Honolulu Dental Providers Info

For the first time in ten years, DHS has resumed dental benefits for adults who have Medicaid and is called PADD, the Prevent Adult Dental Decay program. For a decade Medicaid covered emergency extractions only for adults has now been changed to include $500 a year dental benefit. On page four of the Quest Hawai'i pamphlet, revised 2.14.2007, it states, "two additional adult benefits; adult preventive and restorative dental benefits with a $500 limit."

Although this change is an improvement over extractions only, a single root canal on a back molar is $900 - $1200 UCR, the usual and customary rate. Hawai'i state would save money in the long run if fixed all the problems in one year, instead of waiting another year to pass, allowing the tooth infection to fester and become more expensive to heal later.

An exception to the general exclusion is given by Medicaid if the patient has low immunity against infections. According to the institute of Medicine in "Extending Medicare Coverage for Preventive and Other Services, "Oral infection ... increase systemic morbidity in patients who are immunocompromised." ^[1]

The report on Act 160, Section 4. (43), Section 39.1 states that the Hawai'i Pre-Paid Management Information System expects Medicaid patients who have had zero dental care for ten years will have a higher number of emergent dental needs that coverage should be interpreted correspondingly. The report ends with, "... basic preventive and restorative dental benefits for Medicaid adults will improve their health and self-sufficiency as well as save the State cost in the long run." ^[2] "A filling today is cheaper than a root canal a year from now." ^[3]

Any dental work above and beyond the $500 limit that is medically necessary must be preauthorized for the exception to the exclusion by having the patient's primary doctor write a general note advocating an specific dental procedure for the patient. The dentist's office then fills out a request for dental authorization which takes time for Medicare approval.

Community dental clinics don't normally handle difficult endodontics and are referred to a root canal specialist. For example, a crooked #31 back molar costs between $900 to $1200 in January 2008 in the Honolulu area.

Donated Dental Services (DDS), volunteer dentists who are part of the National Foundation of Dentistry for the Handicapped and work in conjunction with the Hawaii Dental Association, gave $109,534 in dental work towards 32 patients, ^[4] an average of about $3400 per person in the 2006/2007 time period.

For more information call the State of Hawai'i MedQUEST Division Customer Service Branch provider hotline at 524-3370, for 'Oahu call 692-736.

For those without dental insurance, sliding scale fees are available from the Department of Health Dental Clinics at Diamond Head, Lanakila, Leeward and Windward, the main number is 832-5710 for more information.

More 808 resources

Kalihi-Palama Dental Clinic 845-0686
Queen's Dental 547-4292
Donated Dental Services 1-888-449-9670

Sources

[1] IOM, 'Extending Medicare Coverage for Preventive and Other Services' www.nap.edu
[2] Med-Quest Division 'Report to the 23rd HI Legislature 2006' Hawaii.gov
[3] Bismark Tribune 'Editorial Opinion' www.bismarcktribune.com
[4] NFDH 'Hawai'i DDS' nfdh.org
[5] Susan Jaworowski TEETH ON EDGE: THE DEBATE ON DENTAL INSURANCE IN HAWAI`I Hawaii.gov
[6] DHS, 'HB2315 testimony ' capitol.Hawaii.gov