Medicaid is a public health insurance program for low-income people that covers medical and dental expenses. It's a joint effort between the federal government and states. The federal government sets the basic coverage rules, and the states determine their own eligibility criteria and any additional services they cover. For this reason, dental coverage under Medicaid varies depending on the state.
Children Under Age 21
Federal law requires all state Medicaid programs to cover dental care for children. These services include regular dental checkups, treatment of infections, and repair of damaged or decayed teeth. Medicaid must pay for all medically necessary dental procedures for children, even if the procedure is not covered under the state's regular Medicaid dental benefits.
People Over Age 21
Each state can choose to cover adults over age 21. Medicaid programs that offer dental care to adults usually cover annual dental exams, preventive care and treatment of problems such as cavities, gum disease and other damage as necessary.
Emergency Dental Care
All state Medicaid programs cover emergency dental services for children. Most Medicaid programs also cover emergency care for adults. Emergency care includes repair of broken teeth, treatment of extensive infection and extraction of decayed teeth causing extreme pain.
Medicaid dental programs only cover medically necessary procedures and basic preventive care. Procedures Medicaid covers include cleanings, fluoride treatments, crowns and fillings, X-rays, root canals, extractions and dentures. Medicaid will not pay for cosmetic dental services, such as braces, veneers or teeth whitening.
- Utah Department of Health: Dental Benefits
- University of Hawaii: Dental Coverage Under Medicaid
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Lauren Treadwell studied finance at Western Governors University and is an associate of the National Association of Personal Financial Advisors. Treadwell provides content to a number of prominent organizations, including Wise Bread, FindLaw and Discover Financial. As a high school student, she offered financial literacy lessons to fellow students.