Dental health services and insurance in the state of Michigan has a lot of scope for improvement with just around 30 % of Medicaid children having visited the dentist and about 28 % who had preventive dental care in 2003. Moreover, children below the age of 5 irrespective of insurance cover are least likely to have visited the dentist for preventive dental care. It is generally presumed that lack of insurance affordability along with an inadequate presence of dental care providers is responsible for the present state of affairs.
However the state of Michigan offers various dental insurance plans to eligible employees who can select from the following:
State Dental Plan
The State Dental Plan of Michigan wherein the state covers about 95 % of the total premium while the customer pays the remaining 5 % of the premium through payroll deductions.
This plan covers:
- Preventive services (examinations and cleanings) at 100 % of the "usual, customary and reasonable charge”
- Radiographs (X-rays)
- Oral surgery
- Extractions
- Restoratives
- Periodontics,
- Endodontics at 90 %
- Orthodontics at 60 %
- Sealants for children
- Prosthodontics (including repairs) at 50 %
The customer has to pay for any other charges for these services.
Preventive Dental Plan
Under the Preventive Dental Plan the state promises to cover the full premium cost of the plan and for customers who enroll there will be a $ 100 cash payment.
This plan covers:
- Diagnostic cover
- X-rays
- Cleanings
The above coverage has the same extent as the State Dental Plan it covers on other services. This plan is intended as an add-on for those who already have dental coverage elsewhere and the customer can utilize the services of a licensed dental care provider of his choice.
Dental Maintenance Organization (DMO)
The state of Michigan promises to cover the full premium cost of this plan which requires no payroll deductions. This is a managed care dental plan providing all necessary dental care and services at the Midwestern Dental Plans' dental care centers. No member co-payments are required for any dental care received under this plan. However for adults there is a co-payment of $ 1,250 for orthodontics and there are no benefit maximums.
A customer can choose his own DMO service center in his residential area which will provide him personal dental care or refer him for oral surgery, prosthodontics, periodontics, orthodontics or other services to specialists. The DMO will cover half of the reasonable charges for immediate relief of pain and suffering, for out-of-area emergencies.
