Iowa DHS launches first dental-only plan for kids

Mar 7, 2010

The Iowa Department of Human Services (DHS) has launched the nation's first dental-only program for underinsured children in low- to modest-income families, according to an announcement March 5 by Gov. Chet Culver.

Within a year or so, as many as 22,000 children may enroll in the dental-only program, which officially began on March 1, according to Iowa DHS Director Charles Krogmeier. The 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, Iowa 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 Medicaid.

In February 2009, Congress authorized states to begin dental-only programs, and last spring the Iowa Legislature and Gov. Culver approved an Iowa program. The program is free to families with incomes below 150% of the poverty level 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.

Percent of poverty	Less than 150%	150% - 200%	201% - 250%	251% - 300%
Income for a 2-person family	Up to $21,885	$21,856 - $29,140	$29,141 - $36,425	$36,426 - $43,710
Cost	Free	$5 per month per child/$10 family maximum per month	$10 per month per child/$15 family maximum per month	$15 per month per child/$30 family maximum per month

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, however, because only a handful of the state's 120-plus orthodontists have signed up to provide service under the new program, according to the governor's office.

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 upfront, 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, according to the governor's office. The federal share is about 75%, with the state paying the balance.