Developmental Services - Case Management Manual
Medicaid will not reimburse dental services for adults for a majority of procedures. A person's access to community dental services may be constrained by financial resources. Case Managers are encouraged to pursue dental services within their social community prior to approaching the Department funded Dental Clinic.
Dental services are provided at the Dental Clinic and at various outreach sites, as arranged by the district offices. All people with developmental disabilities in Maine are eligible for services from the Dental Clinic. The Clinic does place a priority on serving people who require special expertise and/or anesthesiology services, and people who either do not have access to or do not have financial resources for community dental services.
In order to receive dental services through the Dental Clinic the person must:
- Complete an application for dental services,
- Have had a physical exam within the last year, and,
- Make an appointment with the Clinic.
The role of the CM in arranging dental services at the Dental Clinic varies according to the consumer's individual circumstances. If the consumer has access to family members or service providers who can arrange for dental needs to be met at the Dental Clinic, the CM can simply describe the available services and monitor their delivery. In other instances, the CM will be the person actually responsible for setting up appointments at the Dental Clinic and for arranging transportation
For consumers who are 62 or over, Case Managers should investigate the "Senior Dent" program.
Senior Dent is a program sponsored by the Maine Dental Association in cooperation with Area Agencies on Aging. It provides comprehensive dental care to low income elderly at reduced rates. Maine residents who are 62 or over, have not dental benefits under Medicaid or private insurance plan, and have an income which qualifies them for the Low Cost Drug Program are eligible to enroll in Senior Dent. Eligible persons will receive a minimum 15 percent discount on all dental services from participating dentists.