Medi-Cal has helped millions of people receive dental care in the State of California. However, there have been concerns in recent years about a lack of support for those that need dental implants. Legislation which could change this situation has been tabled, but concerns about this have also been raised.
Medi-Cal is California’s own Medicaid healthcare program – which aims to provide various medical services for low-income families.
Dental treatment is among the services offered by Medi-Cal. While this can be helpful for some people, others find it difficult to get the treatment they need.
This presents a very challenging situation for those with severe dental conditions that cause pain and therefore need urgent treatment [1].
For example, many people are finding out that getting dental implants is very difficult. However, a new bill is making its way through California legislature, which may change this situation.
Medi-Cal
Medi-Cal has been in place for several decades. While California is renowned for its highly-affluent areas, there are also some incredibly poverty-stricken regions too.
Medi-Cal has the intention of helping low-income individuals and families with healthcare costs. Other vulnerable populations, like the disabled or blind, are also eligible for coverage. Medi-Cal is means tested, so the amount of coverage that people receive is in line with their income.
As of 2024, over 15 million people were enrolled in Medi-Cal, equating to approximately 40% of the population of the state [2].
The difficult situation
Some dental services are included within Medi-Cal. However, some dental clinics do not accept Medi-Cal, meaning receiving coverage does not guarantee treatment [1].
For example, the UCLA Center for Health Policy Research found that only 21% of California dentists saw Medi-Cal patients of all ages [1]. Therefore, some people do not live in an area that offers dental care covered by Medi-Cal.
One specific area of concern is dental implants. Implants are artificial teeth that are implanted into the jawbone. They look and feel like a real tooth, and are a popular option for people who have had to have a tooth removed.
Dental implants offer strong results, with past research funding that there is a 90-95% success rate over 10 years for dental implants [3].
Teeth usually need to be removed due to either extensive tooth decay, trauma or gum disease. Those with a lack of teeth face numerous problems. Chewing, drinking and swallowing become very difficult. Moreover, self-esteem can also be impacted.
Dental implants are rarely routinely offered. Medi-Cal covers implants only in cases where “exceptional medical conditions are documented” [1]. Unfortunately, this is rather vague.
This causes many problems for those that have lost teeth. They are faced with the prospect of living without some teeth, or paying large sums in order to get implants. For many, this is not financially feasible.
Could this soon change?
However, this difficult situation may change soon. There is a bill that is making its way through the California Legislature that would expand Medi-Cal coverage of dental implants [1].
The bill was introduced by Democratic Senator Aisha Wahab. Wahab has said that “if you need an implant, you should be able to get it, especially our most vulnerable” people [1].
If this bill becomes law, patients could qualify for an implant in cases where their dentist believes an implant is the best option to replace a missing tooth [1].
The Senate passed the bill on a unanimous basis in May, with a vote currently pending in the Assembly Appropriations Committee [1]. The bill is slowly moving through legislature, and could eventually come into effect.
If the bill does come into effect, then it is likely that many patients will benefit. They may be able to get much-needed dental care.
Concerns about the bill
However, despite the positives, there are also a number of concerns. These surround cost, and concerns about the potential impact of the bill on dental clinics.
The Department of Health Care Services – who oversees Medi-Cal – have estimated that the cost of implementing the bill would be between $4 billion and $7 billion [1].
However, this is likely to be difficult, with Governor Gavin Newsom having recently signed a state budget which featured an estimated deficit of $46.8 billion – meaning that costs need to be cut.
There are other concerns too – including how much dental clinics would be reimbursed. Depending on various factors, the cost of implants can vary anywhere between $3,000 and $9,000 [1].
Alicia Malaby, spokesperson at the California Dental Association, has spoken on behalf of dental clinics. Malaby says that “reimbursement rates need to cover the costs of providing the service” – with implants also expensive for dental clinics to arrange [1].
Furthermore, Malaby said that “coverage is not meaningful unless the state is willing to fully invest in it to ensure people can actually access the care they need” [1].
The California Dental Association have also raised concerns about how invasive and time-consuming implant surgery is. They are not in support of the current bill.
Instead, they are supporting alternative legislation which would require Medi-Cal to cover two teeth cleanings and examinations a year for those aged 21 and over [1].
Summary
There are certainly concerns over the dental implant situation with Medi-Cal. Many people are in desperate need of oral health treatment.
However, as discussed above, there are a number of concerns too. This includes the cost burden and the impact on dental clinics.
Trying to find a compromise will be challenging. With various potential legislations being tabled, we may see a solution soon.
Thinking points…
1) As discussed earlier, dental implants are excellent options for those who need to have a tooth removed, or have already had some extracted. Implants are easy to fit, act naturally, and can boost your self-esteem. Here at Savanna Dental, we provide implant services, and will be happy to discuss your situation with you. We would love to speak to you soon, you can find out more about us at our website – https://savannadentalclinic.ca/!
2) Cost is definitely a barrier to accessing dental care for many. However, here at our Calgary-based dental clinic Savanna Dental, our fees are set in line with the Alberta Dental Fee Guide. Therefore, this means that our prices are transparent, competitive and reliable. This ranges from our check-ups to procedures. We hope to see you at our Calgary dental clinic soon!
What we offer at Savanna Dental
Savanna Dental is a dental clinic based in Calgary, Alberta, Canada. We provide our patients with a range of treatment options and advice, with the aim of improving oral health and boosting overall wellbeing!
We advise our patients to attend our Calgary-based dental clinic twice a year for a dental check-up. If any problems are detected, we have many treatments available. For instance, these include cavity fillings and root canals. To try and prevent problems, it is important to brush your teeth at least twice a day and floss regularly.
Here at Savanna Dental, we also have some cosmetic treatments available! These include dental implants, tooth whitening and Invisalign™! Our patients find that these treatments have a positive impact on their appearance, confidence and self-esteem.
In addition, the fees of our services at our Calgary dental clinic Savanna Dental are set in line with the Alberta Dental Fee Guide.
We would love you to visit our Savanna Dental clinic in Calgary! You can find out more about us by visiting our website https://savannadentalclinic.ca/!
References
[1] Castle, M. (2024). Medi-Cal’s dental care gap: Getting a tooth pulled is easy—much harder to get an implant. Available: https://medicalxpress.com/news/2024-08-medi-cal-dental-gap-tooth.html. Last accessed: 29th August 2024.
[2] California Department of Healthcare Services. (2024). About Us. Available: https://www.dhcs.ca.gov/Pages/AboutUs.aspx. Last accessed: 29th August 2024.
[3] Raikar, S., Talukdar, P., Kumari, S., Kumar Panda, S., Oommen, V. M., & Prasad, A. (2017). Factors Affecting the Survival Rate of Dental Implants: A Retrospective Study. Journal of International Society of Preventive & Community Dentistry. 7 (6): p351-355. DOI: https://doi.org/10.4103%2Fjispcd.JISPCD_380_17.
