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.