Keywords

dental insurance; Medicaid; TRICARE ADDP; oral health; healthcare equity

Abstract

Oral health plays a critical role in systemic well-being, yet dental care access in the United States remains deeply unequal, particularly among low-income and historically marginalized populations. Among those significantly affected are military veterans, who frequently experience barriers to oral healthcare due to eligibility restrictions within the Department of Veterans Affairs (VA) system. This study offers a comparative analysis of dental insurance satisfaction between recipients of Medicaid and the TRICARE Active Duty Dental Program (ADDP), two federally funded programs that reflect the divide between civilian and military healthcare access. While TRICARE ADDP provides comprehensive and uniform coverage for Active Duty Service Members (ADSMs), many veterans, upon separation from service, become reliant on Medicaid for dental care, despite its inconsistent and limited coverage across states.

This study utilizes a cross-sectional survey design. Data was collected from participants in Okaloosa County, Florida, a region notable for both its high military presence and average poverty rates. Participants completed Net Promoter Score (NPS) assessments measuring satisfaction in three key areas: choice of dental care providers, insurance coverage, and annual dental benefits. The study found that TRICARE ADDP recipients reported significantly higher satisfaction across all measures compared to Medicaid users. The Medicaid group exhibited particularly low satisfaction with provider access and benefits, underscoring the inadequacy of coverage experienced by many low-income individuals, including veterans who do not qualify for VA dental benefits.

This research contributes to a growing body of literature examining the transition from military to civilian healthcare and highlights the urgent need for policy reform. The findings suggest that without federal standardization and expanded eligibility for preventive dental services, Medicaid will continue to fall short in addressing the oral health needs of vulnerable populations. Moreover, the study underscores the necessity for independent, third-party evaluations of federally administered insurance programs to ensure equitable care across all stages of service and post-service life. While the study is limited in scale and geographic scope, it establishes a foundational basis for future multi-state research that includes a broader veteran sample and examines policy variation across Medicaid programs.

Thesis Completion Year

2025

Thesis Completion Semester

Spring

Thesis Chair

Gannon, Barbara

College

College of Health Professions and Sciences

Department

Department of History

Thesis Discipline

History; Health Sciences

Language

English

Access Status

Open Access

Length of Campus Access

None

Campus Location

Orlando (Main) Campus

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Rights Statement

In Copyright