CHA Blog

For 7 months, over 3 million Californians, many of which are also Medicare beneficiaries, have had no dental coverage. California’s state Medicaid program, Medi-Cal used to cover basicadult dental benefits such as annual exams, cleanings, and if necessary, root canals before the drastic budget cuts that went into effect July 1, 2009. Now, with no Medi-Cal adult dental services to cover their care, clients who are in pain but have no money or coverage to pay for care are being turned away from dentist offices and community clinics around the state.

Even with dentists and clinics offering discounts and payment plans to Medi-Cal clients, it’s not enough. Often beneficiaries are left choosing between using money for rent and food or for needed dental work. Many clients are wait until the pain is unbearable to get their dental care, and often they resort to having their teeth pulled versus getting a root canal because of expense.

In addition, dental schools and free dental clinics are overrun with clients and many community clinics that have relied on state funding have reduced their services and in some cases, have closed their doors.

Under federal law, dental coverage is an optional benefit for state Medicaid programs. Yet all but 7 states have included it in their Medicaid programs because good dental hygiene and care is such an important piece of maintaining good health. Because of the recession, however, many states have scaled back their coverage and in some cases only cover emergency dental care.

In California, the state will still pay to have a tooth pulled in an emergency, but it no longer covers the cost of expensive dentures. This presents a problem for dual-eligible Medicare beneficiaries (beneficiaries on Medicare and Medi-Cal).  As Medicare doesn’t cover dental care,  these low-income beneficiaries have long relied on the state’s dental benefits when needing dentures.

For more information on the cuts to the adult dental benefits, including frequently asked questions on eliminated services, see Medi-Cal’s website.

You can also listen to National Public Radio’s recent story highlighting this imminent problem.

A growing number of older Americans are selling their life insurance policies to help pay for retirement expenses and/or long-term care (LTC). These transactions are also known as “life settlements,” “senior settlements,” or “viatical settlements” if a person is terminally ill. While this may be an appealing option for some, people should use caution.

In a recent AARP article, Selling Your Life Insurance? Proceed With Caution, Bonnie Burns, our Training and Policy Specialist, comments that most people don’t realize: 1) there may be tax consequences to selling a policy, and 2) money from a life settlement could affect their ability to qualify for public assistance like Medicaid.

The California HealthCare Foundation recently published its 2010 overview report on the demographics, health status, insurance coverage, quality of care, utilization, and spending of Medicare in California. Consumer advocates, health care providers, and policymakers can use its factual framework to better understand California’s Medicare population and inform their efforts in designing effective programs and policies for the state’s beneficiaries.

Some of the report’s key findings include:

• California’s elderly population (those age 65 and older) is expected to more than double between 2000 and 2030.
• California has the largest number of Medicare beneficiaries of any state — 4.5 million enrollees. This number will continue to increase as California’s population ages and the percentage of those by Medicare rises.
• Medicare’s reimbursement for care delivered to California beneficiaries is higher than the national average — as of 2006, it’s about $600 more per beneficiary.
• In 2004 and 2005, total annual medical payments per Medicare beneficiary in California averaged $11,326, of which $1,330 (11%) came out of the beneficiaries’ own pockets.
• A large percentage of Medicare beneficiaries suffer from multiple chronic illnesses. In 2005, 79% reported having two or more chronic conditions and 37% reported four or more.

Download the full report for more information:

• California Health Care Almanac: Medicare Facts and Figures 2010 (PDF)