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Eligibility and Enrollment Model

The eligibility and enrollment model is designed to expand access to oral health services. In rural communities, the eligibility and enrollment model is often a component of a school-based model, dental clinic model, or dental home model.

Some programs provide insurance counseling and enrollment assistance. For example, one rural community works with Medicaid outreach workers to enroll eligible individuals into Medicaid. The Medicaid outreach worker also coordinates with local offices to secure applications and renewal forms ahead of dental visits.

Some programs offer referral services. Another rural oral health program, for example, works with the county health department to refer individuals to a dental home. This program has an arrangement with local dentists to provide dental services at a reduced cost. Programs may also provide information and referrals to help families to access other social services that are available in the community as well as transportation assistance.

Implementation considerations

Eligibility and enrollment models require strong partnerships in the community where patients can be referred for dental or other services. Potential partners may include colleges, health and social service agencies, schools, dental societies, churches, Area Health Education Centers, and legal services organizations.

Resources to Learn More

Access to Baby and Child Dentistry
This program works to increase the number of Medicaid-enrolled babies, toddlers and preschoolers who receive dental care in Washington state. One study evaluated the program in a rural county.
Organization(s): A public-private partnership managed by Washington Dental Service Foundation

Rural Healthy People 2010: The State of Rural Oral Health
Presents an overview of oral health problems in the U.S. and highlights five rural health programs and their models for improving access to dental care for rural populations. Programs that incorporate eligibility and enrollment components include Miles for Smiles and Choptank Community Health System’s Oral Health Prevention Program.
Author(s): Fos, P. & Hutchison, L.
Organization(s): Texas A&M Health and Science Center
Date: 2003