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— This blog post is an excerpt from the Benevis Whitepaper “The Dental Divide and the Health Chasm It Creates for Too Many Children“ —
An estimated 74 million Americans—nearly a quarter of the population—have no dental insurance coverage. For comparison, that is well over double the estimated 28 million(goes to new website) Americans who have no health insurance.*
For low-income families who are least likely to have dental coverage, the cost of dental care can be a major deterrent. They may avoid or delay seeking care (goes to new website)for themselves and their children because they cannot afford to pay for it. Joint federal-state programs help to bridge the gap for many families.
About 40% of children (goes to new website)between the ages of 2-18 have dental benefits through Medicaid or the Children’s Health Insurance Program (CHIP). These phenomena result in significant deficiencies in access to care.
Broad Disparities in Medicaid Payments![8](https://info.benevis.com/hs-fs/hubfs/8.webp?width=463&height=242&name=8.webp)
Medicaid reimbursement rates for pediatric dental care vary significantly in different states nationwide:
Low = 27.8% of private insurance reimbursement rates in Minnesota
High = 90.5% of private insurance reimbursement rates in Nevada
National Average = 61% of private insurance reimbursement rates
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SOURCE
American Dental Association: Reimbursement Rates for Child and Adult Dental Services in Medicaid by State infographic.(goes to new website) ADA Health Policy Institute, October 2021
While greater coverage is a positive, the reimbursement rates for dentists are low for these programs. Rates vary widely state by state. On a national average, Medicaid and CHIP programs pay just 61% of rates paid by private insurers for child dental health services. As a result, only 39% of U.S. dentists accept Medicaid or CHIP.***
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SOURCES
*U.S. Census Bureau: Health Insurance Coverage in the United States: 2020.(goes to new website)” Sept. 14, 2021.
**American Dental Association: Reimbursement Rates for Child and Adult Dental Services in Medicaid by State(goes to new website) infographic. ADA Health Policy Institute, October 2021.
***The Center for Health Care Strategies, Inc.: “Medicaid Adult Dental Benefits: An Overview.(goes to new website)” September 2019.