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Parents On Covered California Insurance Exchange Unable To Get Dentists For Kids

SAN FRANCISCO (CBS SF) -- Pediatric dental care is supposed to be included in all policies sold on California's Health Insurance exchange, but some parents say just because it's included doesn't mean it's actually possible to get an appointment with a dentist who'll treat kids.

Just ask Diane Gasson of Novato.

The mother of two  started looking in January for a dentist to see her daughters,  who are six and seven.  "We have a lot of challenges with teeth coming in in the wrong places," said Gasson whose family purchased a Western Health Advantage Bronze plan during open enrollment.

But when Gasson checked with Western Health Advantage's Dental provider,  Premier Access Dental,  she got  a surprise:  "There wasn't a single pediatric dentist on the website." And she says those that were on Premier Access Dental's site,  told her they would not take children.

"That is concerning,"  said Dana Howard of Covered California.  He says providers are required to provide dental services, but they are not required to offer the services of a pediatric dentist. Still,  he says "you have a right to expect your plan will be able to provide a dentist who will be able to see your child."

After numerous call and emails from Gasson, Western Health Advantage finally did find a family dentist for Gasson's children.  But Gasson says it's 30 minutes away from her home by car, and so far, she hasn't been able to get through to make an appointment.  "Every time I called they've been closed."

Covered California's Dana Howard says parents who have trouble making dentist appointments for their children should file a complaint with the State's Department of Managed Healthcare.    http://www.dmhc.ca.gov/fileacomplaint.aspx#.VQi4wLHaJ-0

The agency tells Consumerwatch it has received about a dozen complaints from Covered California enrollees who have experienced difficulty accessing dental care.

Western Health Advantage tells Consumerwatch is working to add more dentists to its provider list.

 

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