Dental Services That Take Medicaid

Medicaid Dental Coverage By State

As you can see from this table that shows Medicaid dental coverage by state, different benefits are given to those in the Medicaid base population and Medicaid expansion population.

People who fall into the Medicaid base population are those who were receiving Medicaid before the Medicaid Expansion Program under the Affordable Care Act.

People who fall into the Medicaid expansion population are those who began receiving Medicaid benefits after the ACA gave states the option to expand funding for Medicaid.

How To Find Local Dentists Accepting Medicaid For Adults

Finding a nearby dentist that accepts Medicaid for adults can be an enormous challenge or as easy as pie depending on where you live, the types of oral care needed, and other factors.

First, the health insurance element covers dental work across the country when medically necessary: connected to accidental injury or disease.

Second, the medical assistance is sometimes dental insurance, but the benefits vary widely in each state for oral care.

Third, you need to find providers in your area that take your specific plan rather than what others might have. Finally, state offices outsource administration to outside companies, adding a layer of confusing names and acronyms.

Do Medicaid And Medicare Cover Dental Guide To Low

The topic of Medicare and Medicaid dental coverage causes a lot of confusion for people looking for a way to help pay for dental work. And even if you do find low-cost dental care, it can be difficult to find dentists that accept Medicaid or dentists that provide low-income options.

There are a plethora of questions surrounding healthcare and especially dental care in the US.

Confused about Medicaid and dental?

Do you want to know about state-funded and federally-funded healthcare?

Or maybe you’re just wondering where you can find dental clinics for low-income families or individuals.

Oh yeah, and what in the world is CHIP by the way? .

It doesn’t matter what your beliefs are when it comes to the current healthcare debate surrounding health and dental insurance in the US when you need dental care, you need dental care.

The good news is, once you understand a little bit better how the system works, who to contact for which service, and which Medicare and Medicaid dental benefits you may be eligible for, the process becomes much easier. And you may find yourself among the many Americans who manage to find dental care despite the confusing system.

That’s why this article will cover everything you need to know about state-funded health insurance and low-cost dental options, including:

• Medicare dental coverage

Also Check: Medicaid Community Choices Waiver Program

How Do I Find Low

To find dental clinics for low-income families or individuals:

• Contact your local health department
• Contact a local dental school
• Participate in a clinical study
• Contact a Health Insurance Navigator

And to find dentists and dental clinics that accept Medicaid:

• Consult the provider booklet that came with your insurance to find Medicaid dental offices

Individuals Under Age 21

EPSDT is Medicaid’s comprehensive child health program. The program’s focus is on prevention, early diagnosis, and treatment of medical conditions. EPSDT is a mandatory service required to be provided under a state’s Medicaid program.

Dental services must be provided at intervals that meet reasonable standards of dental practice, as determined by the state after consultation with recognized dental organizations involved in child health, and at such other intervals, as indicated by medical necessity, to determine the existence of a suspected illness or condition. Services must include at a minimum, relief of pain and infections, restoration of teeth and maintenance of dental health. Dental services may not be limited to emergency services for EPSDT recipients.

Oral screening may be part of a physical exam, but does not substitute for a dental examination performed by a dentist as a result of a direct referral to a dentist. A direct dental referral is required for every child in accordance with the periodicity schedule set by the state. The Centers for Medicare & Medicaid Services does not further define what specific dental services must be provided, however, EPSDT requires that all services coverable under the Medicaid program must be provided to EPSDT recipients if determined to be medically necessary. Under the Medicaid program, the state determines medical necessity.

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Does Medicaid Cover Dental For Adults

Medicaid covers dental care for adults only in certain states, and each of these states chooses whether they want to provide limited, extensive, or emergency-only care. The states that currently provide at least limited dental care for their Medicaid base population are: AK, CA, CT, IA, MA, MO, NJ, NM, NY, NC, ND, OH, OR, RI, WA, WI.

Todays Dental And Oral Surgery

Todayâs Dental is a general dentistry clinic that accepts Medicaid insurance and can provide care in English, Spanish, or Korean. It was founded in the early 2000s and is owned by Dr. Lee and Dr. Martin, who manage a team of 5 dental hygienists, assistants, and directors. The clinic is able to handle all types of dental work in-office, including not only general dentistry services for the whole family, but also cosmetic dentistry and dental surgery. Their services are listed below:

â Dental Exams and Cleanings

â Gum Disease Treatment

â Root Canals

â Wisdom Teeth Removal

â Nightguards

â Invisalign Treatment

â Dentures

â Bridges and Crowns

â Dental Implants

â Cosmetic Dentistry

Below are short biographies for the two dentists on staff at Todayâs Dental:

â Dr. Robin Lee, DDS takes a proactive approach to caring for his patientsâ dental needs and desires. He is a member of 6 dental associations, including one association in Korea. Dr. Lee received his Doctorate of Dental Surgery from the University of Southern California, Los Angeles in 2000 and specializes in pediatric dentistry.

Todayâs Dental is located at the following address:

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States Determine Medicaid Dental Benefits

The amount of dental care available for an adult on Medicaid depends on the state. The Center for Health Care Strategies, Inc. provides a comprehensive chart listing each states Medicaid dental benefits.

Some states have generous benefits classified as extensive. These usually cover preventative care such as exams and cleanings, diagnostic and restorative care such as x-rays and fillings. They might take care of crowns and other treatments like extractions.

Limited care offered by other states might include exams and fillings, but nothing more. Or, it might place a limit on the dollar amount for some services or require pre-approval.

Other states only provide only emergency care. And each state has its own rules for emergency dental visits. Some might do an emergency extraction, but nothing else. Others might include emergency root canal procedures. Still, others might only cover medically necessary dental work, but a medical doctor will need to determine that it is truly necessary for the persons medical health.

Finally, four statesAlabama, Delaware, Maryland, and Tennesseedo not provide any dental care for adults under Medicaid.

Many states do make an exception and provide dental care for people who are disabled, pregnant, or elderly with low-incomes.

Give Your Child A Brighter Healthier Smile

Dont let lack of insurance or Medicaid ineligibility stop you from visiting us. Our partner dentists will make sure you and your child get the treatment you need, when you need it and that youre able to pay comfortably without feeling stressed out. Theres a reason why 97% of our partner dentists patients keep coming back to us! Give one a to learn more!

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What Does The Dental Benefit Cover

See the Children’s Dental Benefits page for more information about benefits for Health First Colorado members under age 21.

The adult dental benefit is available to eligible adult Health First Colorado members and covers:

• Annual dental exams and cleanings
• Diagnostic and restorative dental services
• Other procedures requiring *prior authorization are also available.

Emergency services and dentures are not subject to the $1,500 limit per state fiscal year.

The replacement of lost, stolen, or unrepairable broken dentures are an once per member lifetime benefit.

What Is Medicare Advantage

Medicare Advantage is a type of healthcare plan offered by some private insurance companies in connection with Medicare. People who qualify for Medicare because of advanced age or a disability can choose to upgrade their Medicare coverage by paying into a Medicare Advantage plan. With this plan, Medicare pays a set monthly or annual amount to your insurance company to subsidize the cost of any treatment you require.

As you might imagine, Medicare Advantage plans cover a far more extensive range of treatments than standard Medicare. This usually includes vision, hearing, and dental care, though coverage will vary from one provider to another.

For this reason, it is extremely important to shop around and make sure your Medicare Advantage plan has been tailored to meet your needs. If you are likely to require a lot of dental treatment, finding a plan with good dental coverage is essential.

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How Can I Enroll In Apple Health

You can enroll in Apple Health at any point during the year on the Washington Healthplan Finder. If you do not qualify for Apple Health, the Washington Healthplan Finder has many other insurance options for you to choose from.

About 7-10 days after applying for Apple Health coverage, a ProviderOne services card will be mailed to you. This is a plastic ID card that looks like other health insurance ID cards. Take this card with you to your doctor and dentist appointments. Providers use this card to make sure your service is covered.

How Does Medicaid Help Provide Child Dental Care

Although many benefits vary by state, Medicaid entitles all children under the age of 21 to dental care services. The Early and Periodic Screening, Diagnostic, and Treatment benefit provides your child with dental services that include:

Relief of pain and infections

Restoration of teeth

Maintenance of dental health

Frequent checkups every six months will help your child develop a healthy smile, and Medicaid dental plans cover the cost of any necessary treatments. Find a dentist near you that accepts Medicaid, so your child can have good oral health, without the worry of paying for expensive dental care services.

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Also Check: How Much Can You Make To Be Eligible For Medicaid

Medicaid Dental For Adults

Dental help for low-income adults is a bit more complicated. Each state gets to choose what Medicaid dental for adults they will provide. There are no minimum requirements for adult dental coverage and less than half of the states in the US provide coverage for emergency dental care.

That being saiddo not despair!

If you are an adult on Medicaid and your state doesn’t cover the services you need, there may be other options available to you. We’ll talk about these options further down in the article.

If accessibility is a concern, be sure to check out our article on dental help for adults with disabilities.

Medicaid Dental Providers For Adults And Children

According to the American Dental Association, 36% of lower-income Americans have lived through untreated cavities. Dentists that take Medicaid can be hard to find, in fact, only 38% of dentists in the US accept Medicaid.

The low percentage of participation of Americans in Medicaid may be due to the facts that:

• Many states make it very difficult for providers to become dentists that accept Medicaid
• Those who can receive dental coverage from Medicaid in their state are unaware.

If you need to find a dentist that takes Medicaid, Medicare or CHIP, you can go to Dentaquest’s Find a Dentist page and search by state.

Another way to find a dentist that accepts Medicaid is simply by calling an office near you and asking.

Also, you’ll most likely receive a booklet along with your Medicaid insurance information. Inside should be listed all of the Medicaid dental providers in your area.

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Can I Get Braces With Medicaid

The answer is yes! If braces are deemed medically necessary for your child, Medicaid can assist in getting them. Some orthodontists will offer a no-cost consultation to discuss your childs needs. This can be very convenient if youre looking into the cost of braces with Medicaid, CHIP, or TRICARE.

Keep Reading to Get Answers to These Questions:

• What is Medicaid and what does it cover?
• How do I know if braces are medically necessary for my child?
• What is the average cost of braces?
• What are the most common kinds of braces?
• Where can I find a no-cost consultation for braces?
• Where can I find affordable payment options for braces?
• Why should I choose a Kids-First dental office or orthodontics?

Ready to schedule a no-cost consultation today? Find a Kool Smiles Kids Club partner dentist near you here. Or keep reading to learn more about braces and how you can find affordable treatment for your child.

Free Dental Care In Brown County

These services are offered in and near Brown County:

• Oral Health PartnershipFind free dental care for kids in and near Brown County. You must be 019 years of age. You also must have Medicaid or BadgerCare Plus or have no dental insurance but qualify for the free and reduced meal program.
• N.E.W. Dental ClinicsAccess dental care for adults in Brown County. You must be on Medicaid, on BadgerCare Plus, homeless, low-income, or without insurance.

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Dental Benefits For Children In Medicaid

Medicaid covers dental services for all child enrollees as part of a comprehensive set of benefits, referred to as the Early and Periodic Screening, Diagnostic and Treatment benefit. Though oral screening may be part of a physical exam, it does not substitute for a dental examination performed by a dentist. A referral to a dentist is required for every child in accordance with the periodicity schedule set by a state.

Dental services for children must minimally include:

• Relief of pain and infections
• Restoration of teeth
• Maintenance of dental health

The EPSDT benefit requires that all services must be provided if determined medically necessary. States determine medical necessity. If a condition requiring treatment is discovered during a screening, the state must provide the necessary services to treat that condition, whether or not such services are included in a state’s Medicaid plan.

Each state is required to develop a dental periodicity schedule in consultation with recognized dental organizations involved in child health care. Dental services may not be limited to emergency services for children entitled to EPSDT.

Dental Services At Axesspointe

If you are looking for affordable, comprehensive dental care, youll find it at AxessPointe.

Visiting a dentist who accepts Medicaid near me is a great way to take control of your health. Having healthy dental hygiene is the best way to prevent problems like cavities, gum disease, tooth decay, and other oral issues and diseases. In fact, gum disease has actually been linked to heart disease and the risk of stroke. Symptoms like mouth ulcers, swollen gums, and dry mouth also show up in at-risk patients. If you visit your dentist regularly, youll get ahead of these issues before they progress.

In addition to visiting your dentist, there are some good habits to form in your daily life that will help you maintain good oral health. Brushing twice a day and flossing once a day should be a standard, and using mouthwash once a day is a great way to kill bacteria that live in other parts of your mouth. It is also important to eat a healthy diet, and try to avoid drinks that are high in sugar such as soda and alcohol. And, steer clear from tobacco products and schedule regular dentist visits. With the combination of dentist visits and healthy at-home habits, youll have a smile you love and outstanding oral hygiene.

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How Can I Book An Appointment Online With A Medicare Dentist

Zocdoc is a free online service that helps patients find Medicare Dentists and book appointments instantly. You can search for Medicare Dentists by symptom or visit reason. Then, choose your location. Based on that information, youll see a list of providers who meet your search criteria, along with their available appointment slots.

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The Limited List Of Dentists That Accept Medicaid

For many families, it can be hard to find a list of dentists that accept Medicaid in their area. Even in states that choose to expand coverage, some dentist offices restrict the number of patients they accept per day, making it difficult to access quality dental care.

At Kool Smiles, we never limit the amount of Medicaid patients we see. If youre looking for dentists that accept Medicaid near you, call us at 254-781-0553 to schedule an appointment or a no-cost dental consultation today.

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