Does Medicaid Cover Dental
The healthcare niche in the United States consists of many types of healthcare insurance coverage, including the federal, state and private sector. Medicaid is one of the most accessed government healthcare programs, aimed at providing medical services to the low-income citizens. This includes dental services of certain type. Yes, Medicaid covers dental healthcare services but of a few types only. The coverage is not very comprehensive and is based upon the age of the individual and the state of residence.
As per Title XIX in the Social Security Act of Medicaid, dental care services are optional for individuals aged 21 years and above. As a part of the EPSDT (Early and Periodic Screening, Diagnostic and Treatment), dental services are usually mandated for most individuals younger than 21 years. EPSDT refers to the child healthcare services provided as a part of Medicaid.
There have been many efforts to include a wider range of dental services under Medicaid since dental problems have been acknowledged serious enough to cause loss of wages and can lead to serious infections. Some states provide a basic form of dental coverage. This includes preventative dental check-ups as this helps to avert serious dental problems.
In states which provide more extensive dental coverage, the focus is often on routine preventative care, as this saves money in the long term by addressing dental problems early or preventing them from emerging. In such states, dental services for all those under the age of 21 are covered. This includes various levels of dental care depending upon the manner in which Medicaid coverage has been extended in their state of residence.
For instance, in states like Alaska, Hawaii, Michigan, Oklahoma, Virginia and Wisconsin emergency dental care services are covered as a part of Medicaid. Similarly, some states also cover dental surgeries along with emergency care while some only provide basic or critical care dental coverage. More comprehensive dental care Medicaid coverage is found across states like Indiana, Kansas, California, Kentucky, Louisiana, Massachusetts, Missouri, New Jersey and New York. This doesn’t mean that Medicaid covered individuals can seek dental care of any time in these states. The coverage is defined by certain stipulations. This includes the number of clinical visits that can be made in a year for dental care or other requirements like co-pay. The amount of co-pay can vary a lot across these states. Among most states, finding Medicaid coverage for regular dental examinations or routine (basic) dental treatment is assured.
Information about a state’s Medicaid dental plans can be found in the office of social security workers. There are some basic mandates in this niche. For instance, the dental care provider chosen by the patient should have been approved as a licensed dental health services provider. Similarly, some states might stipulate that the attending medical care provider or the dentist should have a referral from another provider to underline the need for dental care. This includes referrals from specialists handling orthodontic procedures or dentures.
Before seeking dental services as a part of Medicaid, it is better to gain comprehensive information such as a list of Medicaid-approved dental care practitioners in the area, Medicaid application forms and information about the kind of dental care services that can be accessed.