By JO CIAVAGLIA
phillyBurbs.com

While evidence shows oral health can impact physical health, in Pennsylvania, unlike many other states with insurance mandates, when the worlds of dental and medical cross paths, often it is health plan language and its interpretation alone that dictates patient treatment and coverage, insurance, medical and dental industry experts say. It is language that increasingly excludes or limits dental procedures that health plans have traditionally covered.

“Insurance companies go to great lengths not to pay for things,” said Dr. Daniel Daley Jr., former president of the American Association of Oral and Maxillofacial Surgeons. “They aren't in business to spend all the money they take in with premiums.” ...

Roughly 55 percent of Americans under age 65 have dental insurance compared with 85 percent for medical insurance...

At least 29 states (not Pennsylvania) have insurance mandates that require healthcare plans to cover hospitalization, anesthesia and medically related expenses for some dental care patients, and some states include medical expenses incurred for treatment performed in a dental office.

Nineteen states (not Pennsylvania) mandate that healthcare policies issued within the state to cover the diagnosis and treatment of certain dental conditions, typically involving jaw disorders and craniofacial anomalies.

Two bills introduced in the Pennsylvania Legislature in 2005 sought to require certain health insurance policies to include coverage for dental and anesthesia services, and also cover removing partial and completely bony-impacted teeth and associated medical costs. Both bills died in committee.

In the 2007-08 legislative session House Bill 718 was introduced that would require all health, sickness and accident insurance policies provide medical coverage for treatment of congenital orofacial anomalies. The bill has not been assigned to a committee yet.

Link to full article: http://www.phillyburbs.com/pb-dyn/news/25-08262007-1397928.html