Medicaid provider will add dental

Network Health of Cambridge, which provides health insurance for 72,000 low-income people through the state Medicaid program, said it is adding a no-cost dental benefit for its adult members.

After eight months with the plan, adult members will be eligible for free annual dental checkups, cleanings, and X-rays -- services the plan said would cost almost $250 if paid out of pocket.

The new benefit is a small reversal after years of cuts in dental benefits for adults on Medicaid. Such benefits were largely eliminated in 2002 and 2003, during the state budget crunch. But the Network Health initiative could put pressure on other Medicaid plans in Massachusetts to extend such benefits to more of the 550,000 people under 65 who rely on Medicaid for health benefits.

''This is an enormous benefit," said Michael Doonan, a Brandeis University professor who also heads the Massachusetts Health Policy Forum. ''Even when Medicaid provided dental benefits in the state, there weren't a lot of dentists who would take Medicaid reimbursement. One of the best things that could come out of this is some of the other plans might have to add this too, to keep up with the Joneses."

Medicaid is the joint federal-state program that provides healthcare coverage for the poor. The state program, called MassHealth, is administered by the state and four private companies. Network Health is the third-largest of the private plans, and serves members primarily in central and western Massachusetts; Cambridge, Somerville and East Boston; Lawrence and Lowell; and Cape Ann.

''We asked members what they need, what they're missing, and the loud cry was 'dental,' " said Dr. Allan Kornberg, chief executive of Network Health.

Kornberg said offering the additional benefit will encourage members to stay with his plan, enabling him to spend less on marketing while helping to improve the health of members.

''It's a good use of dollars and has some public health benefits," he said. ''We'd like to see our competitors follow suit."

In 2002, facing a budget crunch, the state eliminated numerous Medicaid benefits, including most adult dental benefits coverage and eyeglasses. Children continued to be covered for dental care.

''The lack of dental benefits has been a really terrible problem for adults on MassHealth," said John E. McDonough, executive director of Health Care for All, a nonprofit advocacy group in Boston. ''It just creates a host of problems for these people. While this is limited, it's definitely a good step. We hope it helps to raise the visibility of the problem so the Legislature sees the value of restoring this vitally important benefit."

In addition to providing the mandated benefits required by the government, Network Health offers a variety of relatively low-cost products and services, including bicycle helmets, home child-proofing kits, and breast-milk pumps for new mothers, as a way to attract and retain members. A company spokeswoman, Phyllis D. Giller, said the new dental coverage is expected to cost $2 per member per year, or a total of about $150,000. ''The cost is real but not huge to us," said Kornberg.

Restoring dental benefits for all adults covered by MassHealth would require action by the Legislature, according to McDonough and others. However, with the House and Senate grappling with a larger health reform plan to reduce the number of uninsured in Massachusetts, such efforts are unlikely to gain traction in the current session.

But Phyllis Peters, deputy assistant secretary for the Office of Acute and Ambulatory Care in the Executive Office of Health and Human Services, said there are ''more and more discussions about the importance of dental benefits."

Jeffrey Krasner can be reached at krasner@globe.com.