YOU ASK:

Does Medicaid cover dental care?

WE ANSWER:

Medicaid may cover some dental treatments, particularly if these are provided for low-income citizens. The standard list of dental care services payable would be:

  • tooth extraction,
  • tooth restoration,
  • laboratory fees, and
  • medication.

Other dental procedures may not be payable under Medicaid. Also, the eligibility for dental care coverage depends on certain factors, such as the state where the patient lives, his age and income.

Those who are under 21 years old can avail of dental services such as fluoride applications and dental check-ups.

Although the federal government provides the guidelines for administering Medicaid, each state is given the authority to run the program (and the benefits included) as it sees fit.  What dental care you can avail of under Medicaid will really depend on your state.

You can check with the Medicaid office in your state. Your state may include additional treatments such as dental care. This really depends on how your state wants to treat dental problems, as well as its willingness to fund the treatments under Medicaid. There are states where Medicaid will pay only for emergency dental care, while there are also some states that include basic critical care. Other more generous states include a more comprehensive list of dental services.

There may also be some conditions and restrictions that apply. Again, these depend on the state you live in. There are some states that opt to provide preventive care but require you to pay a certain portion of the fees. Additional conditions such as limits on the number of visits, the number of cleanings and the amount Medicaid would pay can also be specified by the state.

When you want to use Medicaid to pay for dental care, you should ensure that:

  • The dentist is accredited by Medicaid.
  • A referral has been given from another dentist or provider, especially for orthodontia or dentures.
  • You are enrolled with that dentist. It is advisable that you enlist early, since most dentists put a cap on the number of Medicaid patients he will treat.

For additional help, you can ask a social worker about dental services that are payable under Medicaid in your state.

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