Find Out About Medicaid Dental Insurance

Some low-income patients can seek out dental insurance coverage through Medicaid as part of their health care plans. Dental plans through Medicaid are available to all children and are covered by Medicaid and the Children’s Health Insurance Plan (CHIP).

However, dental coverage through Medicaid is only offered to some adults. Each state government decides whether or not it will elect to provide dental care to adult patients under its Medicaid provisions. For adults that are not able to find the dental plans they need through Medicaid, there are other low-cost options available. Continue on to read more about coverage for dental as a Medicaid beneficiary, and how to find coverage if your state does not include Medicaid dental plans.  

Who can enroll in Medicaid dental insurance?

Dental insurance through Medicaid is always provided to children. All dental services are covered for children as part of their comprehensive Medicaid benefits. Comprehensive dental coverage for children under Medicaid ensures that Early and Periodic Screening, Diagnostic and Treatment (EPSDT)-related benefits are always covered.

Keep in mind that while a dental plan’s oral screening may be a component of a physical exam, that this is not a true substitute for a full dental exam administered by a dentist. Your child is required under the terms of Medicaid coverage to schedule a dental exam. These conditions are enforcements through your home state.

As an adult, you can enroll in Medicaid dental plans if your state provides such coverage. You can continue below to learn about application methods associated with Medicaid. With these application details, you can apply and get the dental coverage you need if your state offers coverage for dental health.

Learn About Dental Insurance Coverage

Children who are covered by Medicaid dental plans have access to certain minimum services. Under the EPSDT protocol, these services must include:

  • Treatment of infections and pain.
  • The restoration of teeth, whenever needed.
  • The ongoing maintenance of dental health.

Additionally, any service deemed medically necessary by a practicing dentist must be covered under state law. If there is a condition discovered through a screening, the state must provide dental coverage for services related to treatment. This is true even if these new services were not originally included as part of a child’s current Medicaid policy.

While CHIP recipients receive coverage for dental through a Medicaid expansion program via the EPSDT package, there are additional dental coverages allotted if necessary, in order to:

  • Prevent disease.
  • Promote oral health.
  • Restore oral structures to health and function.
  • Treat emergency conditions.

States that adhere to a separate CHIP program are required to provide a package of dental benefits that meets the CHIP requirements. This is a dental package referred to as a “benchmark” package. This type of coverage package must be equal to:

  • The most popular dental coverage option offered to federal or state workers with dependents.
  • Coverage offered through the most popular state commercial insurer.

When a state agrees to offer dental coverage for adults, the state has the flexibility to determine which dental-related benefits will be provided to Medicaid recipients. Keep in mind:

  • Most states that offer dental insurance through Medicaid will cover emergency services.
  • There are no minimum requirements enforced through adult dental coverage.

If you are searching for “free emergency dental care near me” as an adult Medicaid beneficiary in a state that provides dental coverage, you should find coverage options suitable to your needs.

Note: Less than half of the states in the U.S. currently provide dental insurance coverage to adults on Medicaid.

How to Enroll in Low Cost Dental Insurance

In order to sign up for dental coverage through Medicaid, you must follow your state-specific Medicaid application process. Before you enroll, however, make sure to review the eligibility requirements related to income, age, household composition and health status (pregnant or disabled), in order to ensure you will meet your state’s coverage requirements. To apply, you can:

  • Contact your state’s Medicaid agency. You must be able to prove you are a state resident when you apply.
  • Fill out an application through the Health Insurance Marketplace website.

Children seeking dental coverage through CHIP must also apply for benefits. To apply for CHIP, you can:

  • Find a program through your home state, online.
  • Fill out an application through the Health Insurance Marketplace website.

Note that you can enroll in Medicaid or CHIP at any time throughout the year. There are no enforced enrollment periods for these programs, so you can request and submit an application when necessary.

Learn About Alternatives to Dental Plans

Those searching, “How to find a dentist that take Medicaid for adults near me” might find that they come up short. If you cannot obtain dental support through Medicaid, you can seek out alternatives. Affordable health insurance options with dental coverage is still available through a wide variety of options. These include:

  1. State and local health departments. The Health Resources and Services Administration (HRSA) supports government-funded community health centers located throughout the country that offer free or low-cost dental services. You should also call your state health department to find out more about free or reduced-cost services, and any other medically based financial assistance plans for which you may qualify.
  2. Medicare. Adults that are 65 years of age and older, or those who have certain disabilities, can seek out coverage through their Medicare benefits. You are likely to find a dentist that takes Medicare and Medicaid plans when seeking out coverage for dental. However, the Medicare dental services are limited, and most routine dental visits and denture-related services are not covered.
  3. Dental school clinic options. Through the American Dental Association (ADA), patients can seek out reduced-cost dental treatments at teaching facilities. You will find ADA-operated clinics that allow dental students to practice their skills, as experienced, licensed dentists provide supervision.
  4. Clinical trials. Through the National Institute of Dental and Craniofacial Research (NIDCR), patients can join oral trials as participants for low-cost dental care. You can find a complete list of trials through the NIDCR online.
  5. United Way. If you cannot find low cost dental insurance options, you can also phone your local United Way charity chapter, or visit the website for a branch in your area, in order to request recommendations on free or low-cost dental providers located in your community.