Would you believe more than 28 million people in the United States have dental benefits through Medicaid? That’s a lot of people! If you are one of them, rest assured, you aren’t alone. While Medicaid is an invaluable health care plan that has helped millions of Americans get the medical and dental care they need, it can also be confusing and difficult to navigate.
- Not all states offer comprehensive dental coverage under Medicaid. While Medicaid is a federal program, dental coverage is administered by the individual states, which means that benefits can vary widely from one state to another. Some states offer comprehensive dental coverage, while others offer only emergency services or limited coverage for certain procedures.
- Medicaid dental benefits are primarily focused on children. While some states do offer dental coverage to adults, Medicaid dental benefits are primarily aimed at children. This is because dental problems can have a significant impact on a child’s overall health, including their ability to eat, sleep, and learn.
- Medicaid dental benefits may be limited to certain providers. In some states, Medicaid dental benefits are only available through certain providers, such as community health centers or clinics. This can limit access to care for some Medicaid beneficiaries, particularly those living in rural areas.
- Medicaid dental benefits may have limits on certain procedures. Even in states where comprehensive dental coverage is available, there may be limits on certain procedures or treatments. For example, some states may only cover a certain number of cleanings or fillings per year, or may require prior authorization for certain procedures.
- Medicaid dental benefits may not cover cosmetic procedures. Medicaid dental benefits are focused on addressing dental problems that impact a person’s health or ability to function. As such, cosmetic procedures, such as teeth whitening or veneers, are generally not covered.
- Medicaid dental benefits may require copays or other out-of-pocket costs. While Medicaid dental benefits are designed to help low-income individuals access care, some states may require beneficiaries to pay copays or other out-of-pocket costs for certain procedures or treatments.
- Medicaid dental benefits may not cover orthodontic treatment. While some states do cover orthodontic treatment under Medicaid, it is generally not considered a medically necessary procedure and may not be covered. When coverage is available, there may be strict eligibility criteria and waiting lists for treatment.