Things You May Not Know About Medicaid Dental Benefits

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Best Cosmetic Dentist in Town

Good dental hygiene is vital for healthy gums and teeth. It entails processes such as regular flossing and frequent visits to the dentist for checkups. For high-quality dental treatments such as dentures, implants, and fillings, reach out to Jordan Landing Smiles.

On the flip side, these procedures can be rather expensive, but that’s where Medicaid comes in. Read on to find out things you may not know about Medicaid dental benefits.

What Is Medicaid?

Medicaid was established in 1965 as a public health insurance program targeting low-income households and individuals. The medical cover also includes children, people with disabilities, and even pregnant women. Medicaid receives funding from both the federal and state governments.

It is the most extensive health insurance program within the US. Each state regulates its Medicaid program but within the legal requirements. Consequently, eligibility requirements and benefits may vary according to state.

The Difference Between Medicaid And Medicare

Medicaid is a government-operated health coverage designed for senior citizens over sixty-five and people with disabilities. It consists of four parts:

  1. Hospital coverage: for candidates over sixty-five years. Individuals or their partners need to have paid medicare taxes and worked for up to ten years. 
  2. Medical insurance: candidates who qualify for the first part automatically progress to the second stage. The insurance caters to doctor visits, lab and imaging services, and outpatient care.
  3. Advantage programs: individuals who qualify for the first two parts automatically get through to this third one. Medicare-approved private corporations provide the advantage programs. They include prescription medication and dental care.
  4. Prescription medication cover: it charges monthly rates and out-of-pocket payments for specific medications. Aside from these charges,  candidates also pay an annual deductible.

On the other hand, Medicaid is a federal and state-backed program created for low-income citizens to provide health coverage. It also serves children who require low-cost care even though they earn a significantly larger income than the average low-income rate.

Who Is Eligible For Medicaid?

As of 2018, Medicaid provided health coverage for over ninety million Americans from low-income backgrounds. Any individual who meets the eligibility criteria can apply for Medicaid while states get the assurance of federal monetary support for certain costs in the program.

Below are the groups of people in the US population who qualify for Medicaid:

  • Children up to 18 years who come from families with income below 138% of the federal poverty line.
  • Pregnant individuals with an income below 138 of the poverty level.
  • People with disabilities receive monetary support through the Supplementary Security Income (SSI).
  • Specific parents with meager incomes.
  • Senior citizens.

What Dental Benefits Does Medicaid Offer?

Medicaid offers children in the program a variety of dental services but only if the interventions are necessary. They include:

  • Relief from pain
  • Relief from infections
  • Teeth restoration
  • Maintenance visits
  • Emergency services


Reach out to your local Medicaid representative to inquire whether your state caters for additional treatments such as braces, root canals, or veneers. Children also get access to dental services when necessary to manage the specific condition they suffer from – even if it’s not included in their Medicaid program. 

The health coverage plan also states that the services should be distributed at standard intervals. Adults also benefit from the Medicaid dental program, although the treatment options are optional. As a result, most adults have to wait until their conditions are too severe to ignore to get dental care.

A large majority of states within the US limit dental Medicaid coverage to simple treatments such as extractions or specific populations like pregnant women. The most they can offer to adults is emergency services.

Poor dental health exposes patients to the risk of diabetes, stroke, pregnancy, and birth complications. If left unattended, it can progress to severe conditions such as cancers and infections of the mouth and throat.

What Other Benefits Does Medicaid Provide?

Medicaid offers two types of benefits to recipients under the health coverage: Mandatory and Optional. Under the Mandatory benefits, states are legally obliged to provide the following for eligible individuals:

  • Inpatient and outpatient services
  • Early and Periodic Screening, Diagnostic, and Treatment Services (EPSDT)
  • Rural health clinic care
  • Laboratory and X-ray services
  • Family planning services
  • Nurse Midwife care
  • Transportation to medical treatments

Eligible candidates are free to choose the following services from the Optional benefits:

  • Prescription medication
  • Physical and Occupational therapy 
  • Speech, hearing, and language disorder services
  • Respiratory care 
  • Diagnostic and screening, 
  • Rehabilitation
  • Podiatry care
  • Optometry 
  • Spectacles
  • Chiropractic care
  • Hospice care
  • Inpatient psychiatric services for individuals under 21

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