Iowa Launches First Dental-Only Plan for Kids

DES MOINES – Governor Chet Culver announced today that the Iowa Department of Human Services has launched the nation’s first dental-only program for underinsured children in low- to modest-income families.

“Ensuring our children have access to quality, affordable health care is a top priority of my administration,” said Governor Culver. “I am proud to announce this dental-only option as a major step toward getting kids the coverage they not only need, but deserve. We are once again showing why Iowa is a leader in helping hard-working families by providing children’s health care.”

DHS Director Charles Krogmeier said that within a year or so, as many as 22,000 children may enroll in the dental-only program, which officially began on March 1.

The dental-only program is open to children in families whose income would qualify for the Healthy and Well Kids in Iowa (hawk-i) program and who have health insurance that does not include dental care.

Until now, families with any health insurance, whether it included dental or not, were excluded from the hawk-i program, which is managed by DHS. Dental care is already covered for children in the regular hawk-i program or in Medicaid.

The National Academy for State Health Policy has declared tooth decay to be the most common chronic childhood disease in America.

“It’s almost entirely preventable if caught early, and Iowa is now offering a chance for more parents to do just that,” Director Krogmeier said.

In February 2009, Congress authorized states to begin dental-only programs, and last spring the Iowa Legislature and Governor Culver approved an Iowa program.

The program is free to families with incomes below 150 percent of poverty and will cost no more than $30 a month, depending on family size and income. The maximum family income threshold is three times the poverty level, or $43,710 for a family of two.

Parents can call 1-800-257-8563 with questions or visit www.hawk-i.org for more information on how to apply.

In addition to routine dental care, the program also covers medically-necessary orthodontia. Children needing that service, especially those in central Iowa, may have to travel long distances because only a handful of the state’s 120-plus orthodontists have signed up to provide service under the new program.

The hawk-i program will pay up to $4,300 for medically-necessary orthodontia. That’s comparable to the amount that is charged in most areas of the state but it compares to fees of up to $5,500 that are common in more populous areas. While the government program will pay less than some orthodontists normally charge, Krogmeier said an advantage for participants is that hawk-i will pay up front, meaning the providers do not have to deal with monthly billings.

The new program will not pay for cosmetic orthodontia.

The dental-only program will cost an estimated $369,000 through June and an additional $4.9 million next fiscal year. The federal share is about 75 percent, with the state paying the balance.

The chart below shows dental-only premiums for various levels of income.