FAQ About Medicaid Dental Coverage

If you are looking at dental insurance for you or your family but don't think you can afford a plan, you may want to look at Medicaid dental coverage. Here are some questions you might have about Medicaid dental coverage.

Who Can Get Medicaid Dental Services?

Every state has its own laws concerning Medicaid, so you will have to check your state's laws to see who is eligible. Medicaid often provides low-cost, or free, dental care to the following:

  • Children
  • Pregnant Women
  • Those with disabilities
  • Senior citizens
  • Low-income households

When you apply for dental insurance online, your state's health plan marketplace will have you enter certain factors — like household size and income — to show you whether or not you qualify for coverage.

If you don't qualify for coverage, then you will have to look for insurance that's covered by tax credits, get coverage through work, or get coverage from an independent provider.

Even if you don't qualify for coverage as an adult, Medicaid and the Children's Health Insurance Program (CHIP) are required to cover children.

What Types of Dental Services Are Usually Provided?

While every state is different, Medicaid mainly covers preventative dental services. These services may include things like the following:

  • Oral cancer screenings
  • Teeth cleaning and polishing
  • Sealant and fluoride applications
  • Fillings
  • X-rays
  • Extractions
  • Stainless steel crowns

Some states may even provide orthodontic services or dental surgeries, especially for children with serious issues, like cleft palates.

Since Services are Usually Limited to Preventative Care, Are They Worth it?

Yes! Although the previously mentioned list of services may seem slim, there are many great benefits of preventative treatments. For instance, the CDC says that sealants are hugely successful in children because once they are applied, they protect against 80% of cavities for about 2 years.

Also, if you stay on top of cleanings and polishings, your teeth may never need restorations. You may avoid paying for more expensive restorations down the road, such as implants, bridges, crowns, or dentures. These types of treatments may not be covered by Medicaid.

Preventative dental care is important for preventing gingivitis and gum disease. Untreated gum disease can cause the jawbone to deteriorate and cause you to lose teeth.

Does Every Dental Office Offer Medicaid Services?

While states are required to cover Medicaid services for children, not every dentist participates in Medicaid and associated programs. About 39% of U.S. dentists offer Medicaid to children at their offices. Before making an appointment with a doctor, you should call the office to make sure that they accept Medicaid; you don't want to be caught with hidden costs!

Contact a dental provider in your area today to learn more about Medicaid dental services.