans and the Agency for Health Care Administration (AHCA), which is the state’s Medicaid agency. Moreover, there is a lack of transparency on whether plans are in fact providing the additional services and to what extent beneficiaries can access them. 

It has been nearly two decades since the Florida Legislature adopted changes to the current, and very restricted, Medicaid adult dental benefit. It is time to update Florida law to provide Medicaid coverage for comprehensive adult dental care.  

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