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Dental Benefits for Medicaid Enrollees
December 07, 2015  |  Uncategorized

Dental Benefits for Medicaid Enrollees

Dental health is a crucial part of everyone’s overall well-being, but not everyone can afford to go through expensive treatments.

A dental insurance may cover some of the dental treatments. However, according to a study there are a large number of people in the United States alone who do not have dental insurance. In fact, access to oral health care for low-income adults due to the lack of the insurance coverage is emerging as one of the most serious challenges facing in the American healthcare today.

It is estimated that about 28% of adults who earn less than $15,000 a year have lost of their natural permanent teeth when compared to 4% of adults who earn $50,000 a year. This is the very reason access to comprehensive denture care is important - to diminish these issues.

Research shows that poor oral health can lead to several chronic conditions including diabetes, heart diseases, leukemia, oral cancer, pancreatic cancer, and can contribute to lost workdays, and the preventable use of costly acute care.

This is where Medicaid comes in the picture.

What is the Medicaid?

It is a joint and voluntary program developed between the federal government and the states, with the aim to provide dental health insurance coverage to the country’s poor, disabled and the impoverished elderly people.

Medicaid covers a wide array of preventive services to meet the needs and requirements of the population it serves, including:

  • Basic preventive dental exams

  • Diagnostic and restorative dental services

  • Extractions

  • Partial and complete dentures

  • Root planning

  • Root canals

  • Crowns

  • Periodontal scaling


Other procedures requiring prior authorization will also be available.

Prior to 2013, Medicaid covered dental services only for children and not for adults. It was only later that the Departments created a new limited dental benefit for comprehensive care for adults age 21 and over, with up to $1,000 in dental service per state fiscal year which runs from July 1 - June 30. This allows the members to have an access to regular dental care that can prevent minor oral conditions from developing into more complex and costly health conditions.

Important: Although Partial and complete dentures are in addition to the $1,000 can per state fiscal year, the will be limited to one set every seven years.

How to Apply?

States have the option to provide dental coverage none at all to the adult, Medicaid-eligible population as a part their Medicaid program. There are no minimum requirements for adult dental coverage. You can apply for Medicaid in your state via online, by telephone or at locations in your community. Get in touch with your local Medicaid office to know more about your state's options at Medicaid.gov.

Those who do not have access to the internet can check the blue pages of your phone book to call your local social security office or contact Affordable Dentist Near Me at (817) 200-7086.

With these many benefits available for Medicaid clients, we encourage you to get enrolled in the program and stay in the know about Medicaid dentist in your area.