Sliding scale keeps care affordable

By Julie Estlick

When Dr. Selissa Mantas thinks about what she sees day-to-day at the Family Dental Clinic, she can’t help but smile. The staff excel at putting people at ease, offering a welcoming environment and a listening ear to patients who often have not visited a dentist in years.

A program of the Health District of Northern Larimer County, the clinic provides everything from routine cleanings to dentures for patients who otherwise couldn’t afford dental care.

“We are happy to help community members overcome financial barriers and access the care they need and deserve,” says Mantas, one of four dentists at the clinic. Whether it’s an emergency with pain, swelling, or a broken tooth, or a simple checkup, we want people to come to us and we’ll work with them.”

Specifically, the Family Dental clinic serves people living in the district who either have insurance through Health First Colorado (Colorado’s Medicaid program) and Child Health Plan Plus (CHP+) or have no dental coverage but qualify based on household earnings. It charges based on sliding scale fees, and additional funding may be available to cover out-of-pocket costs for patients.

Health First Colorado provides medical, dental, and behavioral health benefits to Coloradans who live on a lower income or with a disability, while CHP+ is low-cost insurance for pregnant women and children. Recent changes to Health First Colorado — including removing the annual benefit maximum for adult dental procedures, and a renewal process that has seen thousands of Larimer County residents lose their Medicaid coverage — make the services at the Family Dental Clinic a vital community resource.

Medicaid removes benefit limit

Mantas and her co-workers cheered when Health First Colorado recently ended its yearly cap on adult dental benefits. Now patients can complete care without fear of their benefit running out and having to wait for their benefit to renew or pay out of pocket. (Some procedures still require pre-authorization from Health First Colorado.)

“In the past, we would get through maybe one-half or three-fourths of a person’s treatment plan, then have to pause,” Mantas explains. “Obviously, the cavities in their mouth are not going to pause. You see someone who needs a simple filling, but their benefits are spent — then 8 months later they are back and now they require a crown, root canal, or an extraction.”

With the policy change, clinic staff hopes that patients are able to complete needed treatment without delay, minimize out-of-pocket costs, and stay healthier. In addition, patients can be more involved in their treatment planning and see the end result they imagined. For instance, a man who needs a partial set of dentures must first have all of his decayed teeth pulled and a stable foundation of gum and tooth health to put the denture in place. With the annual benefit maximum removed, he doesn’t have to worry about being left with several missing teeth for months before his dentures are covered by Health First Colorado.

Indeed, taking care of your mouth is critical to your overall health, and should not be neglected, Mantas insists. “Your mouth is not isolated from the rest of your body. Bacteria related to gum disease enter your bloodstream and can harm your health.”

According to the Mayo Clinic, oral bacteria and inflammation can contribute to several serious medical conditions including heart disease, stroke, pneumonia, premature birth, and low birth weight babies.

A healthy smile is also important to one’s self-esteem and quality of life. “A lot of patients say they need to find a job, but they avoid interviews because they are embarrassed about how their mouth looks,” Mantas says. “We give them their smile back so they have the confidence to get back into the workforce.”

To that end, the Family Dental Clinic is adding a fifth dentist this fall to better serve area residents who can’t afford the full cost of care. Over 8,500 individuals in Larimer County had their Health First Colorado or CHP+ benefits discontinued or denied between May and August when the state began verifying client eligibility for the programs following a temporary halt to such checks during the COVID-19 pandemic.

Some of those people may find dental insurance through an employer or on the Connect for Health Colorado marketplace during a 60-day Special Enrollment Period. If you need insurance help, contact Larimer Health Connect’s Health Coverage Specialists for free assistance at 970-472-0444 or see the special insert in this issue

And if you or someone you know currently lacks dental coverage or has Medicaid and is looking for dental care, call the Family Dental Clinic at 970-416-5331 to see if you qualify for services.

You’ll be glad you did, says Leticia Alcocer, bilingual dental services guide who has worked at the clinic for 11 years: “Patients tell me they feel welcome when they come to our clinic, even though they have limited resources. They are treated with respect from the moment they are greeted by the front desk staff. And the doctor explains everything to them. They like our environment.”