Haris Ashley
Nebraska residents enrolled in Medicaid have reported difficulties finding dental clinics that accept their insurance. The issue appears to be prevalent in Omaha and Lincoln, with residents in other parts of the state also voicing similar concerns. The Nebraska Department of Health and Human Services has signed contracts with Molina Healthcare, Nebraska Total Care, and United Healthcare to provide dental services under the Heritage Health program starting January 1, 2024. However, it is unclear how accessible these services will be to Medicaid enrollees, as dental providers accepting new patients on Medicaid seem scarce. Some residents suggest trying dental clinics outside of Omaha and Lincoln, such as Midtown Health Clinic in Norfolk or Gile Family Dentistry in Kearney. Others recommend exploring cash payment options directly with dental offices, as this bypasses the challenges associated with insurance coverage.
| Characteristics | Values |
|---|---|
| Difficulty | It is difficult to find a dentist that accepts Medicaid in Omaha or Lincoln, Nebraska |
| Reasons | Low reimbursement rates, high no-show rates for Medicaid patients, and capacity issues |
| Suggested Options | Ask about cash options, try Midtown Health Clinic in Norfolk, or Gile Family Dentistry in Kearney |
| Dental Provider Platforms | SKYGEN Dental Hub, Envolve Dental Nebraska |
| Dental Insurance Providers | Nebraska Total Care, Molina Healthcare, United Healthcare |
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What You'll Learn
Dental clinics that accept Nebraska Medicaid insurance
Finding a dentist that accepts Medicaid in Nebraska can be challenging. Many people in the state struggle to access dental care, particularly in Omaha and Lincoln. One reason for this is the low reimbursement rates offered by Medicaid, which can make it unviable for dentists to offer appointments to those using this insurance.
However, there are some options for those seeking dental clinics that accept Nebraska Medicaid insurance. Firstly, Nebraska Total Care is an option for those with a Nebraska Medicaid ID card. They offer a 24/7 Nurse Advice Line and can help coordinate all your oral health needs. You can call them at 1-844-385-2192 (TTY 711) to choose or find a dentist in their network.
Molina Healthcare is another provider that accepts Nebraska Medicaid. They have a SKYGEN Dental Hub, which is their exclusive dental provider platform, and they are actively recruiting dental providers to enhance their network. You can access the SKYGEN Dental Hub online or request a printed copy of the Dental Provider manual by calling (855) 806-5192.
Additionally, some individual dental practices in Nebraska that accept Medicaid include Gile Family Dentistry in Kearney and Midtown Health Clinic in Norfolk. For those near Grand Island, UNL's Dental College in Lincoln may also be an option.
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Dental emergencies and Nebraska Medicaid
Nebraska Total Care offers dental coverage through Heritage Health, which includes Nebraska Medicaid dental benefits. When you become a Nebraska Total Care member, you must choose a primary dentist who will coordinate all of your oral health needs. If you do not choose one, Nebraska Total Care will assign a primary dentist to you.
Your primary dentist must be in the Nebraska Total Care network for your care to be covered. If you have a dental emergency, call your primary dentist for direction. You can also call the 24/7 Nurse Advice Line at 1-844-385-2192 (TTY 711). If you cannot reach your primary dentist, go to the nearest emergency room at any hospital. Show the provider your Nebraska Total Care member ID card and your Nebraska Medicaid ID card.
If you go to a hospital emergency room outside of the Nebraska Total Care network, the provider will need to contact Nebraska Total Care right away to ensure they can be paid. If they do not complete the required tasks within 30 days, you may be responsible for paying for the service. After going to the emergency room, call your primary dentist and Nebraska Total Care within 48 hours to ensure you receive the necessary follow-up care.
Nebraska Total Care offers assistance with transportation to appointments if needed. You can call Member Services at 1-844-385-2192 (TTY 711) to request help. Preventive dental care is provided from age one or when a child gets their first tooth.
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Choosing a primary dentist
Next, you should consider the dentist's location and hours. Choose a dentist who is easy to get to from your home or job, and whose hours work with your schedule. You can search for dentists by name, location, and specialty using the ADA's Find-A-Dentist tool or by checking your local dental society.
It is also important to build a trusting relationship with your dentist so that you feel safe and comfortable. You can ask friends, family, or coworkers for recommendations, or ask your current dentist if you are moving. When you have a few options, call or visit more than one to see if the office is welcoming and comfortable and to ask any questions you may have. Some questions you may want to ask include how the dentist handles after-hour emergencies, whether they are a member of the ADA, and whether they have any history of malpractice claims. You may also want to research the dentist's medical background, including their education and experience.
Finally, once you have chosen a primary dentist, be sure to get a Nebraska Total Care member ID card, which will have your primary dentist listed, and always carry it with you in case of a dental emergency.
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Nebraska Total Care member benefits
Nebraska Total Care is a Managed Care Organization and subsidiary of Centene Corporation that provides health insurance in Nebraska. It is established to deliver quality healthcare through local, regional, and community-based resources. Nebraska Total Care offers a range of benefits to its members, including:
Dental Care
Nebraska Total Care covers dental care services, recognizing their importance to overall health and well-being. Members must choose a Primary Dentist, who will coordinate their oral health needs. If a member does not select a dentist, Nebraska Total Care will assign one to them. Preventive care begins at age one or when a child gets their first tooth. In case of a dental emergency, members can call their primary dentist or the 24/7 Nurse Advice Line.
Medical Care
Nebraska Total Care covers all medically necessary services and medications for family planning without copays. They also cover brand-preferred medications on their Preferred Drug List (PDL) with no copay. Some members may have copays for certain drugs, and Medicaid members may have a $3 copay for brand-name prescriptions. Nebraska Total Care can assist members in finding a provider, local resources, and planning appointments.
Behavioral Health Services
Nebraska Total Care provides coverage for behavioral health services, including outpatient mental health and substance use services such as counseling and therapy. They also cover rehabilitation services like Assertive Community Treatment (ACT), Community Treatment Aid (CTA), and Psychosocial Rehabilitation (PSR), as well as behavior modification programs such as Applied Behavioral Analysis. Nebraska Total Care has partnered with Brightside Health to offer online mental health care.
Care Management and Social Services
Nebraska Total Care offers one-on-one assistance to members with special healthcare needs. They provide Community Health Services to help members access social services that facilitate successful medical treatment. Members can choose their healthcare providers from Nebraska Total Care's network. Preventive care visits, such as regular check-ups, are also covered.
Additional Support
Nebraska Total Care offers a telephone language line with interpreters available upon request. They can provide written materials in languages other than English and accommodate other formats such as Braille, CD, or large print. Their Community Health program assists members in choosing a doctor, understanding plan benefits, and living a healthy lifestyle. They also connect members to community programs for additional support with food, housing, and clothing. Nebraska Total Care has a Start Smart for Your Baby program that provides information and support for breastfeeding and new parents.
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Molina Healthcare of Nebraska Dental Network
Molina Healthcare of Nebraska has partnered with SKYGEN Dental Hub to provide dental services to its members. This platform offers several benefits, such as immediate access to member and benefit information, claim and authorization history, and payment records at any time. Additionally, dental providers can easily submit claims and authorizations using pre-populated forms, securely send supporting documents, and check the status of in-process claims.
Molina Healthcare is committed to expanding its network of dental providers to ensure members have access to quality dental care services. They have a straightforward contracting and credentialing process for prospective dental providers. To become a part of the Molina Healthcare of Nebraska Dental Network, providers must be enrolled as Nebraska Medicaid providers with an active Medicaid ID and sign the Dental Provider Service Agreement.
The Nebraska Department of Health and Human Services has contracted with Molina Healthcare, along with Nebraska Total Care and United Healthcare, to provide dental services under the Heritage Health program beginning January 1, 2024. This program aims to streamline the credentialing process for providers and reduce administrative burdens.
Molina Healthcare of Nebraska also offers a range of additional services, such as the Pacify app, which provides 24/7 access to maternal and pediatric experts through video, audio, and in-person visits. They also provide a 24/7 Nurse Advice Line for members with questions or concerns regarding their dental or overall health.
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Frequently asked questions
Nebraska Total Care, Molina Healthcare, and United Healthcare are the three providers contracted by the Nebraska Department of Health and Human Services to provide dental services under the Heritage Health program. However, finding a dentist that accepts Medicaid can be difficult, especially in Omaha or Lincoln. Some suggestions include Gile Family Dentistry in Kearney and Midtown Health Clinic in Norfolk.
Some dentists are reluctant to accept Medicaid patients due to low reimbursement rates and concerns about no-call/no-show appointments.
If you are unable to find a dentist that accepts Nebraska Medicaid insurance, you can try contacting the dental office to inquire about cash payment options, as these may be more affordable for you. You can also try contacting your state's dental college or university dental school to see if they offer reduced-cost services.
