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The ADA has a long history of advocating against dental coverage under national health insurance plans. In 1965, the ADA lobbied against the inclusion of dental coverage in the original Medicare program. [11] In 2021, the ADA launched a well-funded lobbying effort against proposal to provide dental insurance coverage for all Medicare recipients.
In addition, payment to dental professionals is based on the CDT code(s) reported on the ADA Claim Form, so using the most current codes helps to maximize reimbursement and minimize audit liability. [6] In the near future, dental professionals will be required to use diagnosis codes in support of the procedures and services they provide.
Dental insurance companies divide benefits, services, or procedures into categories and refer to them with American Dental Association (ADA) 3-4 digit code. As an example, Preventive and Diagnostic procedures often include exams (ADA code 0120), x-rays (ADA code 0210), and basic cleanings or prophylaxis (ADA code 1110).
Aetna health plans include basic dental coverage, with options for comprehensive insurance, as well as standard Medicare coverage.
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Most people with a Medicare Advantage plan — over 94% in 2021, according to the Kaiser Family Foundation — have some kind of dental coverage, and many have access to extensive coverage.