
Pregnant women and their families often face unique dental challenges, from morning sickness to tooth sensitivity.
Many dental insurance plans offer special coverage for pregnant women, including free cleanings and exams.
According to the article, 75% of pregnant women experience morning sickness, which can lead to tooth erosion.
Regular dental check-ups are crucial during pregnancy to prevent dental problems and ensure a healthy pregnancy.
Pregnant women can also receive priority scheduling for dental appointments, helping them avoid long wait times.
Some dental insurance plans cover oral health education and counseling for pregnant women, teaching them how to maintain good oral hygiene.
By investing in dental insurance, pregnant women and their families can enjoy peace of mind and a healthy smile.
Pregnancy and Dental Insurance
Pregnancy and dental insurance can be a complex topic, but it's essential to understand the benefits and coverage that are available.
The Delta Dental PPO and Premier plans, as well as individual Basic and Premium PPO plans, include an enhanced pregnancy benefit that can help protect women's oral and overall health during pregnancy.
Pregnant women should visit the dentist for annual exams and cleanings to prevent oral infections such as gum disease, which has been linked to preterm birth.
As a Medi-Cal member, you are covered during your pregnancy and 12 months after the birth of your baby, with a yearly limit of $1,800 for covered dental services.
The Medi-Cal Dental Program provides a range of free or low-cost services during pregnancy, including dental exams, X-rays, teeth cleaning, and fillings.
You can receive all covered dental procedures as long as you meet the criteria and requirements for the procedures, and you may qualify for more than the $1,800 yearly limit if you have a medical need.
Here is a list of services provided by the Medi-Cal Dental Program during pregnancy:
- Dental exams *
- X-rays
- Teeth cleaning *
- Scaling and root planing
- Fluoride varnish *
- Fillings
- Crowns
- Root canals
- Partial and full dentures
- Denture relines
- Tooth removal
- Emergency services
* Every 12 months if over 21 years of age or every 6 months if under 21 years of age.
Pregnant women should also undergo other needed procedures, such as emergency root canals and extractions, to reduce any chance of infection.
It's essential to schedule less urgent procedures like teeth whitening and other cosmetic treatments until after giving birth, as they may pose a risk to the child.
Why Extra Oral Care is Needed
Pregnant women are more prone to oral health problems, including gingivitis and gum disease, which affect nearly 60 to 75% of pregnant women.
Hormonal changes during pregnancy can cause gingivitis-causing bacteria to grow, leading to red and bleeding gums and an increased chance of developing gum disease.
Tooth decay and cavities are also a risk, due to increased acidity in the oral cavity and alterations in diet.
Pyogenic granulomas, also called pregnancy granulomas or “pregnancy tumors,” affect the mouths of 2% to 10% of expectant mothers.
Poor oral health during pregnancy is associated with a greater risk for preterm birth and low birth weight.
Pregnant women should visit the dentist for annual exams and cleanings to prevent oral infections like gum disease.
They can also undergo other needed procedures, such as emergency root canals and extractions, as well as fillings and crowns, to reduce the chance of infection.
However, some procedures like teeth whitening and other cosmetic treatments may pose a risk to the child and can be postponed until after giving birth.
Here are some oral health care services that are safe throughout pregnancy:
- Dental exams
- X-rays
- Teeth cleaning
- Scaling and root planing
- Fluoride varnish
- Fillings
- Crowns
- Root canals
- Partial and full dentures
- Denture relines
- Tooth removal
- Emergency services
As a Medi-Cal member, you are covered for all these services, with a yearly limit of $1,800, which may be exceeded if you have a medical need.
Delta Dental's Enhanced Benefit
Delta Dental's Enhanced Benefit is a great perk for pregnant women. It covers additional services to help keep them and their babies healthy.
To take advantage of this benefit, pregnant women simply need to inform their dentist that they're pregnant. The dentist will then submit a claim along with written confirmation of pregnancy for the additional benefits to be applied.
The enhanced pregnancy benefit is included with specific Delta Dental plans, such as group Delta Dental PPO and Delta Dental Premier plans, as well as individual Basic and Premium PPO plans. Review your contract or talk to your account manager for details.
This benefit is a valuable resource for employers who want to support their employees' health and well-being during pregnancy. By reminding them of the importance of oral health during pregnancy, employers can help their team members take care of themselves and their babies.
Plan Details and Eligibility
Delta Dental PPO and Premier plans, as well as individual Basic and Premium PPO plans, include the enhanced pregnancy benefit. Review your contract or talk to your account manager for details.
The enhanced pregnancy benefit is included in these plans.
Medicaid and CHIP coverage is now effective across all 50 states and D.C. as of October 1st.
The Centers for Medicare & Medicaid Services announced this change on September 22nd.
You can now get dental coverage in all 50 states and D.C.
Pregnant and postpartum people enrolled in Medicaid and CHIP will have access to oral health coverage, thanks to the Centers for Medicare & Medicaid Services' proactive approach.
The American Dental Association has praised CMS for prioritizing oral health in pregnant and postpartum patients.
Medicaid covers nearly half of all births nationwide, making it a primary payer of maternity care.
Dental Care and Benefits
Pregnant women should visit the dentist for annual exams and cleanings to prevent oral infections such as gum disease, which has been linked to preterm birth.
The rise in hormone levels during pregnancy causes the gums to swell, bleed, and trap food causing increased irritation to your gums.
Pregnant women can safely undergo dental procedures in their second trimester, but it can be difficult for them to lie on their back for an extended procedure during their third trimester.
They should schedule less urgent procedures like teeth whitening and other cosmetic treatments until after giving birth as they may pose a risk to the child.
How Members Use the Benefit
Using your dental benefits is a straightforward process.
Pregnant women can simply inform their dentist that they're pregnant to be covered for additional services.
To receive these benefits, the dentist submits a claim along with written confirmation of pregnancy.
This process makes it easy for expectant mothers to get the care they need during pregnancy.
Diagnostic
Pregnant women can receive diagnostic imaging services, but they're limited to once in a five-year period.
Delta Dental offers an enhanced pregnancy benefit to help protect women's oral and overall health during this crucial time. This benefit includes clinical oral evaluations, diagnostic imaging, and some tests and examinations.
Some diagnostic imaging services include intraoral-periapical radiographic images, extra-oral 2D projection radiographic images, and panoramic radiographic images. These services have specific limits and requirements, such as the number of images per date of service and the need for authorization in certain cases.
For example, intraoral-periapical radiographic images are limited to four per date of service, and pregnant women can only receive this service once in a five-year period. Extra-oral 2D projection radiographic images are also limited to four per date of service, but there's no specific limit for pregnant women.
Panoramic radiographic images can be taken once every five years, except in certain medical situations that require more frequent imaging. These situations include medically necessary diagnoses and follow-ups of oral and maxillofacial pathology and trauma, or for patients who cannot cooperate for intra-oral film due to disability or medical condition.
Here's a breakdown of some diagnostic imaging services and their limits:
Clinical oral evaluations are also an important part of diagnostic services. These evaluations include periodic exams, limited exams, and comprehensive exams. Each of these exams has specific requirements and limits, such as the need for notation of the specific oral health problem or complaint, and the restriction on performing multiple exams on the same date.
Dental Care
As an expecting mother, it's essential to prioritize your oral health. Pregnant women should visit the dentist for annual exams and cleanings to prevent oral infections like gum disease, which has been linked to preterm birth.
Gum disease can be caused by the rise in hormone levels during pregnancy, leading to swollen and bleeding gums that trap food and cause irritation. This is why regular dental cleanings are crucial.
Pregnant women can safely undergo dental procedures in their second trimester, but it's best to postpone less urgent procedures like teeth whitening and cosmetic treatments until after giving birth.
Some dental procedures are covered under certain insurance plans, including periodontal scaling and root planing (D4341 and D4342), which can be performed once per five years. Full mouth debridement (D4355) is also covered, but can only be done once per five years and not on the same day as other procedures.
Here's a list of covered periodontal services:
By taking care of your oral health during pregnancy, you can prevent complications and ensure a healthy smile for you and your baby.
Medicaid and Pregnancy
As a pregnant woman, you have access to safe and affordable dental care through Medi-Cal. You're covered during pregnancy and 12 months after the birth of your baby, and can receive all covered dental procedures as long as you meet the criteria and requirements.
Medi-Cal will pay up to $1,800 in a year for covered dental services, and you may qualify for more if you have a medical need. You can visit "About the Medi-Cal Dental Program" to find out more.
You're eligible for a wide range of free or low-cost services during pregnancy, including dental exams, X-rays, teeth cleaning, and fillings. Here are some of the services you can expect:
- Dental exams
- X-rays
- Teeth cleaning
- Scaling and root planing
- Fluoride varnish
- Fillings
- Crowns
- Root canals
- Partial and full dentures
- Denture relines
- Tooth removal
- Emergency services
Additionally, Medicaid provides coverage for dental care for low-income pregnant women, including exams, cleanings, restorations, and treatment for infection for those under 21.
Frequently Asked Questions
Do pregnant women get free dental?
Pregnant women can get free NHS dental treatment for 12 months after giving birth, provided they have a valid maternity exemption certificate. This certificate is usually issued by a midwife or GP.
What is the best insurance for pregnant women?
For pregnant women, top insurance options include Blue Cross Blue Shield, Aetna, and Kaiser Permanente, or consider Medicaid and CHIP for affordable coverage. Employer-sponsored plans may also offer lower premiums.
What dental treatment can I get while pregnant?
Most dental treatments, including cleanings and fillings, are safe for pregnant women, but inform your dentist of your pregnancy to ensure a healthy and safe experience. Consult your dentist to determine the best course of treatment for your specific needs.
Are you supposed to get dental work done while pregnant?
Routine dental care is safe during pregnancy for most women, and good oral hygiene is essential for a healthy pregnancy. Schedule a dental visit to ensure your teeth and gums stay healthy throughout your pregnancy.
Sources
- https://adanews.ada.org/ada-news/2022/september/pregnant-postpartum-medicaid-enrollees-to-have-dental-coverage-at-least-60-days-after-pregnancy/
- https://www1.deltadentalins.com/administrators/word-of-mouth/2023/pregnancy-benefit.html
- https://smilecalifornia.org/covered-services/pregnancy/
- https://www.dhs.state.mn.us/main/idcplg
- https://dentalbilling.com/medicaid-dental-coverage-for-pregnant-women/
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