Sorry kid, we know you’re in pain but you’re covered by Medicaid and there are other kids with better insurance who we will be taking care of first.
Is it just me or does this sound ridiculous?
Let’s first start out with some background information. I am an Illinois dentist and have been in practice, serving patients in Lake County Illinois since 1969.
I guess you could call me an “old school” dentist – I treat patients the way I would like to be treated and I feel a deep obligation to treat those in need of care, regardless of their financial ability, color of their skin or political affiliation.
I recently read an article about a group of researchers that uncovered some startling findings about Illinois dentists – they apparently are turning away children who rely on Medicaid, Public Aid or All Kids for their health care coverage.
The findings, published in Pediatrics, show dental access for low-income families varies from state to state, with Illinois receiving some very low marks.
Turning away kids with Urgent Dental Care Needs in Illinois
To conduct the study, the researchers asked six women to pose as the mom of a 10-year-old boy with a fractured front tooth that was in need of urgent care in Cook County, Illinois, which includes Chicago.
The “moms” made two calls, four weeks apart, to 85 dental offices throughout Chicago and Cook County seeking an urgent appointment. The only variation in the calls was the boy’s insurance coverage – one time it was Illinois Medicaid, also known as All Kids, and the next time it was private Blue Cross insurance.
The results of the study were astounding – nearly two-thirds of the Medicaid calls resulted in the women being turned down for an appointment, while more than 95 percent of those claiming to have Blue Cross were told they could be seen. Additionally, 30 percent of the Medicaid moms who called practices enrolled in the State of Illinois’ Medicaid program also were denied appointments according to Reuters.
The study states that the Medicaid reimbursement rate was the key factor. Illinois reimburses dentists for 53 percent of their median usual fees, putting the state among those below the national average reimbursement level of 60.5 percent. Although Medicaid reimburses for emergency dental care, the payments drop off for follow-up visits, which probably makes dentists “shy away” from taking on the patients.
When the researchers were unable to get Medicaid-covered kids into Medicaid dentists, a majority of the dental practices agreed to schedule appointments when they were offered cash payments for their services. This happened even though dentists enrolled in Illinois’ Medicaid program are prohibited from collecting cash from Medicaid, Public Aid or All Kids patients.
Patients in need, children or adults, deserve quality dental care
I think that there is a common misconception that Medicaid (Public Aid, All Kids, etc.) in Illinois “does not pay enough to cover the cost of running a dentist’s office”. In many cases this is true; however there are some procedures where Medicaid reimbursement levels approach those of traditional insurance carriers.
I may be in the minority here, but we are proud to be a respected provider of dental care, oral surgery and orthodontic treatment with braces to Public Aid, Medicaid and All Kids patients throughout northern Illinois. And unlike most of the other dentists and orthodontists in our surrounding Lake County communities, we do not limit the number of Public Aid, Medicaid or All Kids patients that we see. We do our best to accept every patient with State of Illinois dental coverage and provide them with the quality dental care they require and deserve.
As dental health practitioners, we have a duty to treat and if the sole reason that you practice dentistry is to reap the financial rewards, then maybe we should all revisit our ethics.