The Arc of Florida Dental Services Scholarship


kristen_hillsWhat a difference a year makes. Kristen Hills spent the better part of a decade with severe dental problems. There were many days when she could only eat soft foods, such as Jell-O and mashed potatoes… To read more of Kristen’s story, click here.


Dental Scholarship Application for Contract Year Beginning July 1, 2017

2017-18 New Dental Application

The Arc of Florida is currently accepting applications for dental scholarships for eligible individuals.  Please read the information on this page prior to filling out the application so that you are aware of the services covered.


Who is Eligible for Services?

***IMPORTANT: Funding in your APD cost plan for dental MUST be used first.

Who is eligible for services?  The programs below are managed by the Agency for Persons with Disabilities (APD) through the Home & Community Based Waiver.

  1. Individuals on the Medicaid Individual Budgeting Waiver (iBudget Waiver)
  2. Individuals on the Medicaid Waiver Waitlist (iBudget Waitlist)
  3. Individuals who are Consumer Directed Care Plus clients (CDC+)

What Services are Covered?

Some dental procedures are covered by The Arc of Florida Dental Scholarship for eligible applicants.

Dental procedures for eligible Medicaid iBudget Waiver and CDC+ client* include:

  • Crowns
  • Root Canal
  • Sedation
  • Fillings
  • Extractions
  • Dentures

Dental procedures for eligible Medicaid iBudget Waitlist clients* include:

  • X-rays
  • Cleanings
  • Routine Exams
  • Crowns
  • Root Canal
  • Sedation
  • Fillings
  • Extractions
  • Dentures

*Not a complete comprehensive list. All dental treatment procedures are evaluated on a case-by-case basis.


What Services are NOT Covered?

To determine which dental procedures are NOT covered by The Arc of Florida Dental Scholarship, please read below:

Dental procedures NOT covered for Medicaid iBudget Waiver and CDC+ clients*:

  • Cleanings
  • Cosmetic Procedures
  • Braces (Orthodontics)
  • Bleaching
  • Bonding
  • Periodontal Trays & Supplies
  • TMJ Related Treatments
  • Mouth Guards
  • Dental Hygiene Appliances, Products and Supplies

Dental procedures NOT covered for Medicaid iBudget Waitlist clients*:

  • Cosmetic Procedures
  • Braces (Orthodontics)
  • Bleaching
  • Bonding
  • Periodontal Trays & Supplies
  • TMJ Related Treatments
  • Mouth Guards
  • Dental Hygiene Appliances, Products and Supplies

*Not a complete comprehensive list.  All dental treatment procedures are evaluated on a case-by-case basis.


How Do I Apply for The Arc of Florida Dental Services Scholarship?

1. Fill out the application:

The Arc of Florida Dental Application 2017-2018

2. Mail, Fax or Email completed application to:

  • Fax: 850.921.0418
  • Email: dental@arcflorida.org
  • Mail: Attn: Dental Services Scholarship Program
    The Arc of Florida
    2898 Mahan Drive, Suite 1
    Tallahassee, FL 32308

Frequently Asked Questions:

  1. How long may I have to wait to hear about the status of an application?

Scholarship applications are processed in accordance with our contract with the Agency for Persons with Disabilities.  NOTE: The first two months of the contract year, July and August, we will focus on helping as many iBudget Waitlist clients as possible.

We receive hundreds of scholarship applications each month and will get in contact with you as soon as we can.  Filling out the application thoroughly and legibly will enable the process to go much faster.  Attaching your Dental Treatment Plan, which can be obtained from your dentist, will also speed up the process.

2. What if I don’t have a current dentist or if I can’t remember the last time I saw a dentist?

Applicants who do not have a current dentist and those who cannot recall the last time they saw a dentist are still invited to apply for the scholarship.  The Arc of Florida Dental Scholarship staff will work with applicants to identify dentists in or near to their area of residence.

 


Dental Resources

The following link will take you to some great resources and short videos.  These videos center around Oral Hygiene, and will help guide parents, caregivers and self-advocates on ideas and strategies to use, as well as give advice on how to help alleviate anxiety, and much more.

https://www.dhsv.org.au/professionals/health-promotion-resources/videos/brushing-up-on-oral-health


Questions regarding the “Payor of Last Resort”

According to federal law, providers are obligated to bill all third party payers before filing a claim with Medicaid.  There are several Federal and State statutes that govern this requirement.  First Section 1902(a)(25) of the Social Security Act requires participating states to:

“Take all reasonable measures to ascertain the legal liability of third parties…to pay for care and services provided to Medicaid recipients.

It is common for Medicaid beneficiaries to have one or more additional sources of coverage for health care services. Third Party Liability (TPL) refers to the legal obligation of third parties (e.g., certain individuals, entities, insurers, or programs) to pay part or all of the expenditures for medical assistance furnished under a Medicaid state plan. By law, all other available third party resources must meet their legal obligation to pay claims before the Medicaid program pays for the care of an individual eligible for Medicaid. States are required to take all reasonable measures to ascertain the legal liability of third parties to pay for care and services that are available under the Medicaid state plan.

The Arc of Florida Dental Services Scholarship Program does not have “legal liability” or an obligation to provide dental services to any particular individual.  However, the I-Budget Medicaid Waiver has to provide medically necessary services to specific individuals and in fact lists dental services as one of the covered services under the waiver.

While The Arc of Florida is proud to receive funding to provide much needed dental services to Floridians on the I-Budget Waiver and waitlist, this program does not have a legal obligation to a
particular Medicaid recipient and therefore, The Arc of Florida Dental Services Scholarship Program does not replace I-Budget Medicaid Waiver funding for dental.

Actual Contract Language states:

3. Clients to Be Served

a. General Description

The population receiving services funded by this Contract are the Agency’s clients with developmental and/or intellectual disabilities residing in Florida.  The clients to be served shall be children or adults with intellectual and/or developmental disabilities throughout the State who receive services through the DD Waiver whose iBudget cost plan do not include adequate or any funding for comprehensive of preventive dental care, or do not have access to a DD Waiver dentist.  The clients to be served shall also include children or adults who receive services through the Waitlist who have comprehensive and/or preventive dental care needs.