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Kids and Health Care: Chips and Teeth

In early 2004, Florida Governor Jeb Bush made a budget-based proposal to change the amount of dental care provided by the state's CHIP. Under Bush's proposal, children on the plan would only receive preventative care -- things like cleanings and x-rays. Fillings, root canals and pulling of teeth would not be covered.

According to Florida budget officials, the changes would save between $7 and $9 million in state funds, by cutting the monthly premium dental insurance companies would receive $9 per child, down from $17. (Even Bush's political opponents admitted the cuts were necessary -- they just disagreed on the amount. The House Subcommittee on Health Appropriations proposed cutting the premium to $12 per child.)

The 2004 cuts would be the second in two years. In 2003, Florida lawmakers put a $750-a-year cap on dental benefits offered by Healthy Kids (the public name of the best-known part of the state's CHIP).

Dentists in Florida warned that, if the state cut the benefits covered under its CHIP, most dentists would simply opt out of the program and not accept its payments -- or its kids -- at all.

At press time for this book, Bush was working out a deal to reduce the size of the cuts.

If you're getting health coverage for your children through a state-run Children's Health Insurance Program, your access to dental care is going to be more difficult.

To start, many state CHIPs don't cover dental care at all. In the push-and-pull budget battles of the 1990s, a number of states decided that cutting dental coverage was a politically painless way to reduce spending related to the programs.

Social workers and program administrators will usually direct families using CHIPs to dental clinics in their areas. Like dentists generally, these clinics are accustomed to offering payment terms -- especially to families with children. They often will have some sort of brief financial disclosure form that's attached to the patient information forms that you need to fill out when you arrive. (A few better-funded clinics don't do this...but they are the exception.) Once the clinic has done a quick review of your information, it may ask you to pay a partial fee; in a few cases, it may ask you to pay more over time.

How much a dental clinic asks you to pay will be based on the type of work your kids need and your ability to pay.

But -- since you're often going to be offering financial information about yourself, anyway -- it might be worth making a few phone calls to regular dentists in your area before you go to a clinic.

There are a number of telephone- and Internet-based dentist referral services in the U.S. that can put you in touch with local dentists who specialize in working with kids. The best known of these referral services is 1-800-DENTIST. And there are others.

One approach is to get a list of dentists from one of these referral services (the lists are usually free -- the dentists pay to be included on them) and call each office to find out what sort of credit, child-discounts or alternative payment arrangements it offers. Even if they don't offer special terms, some dentists volunteer time at dental, their offices may know the best clinics in your area.

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