For the first time in state history, all adult TennCare members will be able to access dental care, including regular exams, cleanings, X-rays, fillings, crowns, dentures and more at no cost to them starting Jan. 1.
TennCare Director Stephen Smith said during recent budget hearings that roughly 600,000 low-income Tennesseans will gain dental coverage in 2023 as a result of the new benefits.
The added coverage is one of the promised investments made as a result of a waiver that Tennessee received from the federal government for more flexibility in spending Medicaid funds.
TennCare is Tennessee's Medicaid program and provides health care coverage to low-income pregnant women, parents or caretakers of minors, children, seniors and people with disabilities. Tennessee has been one of three states whose Medicaid program provided no dental coverage for adults.
Dr. Leigh Kuyrkendall, a dentist at Revive Dental -- a community dental center in Chattanooga that treats primarily uninsured patients -- said many of Revive's patients will gain coverage through the new TennCare benefit. Revive has applied to be a TennCare dental provider.
Without TennCare dental coverage, Kuyrkendall said many adults' oral health has been neglected to the point that they wind up in the emergency room with an abscess or needing an extraction, which can cost between $150-300 at a dental office for someone without insurance.
"In the emergency room, they're given antibiotics and pain medicine, which is a temporary fix," Kuyrkendall said. "It's just a terrible situation, so it's really exciting to see the state come in and provide dental care for people on TennCare."
Coverage will now allow adult TennCare members to access dental care consistently and prevent more costly and painful outcomes, she said.
"If they get cleanings and fillings, we can stop things before they get to the infection point. That point is the most expensive, and that's when they end up in the emergency room often," Kuyrkendall said, adding that in addition to improving health, dental care has a huge effect on a person's self-confidence and ability to succeed in the workforce.
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TennCare members should receive a welcome information packet in December from DentaQuest, TennCare's dental partner, that outlines how to find a dentist and get services. After Jan. 1, TennCare members needing support can visit dentaquest.com or reach out directly to DentaQuest at 855-418-1622.
Michele Johnson, executive director of the Tennessee Justice Center, called the added dental coverage a "huge positive" for the state but said she's concerned there won't be enough participating dentists to actually meet the need.
While TennCare has long provided dental care for children, Kuyrkendall said past administrative challenges and low reimbursement has kept many dentists from wanting to participate.
"If the payment process and the approval process are smooth, we'll have more dentists taking it, and it seems like they're putting a lot of money into this program," Kuyrkendall said. "I feel like they're making it a priority."
Smith said during the budget hearing that part of TennCare's investment in the adult dental benefit included increased payment to providers.
So far, 750 dentists (50 in Hamilton County) have contracted to be in TennCare's adult dental network, according to TennCare spokesperson Amy Lawrence.
"DentaQuest has been working diligently since late August, when the contract amendment was officially approved, to grow and build this network and anticipates continuing to add to the number of dental providers who will serve the TennCare population," Lawrence said via email.
Smith said during the hearing that TennCare leadership is exploring what additional new investments can be made under the federal waiver in the coming year, with a particular focus on efforts to improve maternal health and strengthen families.
Contact Elizabeth Fite at email@example.com or 423-757-6673. Follow her on Twitter @ecfite.