Whistleblower: Dental woes left a bad taste

After his teeth were pulled, Byrl Johnson's transition to dentures got hung up in an insurance changeover.

Byrl Johnson looks forward to sinking his teeth into the first sweet corn of the season. That is, if he has teeth by then, and he doubts that will happen.

In May, the month Johnson turned 65, he transitioned from MinnesotaCare, a state health insurance plan for the working poor, to Medicare, the federal health plan for seniors.

The changeover happened just as Johnson was about to get bone chips removed from his jaw. He had all his teeth pulled last year and got dentures made, with MinnesotaCare footing the bill. But the bone chips made it impossible to use the lower denture, so he made a new appointment with the dentist.

Then, a few days before Johnson's appointment for surgery May 3, the dentist's office called to say MinnesotaCare wouldn't cover it because the insurance was canceled at the end of April. Medicare doesn't pay for most dental care.

Johnson, who lives in Cannon Falls and works part time in a nursery, doesn't have several thousand dollars to pay for the surgery out of pocket.

"I still have my bone chips, and don't have my bottom teeth, and I'm a little irritated," Johnson said.

The state Department of Human Services (DHS), which administers MinnesotaCare, said its records show Johnson had at least six weeks' notice that his state insurance coverage was ending, something he denies.

"We know that continuity of health care services when people change insurance is important, and Mr. Johnson's situation unfortunately emphasizes this," DHS spokeswoman Karen Smigielski said. "Under state law, people are not eligible for MinnesotaCare if they have other insurance, including Medicare, so we cannot continue his MinnesotaCare coverage."

Johnson's story speaks to a number of issues, health advocates say -- the sometimes bumpy transition from one public insurance plan to another, and the need for better dental coverage for low-income people.

"We're quite concerned about this kind of phenomenon," said Dick Diercks, executive director of the 3,100-member Minnesota Dental Association.

Research shows that the health of teeth and gums affects a person's overall health, yet in recent years, dental benefits in state public insurance programs have been scaled back, Diercks said.

"Dental services are one of the biggest holes in the health care system," said Debra Holmgren, executive director of Portico Healthnet, a St. Paul-based nonprofit that links low-income people with health insurance.

Last year, one patient told Portico that the state paid to have his teeth pulled, but then his dental coverage was taken away before he could get new ones.

Johnson's quest for new teeth got further. A Goodhue County native who grew up on a farm, he loves hunting and fishing and spends his quasi-retirement crafting birdhouses and feeders in his basement.

Last summer, he was ready to part ways with his 20-odd remaining teeth. A dentist extracted them in a single session last September. He got fitted for dentures later that fall. But the lower denture always hurt him because of the bone chips.

So his false teeth stay on a shelf and he "gums the heck" out of whatever he's eating.

"It ain't fun," he said. "Your gums get sore."

Crunchy foods are never on the menu. He'd love to have some popcorn.

The earliest appointment he could get for the bone chips was May 3. That was 10 days before he turned 65. But Medicare kicks in on the first day of the month of a recipient's birthday.

Johnson is puzzled that the state would pay for most of a procedure and then cut him off.

Smigielski said MinnesotaCare would have tried to work it out, had Johnson told them about the timing problem earlier. She said, however, that DHS plans to revise the letters it sends to new Medicare recipients like Johnson so they include more information about state programs that might fill the gaps in Medicare coverage.

Johnson was told by DHS that he may qualify for Medical Assistance, another state insurance program that covers dental care, but that's administered by counties. So he's applying to Goodhue County for that coverage.

Meanwhile, his prospects for eating corn on the cob have improved. After being contacted by Whistleblower, the dentist who was scheduled to extract Johnson's bone chips, Dr. James Midtling of St. Paul, agreed to do the procedure without charge, Johnson said.

Johnson said his surgery is scheduled for July 7.

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  • DENTAL OPTIONS

    The Senior LinkAge line (800-333-2433) offers information on the benefits and resources available to Medicare recipients, including dental care.

    The Minnesota Dental Association (800-950-3368) has a list of dental clinics that take patients enrolled in public insurance programs.

    The nonprofit Portico Healthnet (866-430-5111) helps people find out whether they're eligible for public insurance programs.

    The University of Minnesota School of Dentistry (612-624-8400) offers discounted dental care as part of its academic mission.

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