What Medicaid Covers in Terms of Dental Care

First of all, even though Medicaid is the number one choice coverage for low income people, it does not always and everywhere offer dental coverage. Each state has its own rules and regulations, so Medicaid dental coverage differs greatly from one state to the other.

Until now some truly big efforts have been put into trying to reform the entire Medicaid system and have better coverage for the people, but these efforts are quite unsuccessful…

Access to dental care is of primordial importance. Especially basic, preventative and emergency dental care are the three branches which are essential. Unfortunately there have been many cases in which patients did not have access to proper basic dental care and then the issue got complex and an abscessed tooth turned into a systemic disease…and the patient died.

Generally in states where Medicaid offered a higher level of dental coverage, the main focus is on offering routine and preventative dental care. This way, patients can respect those regular checkups and avoid dental complications later on. Medicaid offers coverage for the needed dental services for people below 21 years of age. Those who are 21 and over can have access to only a few dental services, depending on the rules and regulations existent in that respective state.

Medicaid provides mainly emergency dental care coverage in the follow states: Arizona, Hawaii, Michigan, Maine, New Hampshire, South Carolina, Oklahoma, Wisconsin, Virginia and Tennessee. In only some of these states will Medicaid offer coverage for emergency dental surgery treatments.

On the other hand, Medicaid offers a much higher level of dental coverage in the following states: California, Connecticut, Indiana, Illinois, Kentucky, Kansas, Georgia, Massachusetts, Maryland, Louisiana, Montana, Missouri, Minnesota, Mississippi, South Dakota or Texas.

Certainly, each state has its own regulations, and there are described the limitations/restrictions that apply, such as the maximum allowed number of yearly visits, the co-payment amount, and so on. However, in these states Medicaid always offers coverage for regular professional dental cleanings and dental examinations.

Now an interesting fact is that some states exclude emergency dental care coverage altogether. Why? Because officials say patients who visit the dentist regularly as suggested by the Medicaid coverage, will never need emergency dental treatments. Patients under Medicaid always need to see a dentist which has been appointed as a Medicaid provider of dental services.

Ever since the health system “funding crisis” has started, the dental benefits and coverage has been a definite target. Many health coverage programs under Medicaid have been reduced or even eliminated, and dental care was somehow listed among these “not so important benefits”. On the other hand, the number of dentists participating in the system is getting lower and lower each year, but some of the reasons are understandable too: very low reimbursement rates and extremely complex administrative issues keep dentists away.

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