Nursing Home Plans
Introducing the Dental Plan of
Choice for Long-Term Care Residents
The Problem:- The U.S. Surgeon General reports that over 1.7 million Americans in LTC facilities receive inadequate dental care, especially preventive and periodontal care.
- Lack of daily oral care in nursing home facilities is reaching epidemic levels and poses a greater health risk to nursing home residents.
- Unfortunately, discomfort, pain and poor hygiene are not the only dental symptoms affective resident in LTC facilities.
- According to the Nation Center for Health Statistics, five of six leading causes of death in the U.S. (2005) are linked to periodontal disease.
- The fact is, when residents do not have routine dental care or access to regular check-ups, it drastically increases the likelihood of these diseases, mouth pain, and other dental problems.
The Solution - OraQuest
Senior Dental Care Plan:OraQuest dentists will complete an oral examination on every
resident in the facility annually at no cost to the resident or the facility so
that all regulatory obligations are satisfied.
- Nursing homes residents can lower their risk to the grown volume of dental problems associated with poor oral care resulting from limited access to dental care.
- The most effective solution is to receive oral care by dental professionals on an ongoing basis by enrolling in a comprehensive dental insurance program.
- Offers convenience of on-site dental services on an on-going basis versus seeing a dentist only when symptoms arise.
- It is significantly more beneficial to your residents if they are seen by dental professionals, not only for treatment of symptoms but also for maintenance and prevention on an on-going basis.
- It is highly recommended that oral health be maintained and preventive measure be taken to maintain the overall health your residents.
OraQuest Senior
Dental Care Plan – Benefits:
- Our policyholders’ oral
health can be maintained through regular visits by our contracted general
dentists without any copayment.
- Diagnostic and preventive
services are covered:
- Comprehensive oral
examination
- X-rays
- Teeth cleanings
- Fluoride treatments
- Oral hygiene instructions
- Restorative, Endodontic, Periodontal, Extractions and Prosthodontic services are all covered without any copayment:
- Fillings
- Simple extractions
- Denture impressions
- Dentures
- Denture repairs and relines
- Dentist treatment recommendations
Note: Not all procedures are
available to every resident. All
treatment plans are determined by the sole discretion of our contracting
dentists
Benefits to the LTC
Facility: - According to the American Dental Association, approximately 1.3
million nursing home residents face the greatest barriers to accessing dental
care of any population group, and this number is expected to increase
- Certain Medicaid recipients with Applied Income (AI) can qualify
to use their AI to pay for dental care as an incurred Medical Expense (IME),
which provides a way for LTC residents to pay for dental care without
decreasing their personal allowance or taking money from the nursing homes.
OraQuest Dental
Plans – Service Area:
The Process:
- OraQuest will determine whether one qualifies for this program.
- Once the resident enrolls in the program, OraQuest will file a form with the state Medicaid agency to reduce the resident’s payment toward expenses at the nursing home facility.
- Once approved by Medicaid, the resident pays the monthly premiums to OraQuest for the dental care received under the program (please note: This does not increase the resident’s total out-of-pocket expenditures).
- Since the resident reduced their payment to the nursing home, Medicaid will increase the amount it pays to the facility to ensure that the facility continues to be paid in full.
- As a result of necessary dental care expenses qualifying as an IME, dental care benefits not covered under Medicaid can be paid through this process.
- There is no extra cost born by the resident to be on the OraQuest Senior Dental Plan.
In Summary:
- Good oral care starts with prevention and maintenance.
- OraQuest Dental Plans, Inc. is one of the pioneers in underwriting a dental policy that is uniquely customized to meet the needs of oral care for nursing home residents.
- OraQuest’s Senior Dental Care Plan provides comprehensive dental benefits to improve oral health by bringing dental professionals to nursing home facilities.
- Not only does this plan have essential benefits, but these benefits are conveniently brought to nursing home residents on site.