If you have health insurance through Medicaid, you probably wonder about dental work. The good news is that Medicaid does cover annual dental cleanings and other work in many states. Medicaid covers dental care for individuals under the age of 21 around the country.
Medicaid dental insurance services vary by state. Only three states — Alabama, Delaware, and Maryland — do not offer any dental coverage whatsoever. Other states provide limited dental services or emergency services. You may even have out-of-pocket costs that function similarly to a deductible before your dental care is covered by Medicaid. For a complete list of adult dental coverage under Medicaid by state, look at this list.
Medicaid’s coverage of other dental work such as pain relief, treatment of infection, and care for other oral issues varies from state to state. Many states cover emergency treatment, which includes services like emergency tooth extractions, infections, etc. Since this varies widely, patients covered by Medicaid should research their local offerings before booking a dentist appointment.
All individuals under the age of 21 are eligible for dental cleanings through Medicaid as part of the Early and Periodic Screening, Diagnosis, and Treatment benefit. Law requires Medicaid to provide a minimum of the following services to people in this demographic:
Other dental services for children may be covered based on medical necessity. However, this is determined on a state-by-state basis and sometimes on a case-by-case basis.
Even if you live in a state with extensive dental coverage under Medicaid, you may have to do some research before booking an appointment. Not every dental office accepts Medicaid as insurance. For this reason, make sure that you find a covered dentist in your state, even if you are just planning on getting a dental cleaning.
You may also be able to find a dental office that specializes in low-income patients. Most of these accept Medicaid insurance, so you will find most or some of your costs covered, even if you have to pay a copay.
If you are booking an appointment for someone under the age of 21, you still need to find a dental office that accepts Medicaid insurance. By law, children’s dental services are covered but only by certain providers.
To ensure that your dental care will be covered, use an online tool to find a dentist near you that accepts Medicaid. You can also ask detailed questions before and after your appointment about what services will be covered, especially if you are booked for a non-routine procedure like an extraction.
Depending on where you live, Medicaid may provide excellent dental coverage. However, it is important to familiarize yourself with your state’s requirements to avoid any unexpected costs out of pocket.
If you are looking for a dental office that accepts Medicaid, Kool Smiles Kids Club has partner dentists across the country that can assist you.