Louisiana Medicaid Dental Coverage For Adults

Date:

Exciting New Dental Benefits For You

Making the Case for Adult Dental Coverage in Medicaid

Date:01/16/19

Starting February 1, 2019, our members ages 21 and older will get up to $500 per year in dental benefits, including:

  • Dental exams and cleanings
  • Preventive x-rays
  • One whole mouth set of x-rays
  • Fillings
  • Simple tooth extractions

And you will leave your appointments with a new toothbrush, toothpaste and floss so you can keep your smile healthy at home!

American Disabilities Act Notice

In accordance with the requirements of the federal Americans with Disabilities Act of 1990 and Section 504 of the Rehabilitation Act of 1973 , UnitedHealthcare Insurance Company provides full and equal access to covered services and does not discriminate against qualified individuals with disabilities on the basis of disability in its services, programs, or activities.

How Does Medicaid Dental Coverage Work

In all of the United States, each state is required to have a Medicaid program that meets mandatory criteria set by the federal government. In all of the states, these minimum requirements do not include dental for adults, only for those who are under the age of 21.

However, after the passing of the Affordable Care Act, states can now extend those original benefits to offer more healthcare to a larger group of its residents. Many extensions include at least some adult dental coverage, and some even have full coverage. However, there are a few states which have no adult dental benefits added to their Medicaid program.

Depending on your state of residence, the type of care available to you is one of the following: none, emergency, limited, and comprehensive.

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Which States Have Limited Adult Dental Coverage

When Medicaid has limited coverage for dental, this usually means one of two things. Either there is a financial cap to the dental care you can have covered, or there is a fixed list of services that will be covered.

If it is a financial cap, the range is usually somewhere between $500 to $1000. Once that amount is met, dental wont be covered unless it is an emergency.

If it is a fixed list, your Medicaid dental benefits will typically include preventative care such as cleanings and restorative care such as fillings, as well as emergency care.

States with limited adult dental care:

  • Arkansas
  • Washington
  • Wisconsin

Something that is not typically covered even in comprehensive plans is adult orthodontic care or braces. If this is something that you require, you may need to pay out-of-pocket. Luckily, this is not something that would be an emergency, so you will still have all the care that you need to maintain good dental health.

Does Louisiana Medicaid Pay For Partial Dentures

MCNA Dental

COVERED SERVICES:

Only one complete or partial denture per arch is allowed in an eight-year period. The partial denture must oppose a full denture. Two partials are not covered in the same oral cavity . Additional guidelines apply.

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Does Louisiana Medicaid Cover Braces

Good oral health involves the usual brushing and flossing, but it may also require corrective procedures in order to reduce the potential for structural problems. For some people, including those in Louisiana, structural concerns in the mouth are a matter of cosmetics, but for others, these issues can lead to problems chewing food, the development of pain and the worsening of tooth decay and gum disease. Ultimately, dental health concerns may go on to severely impact other parts of the body, including the heart, liver and lungs. While there are plenty of surgical procedures available to address structural dental problems, one of the most common first lines of defense is to fit a patient with braces.

In most cases, braces will be ordered for a dental patient who is still young and has a changing and developing bone structure. Addressing oral health concerns early provides a high likelihood of success as opposed to using braces to correct dental problems in adults. Unfortunately, braces are often expensive and may need to be adjusted over the course of months or even years. This makes it difficult for many low-income families to afford however, Medicaid may pay for dental treatment with braces in Louisiana.

Does Louisiana Medicaid Cover Braces?

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Types Of Medicaid Plans Including Dental

The type of Medicaid that you have could impact whether it pays for dental work for adults. Each state offers a variety of plans designed for different groups of low-income individuals.

In addition to the straight or regular program, you could enroll in unique plans for pregnant women, dual-eligible Medicare recipients, and individuals deemed medically needy.

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Unitedhealthcare Senior Care Options Plan

UnitedHealthcare SCO is a Coordinated Care plan with a Medicare contract and a contract with the Commonwealth of Massachusetts Medicaid program. Enrollment in the plan depends on the plans contract renewal with Medicare. This plan is a voluntary program that is available to anyone 65 and older who qualifies for MassHealth Standard and Original Medicare. If you have MassHealth Standard, but you do not qualify for Original Medicare, you may still be eligible to enroll in our MassHealth Senior Care Option plan and receive all of your MassHealth benefits through our SCO program.

Healthy Louisiana Plan Eligibility

Virginia to expand Medicaid to provide dental benefits to adults

You must qualify for Medicaid to be a member of this health plan.

Medicaid is a program for people with low to moderate incomes who meet certain eligibility requirements.

To see if you qualify for Medicaid, call the Medicaid hotline toll free at 1.888.342.6207 or visit the Louisiana Medicaid website.

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Should Medicaid Cover Dental Care For Adults With Developmental Disabilities Lawmakers Say Yes

For adults with developmental and intellectual disabilities, preventive dental care is hard to come by. Few can afford the out-of-pocket expenses and many end up with no teeth at all.

House Bill 172, sponsored by Rep. Rhonda Butler, R-Ville Platte, seeks to fix that by requiring Medicaid to cover routine dental care for those 21 and older with such disabilities. It sailed through the House Committee on Health and Welfare on Tuesday.

Under current law, Medicaid offers adults with disabilities limited coverage for tooth removals, dentures and hospital visits tied to dental emergencies.

Without routine check-ups, dental issues among disabled adults often go unnoticed. Verbalizing tooth pain can be difficult for those who are developmentally disabled.

The expansion would increase Medicaid expenditures by $17 million, with $11 million coming from the federal government though Butler said that covering preventative dental care could save the program money in the long run.

One woman racked up $500,000 in hospital bills and had to get a lung removed after breathing in bacteria from an infected molar that went undetected, Butler said.

“They have to land in the hospital with a medical problem before Medicaid pays for it,” Butler said. “If we start with preventative care, we don’t land in those emergency rooms.”

Dental Vision And Hearing Care

We help you keep your smile, sight and hearing at their best. Benefits include:

  • Dental. Covered cleanings, checkups and dental work are provided by MCNA Dental for members under the age of 21. We also offer coverage for adults.
  • Vision. Exams and eyeglasses or an allowance for lenses are covered for members under the age of 21. We also offer coverage for adults.
  • Hearing. Tests, exams and hearing aids for members to age 21.

Get the medical care and equipment you need to live safely at home. Benefits may include:

  • Equipment and Supplies. In-home medical and safety equipment are covered for medically necessary equipment.
  • Home Health Care. Medical and personal care at home, if necessary.

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What Is A Root Canal Procedure

Root canal treatment is designed to eliminate bacteria from the infected root canal, prevent reinfection of the tooth and save the natural tooth. When one. undergoes a root canal, the inflamed or infected pulp is removed and the. inside of the tooth is carefully cleaned and disinfected, then filled and sealed.

Unitedhealthcare Dual Complete Plans

Louisiana Medicaid Dental Coverage For Adults  Find Local ...

Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Enrollment in the plan depends on the plans contract renewal with Medicare. This plan is available to anyone who has both Medical Assistance from the State and Medicare. This information is not a complete description of benefits. Call TTY 711 for more information. Limitations, co-payments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year.

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Adult Medicaid Denture Benefits 2021 In Louisiana

With the start of a new year comes new opportunity for denture coverage in Louisiana via Medicaid. In 2021, Medicaid Adult Dental Benefits that include specific denture-related dental services are available from two providers. These companies are DentaQuest USA Insurance Company and MCNA Dental Plans.

How Can I Get Dentures With No Money

Free Dentures for Low-Income: Medicare, Charities and Dental Schools

  • You can find affordable dentures.
  • A local health department can point you in the right direction.
  • Ask your local dentist if they offer low-cost options.
  • The VA offers some benefits.
  • Dont hesitate to ask for help.
  • Seniors can find options too.
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    The Scoop On State Politics In Your Inbox

    It wasn’t until a rare dental visit months later that Cowen learned her brother needed a root canal. Once the tooth was pulled, the swelling subsided.

    “Tommy couldn’t tell us,” Cowen said. “I can’t imagine how long this man lived with that pain. I felt like I failed my brother, to be honest”

    The measure is only the first step in improving dental care for disabled adults, advocates say. There’s still a shortage of dentists and facilities that can provide the specialized care required.

    Kathy Dwyer’s daughter, Jennifer, has problems allowing doctors to examine her orally. She had to pay $3,600 to put her under general anesthesia just to receive a routine teeth cleaning.

    Butler, who has a son with special needs, called the status quo of pulling teeth and providing dentures “inhumane.” She noted that many of the adults who receive dentures don’t understand that they need to keep them in place and end up chewing their food improperly. That can land them in the hospital with intestinal issues.

    HB172 would cover diagnostic, preventative and restorative dental and oral health services, as well as endodontics, periodontics, prosthodontics, oral and maxillofacial surgery, orthodontics and emergency care. More than 10,000 adults with developmental and intellectual disabilities are enrolled in the waiver program that would be covered.

    Email Blake Paterson at and follow him on Twitter @blakepater

    Answer These Questions To Help You Choose A Dental Plan:

    Medicaid Dental Changes
    • Do you want to keep your dentist or dental clinic, or do you want a new one?
    • Does the dental plan have the dentists and specialists you use? To find out, go to Find a provider.
    • Do you need a dental provider who speaks a certain language?
    • Does anyone in your family have special dental needs?
    • What extra services does the dental plan have? To see each dental plans extra services, go to Compare plans. Or read a PDF of the dental comparison chart.

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    Which States Have No Adult Dental Coverage

    Only a small number of states have no dental coverage whatsoever. If you live in the following states and need dental care, you will have to do so outside of Medicaid benefits.

    States with no adult dental benefits:

    • Alabama
    • Tennessee

    If your state of residence is one of these four, then any dental care will not be covered by Medicaid. This can be very alarming to hear since out-of-pocket dental expenses can be incredibly high.

    Resources For Those Without Dental Coverage

    However, there are still ways to get affordable dental care without Medicaid. Here are some options that may be available to you:

    • If you are 65 or older and are enrolled in a Medicare Part C program, there is a good chance that you have dental coverage through this program. Talk to a program coordinator and find out if you are covered.
    • Find the nearest dental school. Every state has a university that includes a dental program. This is one of the most competitive programs to get into, so even a student dentist will be very capable of your care.
    • Get in touch with your local 211. The specialists on the other end will be able to direct you to dental clinics that offer affordable care.
    • If you are 65 and over, disabled, or otherwise medically vulnerable, you can apply for free dental care through Dental Lifeline. This is a service that dentists and dental professionals provide donated dental care. Dental Lifeline operates in every state.

    When Does Medicaid Cover Dentures For Adults

    The answer to whether Medicaid covers dentures for adults in 2022 has many layers and no single correct answer. The tax-payer-funded program has a dual nature affecting the kinds of false teeth covered.

  • The health insurance component often pays for medically necessary services uniformly across the country when the problem originates elsewhere in your body
  • The dental insurance element pays for the least expensive alternative in states supporting specific oral care benefits when the problems start in your teeth or gums
  • Dental grants for low-income adults could prove a superior avenue for people living in states without the needed restorative care benefits and those wanting an upgrade over the least expensive treatment.

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    Which States Have Emergency Adult Dental Coverage

    There are situations where the need for dental care becomes an emergency. Infections of the mouth can be very dangerous due to the proximity to the brain.

    What counts as a dental emergency can vary from state to state. If it is life-threatening or requires surgery, then it is an emergency. Severe and acute pain is probably an emergency, so you can probably get extractions if needed as well.

    If you arent sure if you are in an emergency, your best course of action is to call a dentist or have someone call for you. They will be able to advise on the situation.

    States with only emergency adult dental:

    • Alaska
    • Utah
    • Virginia

    If you live in one of these states, Medicaid will cover you in a dental emergency. If you need treatment outside of this, see above for resources for those without dental coverage.

    Answer These Questions To Help You Choose A Health Plan:

    What is Medicaid?  Exceptional Lives
    • Do you want to keep your doctor or clinic, or do you want a new one?
    • Does the health plan have the doctors, hospitals and specialists you use? To find out, go to Find a provider.
    • Do you need a Primary Care Provider who speaks a certain language?
    • Does anyone in your family have special health needs?
    • What extra services does the health plan have? To see each health plans extra services, go to Compare plans. Or read a PDF of the medical comparison chart.
    • Does the health plan offer all the prescription medicines you take? For the list of medicines that all health plans offer, and for links to each health plans preferred drug list, click here.

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    Will Louisiana Medicaid Cover Dental Care And Orthodontics

    Medicaid is a federal program administered by states to ensure low-income Americans can access health care coverage. To qualify, you must have limited income and resources. In compliance with federal rules, each state determines the financial threshold and other eligibility requirements applicable to state residents. People enrolled in Medicaid include:

    • Adults with limited means
    • Children

    Dental care for children with Medicaid

    The Childrens Health Insurance Program is a low-cost health insurance program for children in families where the household income exceeds the level that would qualify them for Medicaid but falls below the level needed to purchase private insurance. CHIP is available in every state and partners with the Medicaid program.

    Every state must provide access to dental coverage for every child covered by Medicaid and CHIP. All children enrolled in Medicaid get the comprehensive dental benefit known as Early and Periodic Screening, Diagnostic and Treatment . At minimum, states must provide dental services that include:

    • Pain and infection relief
    • Dental health maintenance

    Orthodontics

    Orthodontia falls under restorative services. However, coverage applies only if the braces are medically necessary. States can decline coverage for braces requested for cosmetic reasons.

    Dual-eligibles

    • Qualified Medicare Beneficiary
    • Specified Low-Income Medicare Beneficiary
    • Qualifying Individual
    • Qualified Disabled and Working Individuals

    Dental care for adults with Medicaid

    Wellhop For Mom & Baby

    Connect with other expectant moms. Get support and information during your pregnancy and after you deliver. This program is part of your health plan and there is no extra cost to you.Heres how it works:

    • Join video conversations every other week with women who have similar due dates and a group leader.
    • Chat and share experiences with moms from your group on the Wellhop app or website.
    • Visit the Wellhop library. Youll find articles, videos and more.

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    Unitedhealthcare Connected For Mycare Ohio

    UnitedHealthcare Connected® for MyCare Ohio is a health plan that contracts with both Medicare and Ohio Medicaid to provide benefits of both programs to enrollees. If you have any problem reading or understanding this or any other UnitedHealthcare Connected® for MyCare Ohio information, please contact our Member Services at from 7 a.m. to 8 p.m. Monday through Friday for help at no cost to you.

    Si tiene problemas para leer o comprender esta o cualquier otra documentación de UnitedHealthcare Connected® de MyCare Ohio , comuníquese con nuestro Departamento de Servicio al Cliente para obtener información adicional sin costo para usted al de lunes a viernes de 7 a.m. a 8 p.m. .

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