Full dental and vision coverage could return for Medi-Cal patients

Adult Medi-Cal patients could soon qualify again for services like gum treatments.
Adult Medi-Cal patients could soon qualify again for services like gum treatments.
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Medi-Cal patients may soon be able to go to the dentist confident that every treatment they need will be covered, and the same could be true by 2020 for those seeking vision treatment under the program. State lawmakers have cut a deal with Governor Brown to restore previously cut dental and vision benefits, according to consumer advocates and a legislative staffer.

Legislators are set to vote next week on a bill that would implement the changes, according to Luan Kim Huynh, who consults Sen. Holly Mitchell (D-Los Angeles) on budget matters. Mitchell chairs the budget committee.

California cut all dental coverage and most vision benefits for adults on Medi-Cal in 2009, during the Great Recession.

The state restored some, but not all, dental coverage three years ago. Gum treatments, partial dentures and certain root canals still aren’t covered.

Under the new bill, full dental benefits would be restored right away.

Currently, Medi-Cal only covers an eye exam every other year, but it won't pay for glasses or frames. The legislation would restore full vision benefits in 2020.

Huynh says the bill would allocate $73 million a year for Denti-Cal. It provides for $26 million a year for vision benefits, once they would return in 2020.

Corona optometrist Dr. Bill Rogoway welcomes the possible policy change. He says his patients frequently tell him that they can't see very well because they're using cheap glasses they found at a thrift store.

"And I look at them and they’re nothing what they need," he says. "That can cause more problems than it can solve." 

Rogoway tells the story of a 48-year-old man who came in recently asking for his help getting his expired driver’s license reinstated.

"But on the bottom of the form it says, 'Have glasses been provided for this individual?' and I had to put no. I did not provide them," he says.

Incomplete dental care can have negative consequences for an individual's overall health, experts say. 

For example, people with diabetes are at greater risk for gum disease. Failure to treat that can complicate a diabetic's efforts to stay healthy, says John Baackes, CEO of LA Care Health Plan, a major Medi-Cal provider.

"Good teeth are also necessary for good nutrition," he says. "So it’s a problem when that benefit is not covered."