Presents Medicaid Dental Coverage Overview


Dental coverage is essential for maintaining your health. Tooth decay, pains and infections are often preventable ailments. Particularly for low-income citizens, poor oral health is prominent. Fortunately, Medicaid offers some dental health coverage for children and adults, but the amount and type of dental coverage that beneficiaries can receive varies due to availability of dental health providers and state regulations. When states are forced to reduce coverage costs, dental benefits are among the first medical services to face budget cuts. Regardless, dental health initiatives have encouraged federal administration to continue funding dental health coverage through Medicaid. While most states support dental benefits for children through the Children Health Insurance Program (CHIP), federal guidelines do not mandate adult dental coverage. The team at recommends that applicants learn their potential dental benefits options through Medicaid in the following Medicaid dental coverage overview.

National Medicaid Dental Coverage Requirements

According to federal law, Medicaid programs must offer dental coverage for children and teens younger than 21 years of age. The dental health coverage includes screening and diagnostic services, treatment and emergency care and is a part of the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit. Comprehensive exams and education attempt to identify poor health issues early and properly diagnose and treat affected children and teens. The team at suggests families utilize dental health coverage benefits before dental health issues occur. However, the federal government does not regulate dental coverage for adults. Rather, states decide specific dental coverage benefits.

Potential Medicaid Dental Benefits

Medicaid programs may offer dental services such as emergency coverage, preventative care, dentures and oral surgeries, but not every state funds all dental services. For instance, few states provide monetary annual coverage for dental services, and even fewer states perform orthodontic care. Currently, less than half of all U.S. states have basic dental health benefits through Medicaid. The team at encourages you to research your state’s dental benefits for adults to determine how much coverage you will receive through Medicaid. If you are unsure of your coverage, or if you need dental care that certain Medicaid programs do not provide, the team at recommends that you seek additional dental insurance plans to supplement your Medicaid insurance.

The team at recognizes the value of good dental care and encourages candidates and recipients to learn the benefits Medicaid may offer to households. Important dental benefits Medicaid may offer to Medicaid patients include pain and infection relief, teeth restoration and annual dental cleanings. For children and teens, these services are covered through CHIP benefit packages, but in-network Medicaid doctors must write referrals to dentists for dental appointments. Following an initial consultation, the EPSDT benefit also requires children and teens to continue regular dental health visits with dental organizations. Although comprehensive dental coverage for adults on Medicaid is minimal, it is beneficial for everyone of all ages to maintain appropriate dental care.

Other Dental Insurance Options

U.S. residents have numerous options for purchasing alternative dental insurance. If Medicaid enrollees cannot attain necessary dental coverage, then they may search for other insurance plans outside of the Medicaid network. For instance, Preferred Provider Organization (PPO) plans, such as Aetna, Delta Dental, MetLife and United Concordia can supplement Medicaid dental insurance programs and enable everyone to receive the dental care they require.

What Is Medicaid?

Medicaid is a medical assistance program that provides coverage for various types of medical care. Eligible individuals and families can receive coverage for doctor visits, X-rays, labs, inpatient care, outpatient care and more. However, not all procedures are covered under the federal medical assistance program. To learn about which procedures are covered and to find out all about the Medicaid program, download our comprehensive guide.

Who Is Eligible to Receive Medicaid Benefits?

Medical assistance benefits are available to a wide variety of low-income individuals and families within the United States. However, all Medicaid applicants must meet the established eligibility requirements, which range from income limits to citizenship qualifications. To find out if you or your family is eligible to receive Medicaid benefits, download our comprehensive and complimentary guide.