Maine law eliminates insurance waiting periods for kids
May 04, 2020
— Gov. Janet Mills signed into law a bill that eliminates insurance waiting periods in dental insurance plans for children in Maine.
LD 1975, An Act to Facilitate Dental Treatment for Children, enacted on March 17, enables children with private dental insurance to receive care without having to wait up to several months for coverage to start.
“The passage of [this legislation] is timely since we are postponing dental care for children now because of the coronavirus,” said Dr. Jonathan Shenkin, a pediatric dentist practicing in Augusta. “When dental care resumes again, this law will help expedite getting dental care to children and reduce parental financial barriers to that care.”
Dr. Shenkin, a former ADA vice president and past president of the Maine Dental Association, advocated strongly for the passage of the legislation.
“This bill was of particular interest to me because waiting periods have had a direct impact on my own patients’ ability to access dental treatment when they were in pain but couldn’t afford treatment,” he said. “Eliminating waiting periods after enrollment for children is just one more way to ensure children get proper care.”
According to the law, which does not include orthodontic treatment, it prohibits insurers that issue individual and group dental insurance or health insurance that includes coverage for dental services from imposing a waiting period for enrollees under 19 years of age.
“As a small business owner who provides health benefits to my employees, I expect that those benefits will cover the urgent needs of my employees and their families,” Sen. Heather Sanborn, the bill’s primary sponsor, told ADA News in December 2019. “Forcing a child who has tooth decay to wait for months before it can be dealt with (or forcing an insured parent to pay out of pocket in order to get timely access) is deeply disturbing to me. In the end, rather than controlling costs, these delays may actually drive them up. This bill seems like an important first step in ensuring that insurance companies are covering needed care in a timely manner.”
Dr. Shenkin had said that MaineCare, the state’s Medicaid program, has “always provided immediate coverage for dental treatment for eligible children” and noted private insurers have had waiting periods for treatment for decades. Previously, he added, most families with private dental insurance waited an average of three to 12 months after signing up for a plan.