Does Dental Insurance Covers Dental works for Disabled ? – Today in this article, we will provide you with all the information you need regarding the insurance that provides quality dental care for the people with disabilities. Luckily, there are programs around the country that assist with funding dental work for patients with disabilities. In addition, an increasing number of clinics are educating staff on how to assist individuals with both physical and developmental disabilities and are supplying the infrastructure necessary to enhance the comfort of disabled patients. It is possible to get free dental for disabled, as you can find a number of opportunities.
Social Security Disability Dental Insurance (DI) provides monthly benefits to workers who are unable to work any longer due to a significant illness or a disability that is expected to last at least a year or to result in death within a year. Meanwhile federally-funded services like Medicaid Disability Dental Coverage covers preventative services such as cleanings, x-rays, check-ups and sealants. It also covers restorative services such as root canals, crowns, fillings, oral surgery and other emergency procedures.
If you are looking for free dental for disabled individuals and a dentist for disabled adults near you that accepts Medicare or Medicaid dental coverage and treats patients at a free or reduced-cost, then you are just at the right place!
Although the fact that people with disabilities frequently encounter significant obstacles when seeking dental care is, to put it mildly, frustrating, we hope this article will help you in finding the care you need. So, what are you waiting for? Read the article till the end to know everything about it.
Highlights of this Post
Who Qualifies for Special-Care Dentistry?
People with disabilities who require free, comprehensive dental care are eligible for Special Care Dentistry (SCD) – a branch of dentistry that provides these services. This includes:
- The seniors
- Disabled people
- Mentally and medically compromised people
The elderly make up a significant part of the disabled community in most countries. Most of the time, they live alone by themselves in their own homes or in nursing homes for special care.
Dental professionals who work to promote the oral health of people with special needs are the members of international organizations like the Special Care Dentistry Association (SCDA).
Are There Specific Dentists for People With Disabilities?
People with special needs can be treated by many dentists. Moreover, specialized dental services may be required by some people with certain disabilities.
Anyone who requires treatment for their teeth can expect comprehensive care from trained dental professionals. However, recent advancements in continuing education programs (such as the MSc in Special Care Dentistry) have made it easier for dentists to provide care for patients with special needs.
Additionally, there are dental clinics that give disabled adults’ oral health care top priority. Volunteer dentists work for these clinics. Adults with disabilities can get affordable dental care from them.
Does Disability Insurance Cover Dental Work?
In the case of a disability that prevents a person from working, disability insurance primarily protects a portion of the person’s monthly income. However, it rarely provides dental coverage.
Government Insurance Options
People with disabilities in the United States have three options for government-provided health insurance:
- Affordable Care Act (ACA)
Adult oral care services, on the other hand, are typically not fully covered by these insurance options. Medicaid only covers some dental services for disabled children and adults under the age of 65. There are some Medicare plans that provide partial dental insurance coverage. Children can get dental insurance through The ACA.
Dental coverage is covered by some insurance, like Basic Social Security Disability Insurance. However, the majority of people who sign up for Medicare and Medicaid do not have proper health insurance that covers routine dental care or other dental services.
Insurance Waiting Period
Some coverage comes with a waiting period, depending on the type of insurance and the insurance company. MDRC, a non-profit social policy research organization received funding from the Social Security Administration (SSA) in 2005. Accelerated Benefits (AB) Demonstration was the project that it carried out.
The purpose of the AB Demonstration was to determine the benefits and costs of altering the Medicare waiting period, particularly for disabled individuals. Its findings include:
- Increased healthcare use
- Improved health and functioning
- Unaffected employment levels
- Reduced unmet medical needs
Can You Get Free Dental Work With a Disability Living Allowance (DLA)?
Benefits like disability living allowance (DLA) are tax-free. It typically comes in monetary form and is intended for disabled people who require extra care, support in their daily lives, and mobility assistance.
Although a DLA does not guarantee access to free dental work, it can reduce prescription costs and doctor fees. You might be eligible for other free benefits like:
- Travel support
- Universal credit
- Higher child tax
Programs That Provide Low-Cost Dental Care for Adults With Disabilities
The government of the United States defines a person with disabilities as someone who:
- The person is unable to do substantial, gainful work
- Has a disability that is expected to last for up to a year or beyond
- Has an disability that is on Social Security’s list of disabling medical conditions
Some programs that may provide low-cost dental services for such people are:
Donated Dental Services (DDS)
The Dental Lifeline Network offers a program called Donated Dental Services (DDS). People who cannot afford education or dental care can access them through this non-profit organization. Over 15,000 volunteer dentists are part of this nationwide program’s network. People who are unable to pay for standard treatment fees can take advantage of its comprehensive free care.
Aspen Dental Healthy Mouth Movement
Aspen Dental’s Healthy Mouth Movement helps people who struggle with accessing dental care because of a disability, lack of funding, or both. They also focus on providing dental care for disabled veterans.
MouthMobile is Aspen Dental’s mobile dentist office on wheels. It travels throughout the U.S to provide veterans living in remote communities with free dental services.
The University of Washington (UW) School of Dentistry, for example, trains dentists and providers to provide specialized care to people with special needs. The DECOD clinic at the UW School of Dentistry provides care to patients with acquired or developmental disabilities like multiple sclerosis (MS) and cerebral palsy (CP), and it is partially supported by private donations.
NYU College of Dentistry
The New University College of Dentistry (NYU) is another school that offers this program. The purpose of this school’s oral health center was to provide people with disabilities with support and sensitive essential care. The dental clinic at the school is fully equipped to accommodate the needs of caregivers, patients, and families.
Their services mainly include:
- Basic dental care
- Implant dentistry
- Pediatric dentistry
- Oral and maxillofacial surgery
NYU College of Dentistry also have special accommodations for patients, including the following:
- Multi Sensory room: It reduces anxiety and helps patients relax
- Wheelchair tipper: It allows patients to receive treatment from their own wheelchair
- Bariatric chair: It accommodates patients up to 650 pounds
- Private treatment rooms: It provides ample space and privacy
- Sedation: Before using sedation on the patients, a nurse practitioner and anesthesiologist examine each patient to determine a safe and effective level for their own needs
Figure out how you or your loved one can become a patient by visiting their webpage. Although this center is in New York, the health department or dental association website of your state can help you find similar schools and programs in your state.
Illinois Foundation of Dentistry for the Handicapped
The Illinois Foundation of Dentistry for the Handicapped through the DDS programs offers free or exceptionally low-cost dental services to the elderly and individuals with disabilities. Elderly, chronically ill, or permanently disabled applicants are qualified.
Community Dental Programs
There are some community dental clinics that offer low-cost dental services. You can look up “community dental clinics” on the internet or ask your local hospital to recommend one.
Volunteers with particular dental, oral, and craniofacial conditions are sometimes sought out by the National Institutes of Dental and Craniofacial Research (NIDCR) for participation in research studies – It is also known as clinical trials. For the particular condition they are studying, researchers may provide limited free or low-cost dental care to study participants.
Go to “NIDCR Studies Seeking Patients” to see if there are any NIDCR clinical trials where you might be interested in fitting in. Visit ClinicalTrials.gov for a comprehensive list of all clinical trials funded by the federal government. Call the Patient Recruitment and Public Liaison Office of the Clinical Center at 1-800-411-1222 to see whether you are eligible for any of the clinical trials that are being conducted at Bethesda, Maryland, campus.
State and Local Resources
Programs in your area that provide dental care for free or at a reduced cost may be known to you by your state or local health department. Contact the health department in your state for more information about their financial assistance programs. Check your local telephone book for the number you are supposed to call.
You might be able to find information about free or low-cost dental services in your community by clicking on the United Way exit disclaimer icon. On the United Way website, you can locate local chapters.
Local Health Departments
The Bureau of Primary Health Care, a service of the Health Resources and Services Administrations (1-888-Ask-HRSA), supports federally-funded local community health centers across the country that offer free or decreased cost health services, including dental care.
Medicare, Medicaid, CHIP
Three significant federally funded programs are administered by the Centers for Medicare & Medicaid Services (CMS): Medicare, Medicaid and The Children’s Health Insurance Program (CHIP)
- Medicare is a program that provides health insurance to those over the age of 65 and those with specific disabilities. However, Medicare dental coverage is limited; Dentures and most routine dental care are not covered by it.
- Medicaid is a state-run program that covers eligible individuals and their families’ medical benefits and, in some cases, dental costs. States set their own guidelines in regards to who is qualified and what services are covered. The majority of states provide limited emergency dental care to people over the age of 21, though some provide comprehensive services. Medicaid covers dental services for the individuals under the age of 21.
- Children under the age of 19 who do not have health insurance are helped by CHIP. In most cases, children who meet the eligibility requirements can take advantage of CHIP’s dental services and medical coverage. The dental services that are covered under this program may vary for each state.
You can get detailed information about each of these programs from CMS by calling 1-800-MEDICARE, and they can also refer you to state programs if they are applicable.
Dental care considerations for adults with disabilities
Clearly, different disabilities may necessitate different levels of care requirements. For routine dental care, a person with a developmental disability may require anesthesia and a person with a physical disability may require wheelchair accessibility. Let’s take a look at just a few of the things patients and caregivers might want to consider when choosing a clinic that meets their needs.
Sometimes, people with Down syndrome have macroglossia (an enlarged tongue) that can make it harder for a hygienist to properly clean a patient’s mouth and lead to oral health conditions like gingivitis and halitosis (bad breath).
Numerous patients with Down disorder don’t find it challenging to visit the dental specialist, however there are a few things you should keep in mind while choosing a clinic, for example, special training for cleaning mouths with macroglossia and experience treating patients with Down condition overall. Check out this National Institute of Dental and Craniofacial Research resource for more information on oral care for people with Down syndrome.
A dentist with experience or at least an active willingness to work with people with special needs can be especially important for patients with autism. Caregivers and family ought to explain to the dentist in advance the most ideal way to communicate with the patient and prepare the dentist for certain reactions the patient might have. This pamphlet from autismspeaks.org contains additional information regarding going to the dentist for autism patients.
Individuals with limited mobility may find themselves facing a whole different set of problems with regards to going to the dentist. The reality is that the majority of dental offices lack the capacity to accommodate individuals with physical disabilities. That includes the dentists themselves as well as an absence of adequate technology and machinery.
For instance, cerebral palsy, causes involuntary movements, and numerous dentists might be hesitant to perform dental work. The fact that many patients with physical disabilities are on Medicaid is another obstacle. It can be difficult to locate offices that accept Medicaid.
Fortunately, there is a development among dental clinics accross the nation that are effectively addressing the way their centers aren’t accessible to people with limited mobility. Extra-large operatories, a ceiling track lift system for transferring patients, and an articulated dental chair for those who are unable to sit in a regular chair are all available at the CP Rochester dental clinic in New York.
The Safe Patient Handling statute is a law in Minnesota that is making this the norm. Clinics are required to have a plan for patients who require assistance entering and exiting dental offices as well as transferring into a dental chair. Additionally, these clinics’ staff members have been trained to work with patients who have difficulty controlling their movements.
In an interview with The Mobility Project, Dr. Steve Shuman from the University of Minnesota School of Dentistry’s Oral Health Services for Older Adults program offers the following advice in case you are unable to locate a dental office in your area that specializes in treating people with disabilities:
- You need to inform the dental office if you have mobility disabilities as soon as possible.
- Let the dental team know if someone will accompany you to the appointment and whether or not they can offer additional assistance.
- Tell the clinic ahead of time if you know what dental services you might be looking for.
Silver diamine fluoride may be an option for dental treatments for people with developmental disabilities at high risk for decay. This solution contains stronger fluoride than that used in standard fluoride treatments. According to the American Academy of Pediatrics, the patients with intellectual or developmental disabilities can use silver diamine fluoride as an useful preventative tool because they may have a difficult time caring for their teeth at home or spending a lot of time in the dentist’s chair. However, there are some drawbacks, such as irreversible staining.
Dental Care Challenges for People with Disabilities
There are a few reasons why people with intellectual and developmental disabilities are more likely to have dental issues and poor oral health than people without disabilities. This is due to a number of reasons:
When a dentist accepts Medicaid, they typically make less money on each visit. Many people with disabilities, who typically have Medicaid dental coverage, face this issue.
Dental clinics sometimes refuse to accept insurance, making it difficult for people with disabilities or special needs to access dental care that is both affordable and of high quality.
Lack of Training or Equipment
Because their staff lacks proper training or equipment, some dental clinics are unable to provide disabled patients with dental care.
A clinic might be unable to meet the special needs of people with disabilities because of this reason. The staff may even be led to compromise their care as a result.
Inability to Keep a Routine
Dental professionals always advise going to the dentist at least twice a year. However, accomplishing this can be challenging for people with disabilities, particularly those with severe physical disabilities.
Additionally, it might be difficult to find a dental clinic that specializes in providing care to people with special needs or disabilities.
Tips for Finding a Special-Care Dentist
The first step in finding a special-care dentist is to ask around. Asking your local dentist, family members, friends, or even disability services can help. They might be familiar with a clinic with a dental team that caters specifically to the needs of people with disabilities.
In addition to seeking recommendations and referrals, the following are additional tips for finding a special-care dentist:
- Research the credentials of the dentist to whom you were referred to
- Search for special-care dental clinics in your browser and find the dental clinics near you
- Check for a school of dentistry that offers special needs program; they are likely to have the dentists you are looking for
- Look beyond your locality; telemedicine makes it possible to treat people in need using telecommunications and minimises trips to the dentist’s office
- Check for the dentist’s experience; the more experience a dentist has with treating people with special requirements, the better your treatment results are likely to be
- Make sure to read reviews online, as this can provide insight into a dentist’s practice
Dental benefits for Veterans with disabilities
If you’re a Veteran, you may be eligible to get VA dental care. Dental coverage is distinct from other VA medical coverage. When deciding who is qualified for VA dental care and the kind of dental benefits each Veteran may receive, we take into account a variety of factors. Dental treatment and benefits can be decided on by either the Veterans Health Administration (VHA) or Veterans Benefits Administration (VBA).
If you think you might be eligible for VA dental care, check out the Dental Benefits for Veterans fact sheet. Download the PDF version of the Dental Benefits for Veterans fact sheet.
Other resources for people with disabilities and caregivers
Clinics prioritizing people with disabilities:
University of Washington School of Dentistry DECOD Clinic
1959 NE Pacific Street
Seattle, WA 9819
Website : https://dental.washington.edu/decod/
CP Rochester Dental Clinic
1000 Elmwood Avenue, Door 7
Rochester, NY 14620
- Dental Care Every Day – A Caregiver’s Guide
- Practical Oral Care for People With Cerebral Palsy
- Practical Oral Care for People With Down Syndrome
- Wheelchair Transfer – A Healthcare Provider’s Guide
It’s possible that people with disabilities share one thing in common: difficulty in accessing oral health care. Dental offices are frequently majority spaces that were designed by and for people without disabilities. Additionally, many dental offices do not accept Medicaid, that is the sole means of payment for many disabled patients.
Fortunately, there are some programs around the country that can financially assist disabled individuals in paying for dental work. Clinics are also becoming more aware of the importance of making spaces accessible to all people, including those with physical or developmental disabilities. In many states, Supplemental Security Income (SSI) recipients automatically qualify for Medicaid and they don’t need to fill out a Medicaid application to get dental coverage. In other states, your SSI guarantees you SSI Medicaid dental coverage eligibility, but for that you have to sign up for it first. Although, it is to note that in a few states, SSI doesn’t guarantee Medicaid eligibility. But most individuals who get SSI are still eligible. Hopefully this article has provided you with everything you needed to know about the dental insurance covering for the disabled people. If you are a senior over the age of 65, looking to get insurance for your dental care needs, check out dental insurance for senior citizens. Similarly, if you are a veteran, regardless of you having a disability, you can get your dental care needs fulfilled via dental insurance for veterans. Thank you so much for reading this post til the end. I hope your day is good!
Frequently Asked Questions
We will be discussing some of the most frequently asked questions regarding the topic of dental insurance for disabled individuals. Be sure to review them thoroughly to gain your additional knowledge.
Do dentists have to provide disabled access?
A: Under the Disability Discrimination Act (DDA) you have rights of access to dental specialist medical procedures or dentist surgeries. “Reasonable adjustments” should be made to their premises and procedures used by dentists.
How can I find a dentist that accepts Medicaid?
A: You can start your research for a dentist who accepts Medicaid for adults with disabilities by typing “dentists who accept Medicaid in…,” followed by the name of your state. If you were approved for Medicaid and were given informational materials, a list of nearby Medicaid dentists is probably also included.
Are there dentists for people with disabilities?
A: There are clinics that give disabled adults’ dental care priority. Start by contacting a local dentist to see if they can refer you to a professional who has the necessary experience and equipment. In point of fact, it is now mandated by law that dentists cannot simply refuse to treat disabled patients; At the very least, they must make a referral.
Does disability insurance cover dental?
A: Dental treatment is covered by Basic Social Security Disability insurance. Medicaid disability dental coverage, on the other hand, is available to disabled adults under the age of 65. On the official government website, you can learn more about how to apply for Social Security or Medicaid disability benefits.
By going to Dentalinsurance.com, you can also look at the various dental insurance plans that are available in your state. They provide helpful advice for selecting a plan that suits your needs as well as a wide range of plans. You can also get help from one of their helpful licensed agents by calling 888-626-0057.