Does Medicaid Help For Dental Care and What Does It Cover?

Section 1331 of the federal law on the Affordable Care Act pushes for the creation of a Basic Health Program (BHP). Why is the BHP important? It’s a health benefits coverage for low and middle-income residents to get health coverage. With the increasing rates of dental issues, many individuals have been wondering if Medicaid can help. Does Medicaid help for dental care and what does it cover? Read through to learn more about Medicaid and if it can cover your dental issues.

MEDICAID CAN HELP ELIGIBLE INDIVIDUALS WITH DENTAL CARE BY COVERING VARIOUS PROCEDURES. WITH THE DIFFERENT STATES HAVING VARYING PROGRAMS, THE COVERAGE IN THESE AREAS MIGHT VARY. IN MOST STATES, THE COVERAGE WILL ONLY COVER AND PROVIDE KIDS’ COMPLETE SET OF EARLY PERIODIC SCREENING, DIAGNOSTIC, AND TREATMENT BENEFITS. WHILE THE DIFFERENT STATES HAVE VARYING OUTLINES FOR THE PROGRAM, IT’LL BE GOOD TO UNDERSTAND IF YOU QUALIFY IN YOUR STATE.

What is Medicaid?

Medicaid is a common federal public health insurance policy in the United States. What is the importance of Medicaid? This policy allows the country’s citizens with particular assets and income ranges to access affordable medical care. What will the policy cover? This program can either pay for some or all medical treatments and procedures.

For instance, the coverage can pay for emergency treatment, hospital care, and preventative therapies. Generally, it’s a program facilitating US residents with low income to access treatments at cost-effective or at no cost. Nevertheless, individuals have been wondering if the program can facilitate or cover dental care costs.

Does Medicaid Cover Oral Treatments and Procedures?

Medicaid is an important policy that can cover dental costs for eligible residents. But does it cover all the procedures and treatments? With this coverage being a state-run policy, the eligibility and procedures it covers depend on the particular state. Thus, in different states, the program can cover dental care and treatment procedures.

As you get old, you become susceptible to numerous problems and oral infections. You require oral examinations and checkups to establish the issue. But will medicare cover your dental examination and treatment? Yes. Medicaid can help you cover your dental procedures or treatments, but the program comes with limitations.

Depending on your state, this health policy or coverage covers a wide range of medical procedures. In some states, authorities allow the program to cover all teeth and mouth procedures. For instance, it can help with complications falling under the oral emergency category, including injuries, severe bleeding, etc. Nevertheless, the eligibility depends on the specific states and your age.

What Procedures Does the Program Cover?

Various dental problems may push you to seek medical intervention. We’ve got a wide range of procedures and treatments you can get after visiting your dentist. But what oral treatments or procedures does this health policy cover? The oral conditions or complications that the policy covers vary between the states.

It’s also good to consider that age is a crucial factor in determining if the policy can cover your oral health complications. In most states, the program covers treatment or procedures that get you ready for surgery or extensive medicine. What are examples of these services? The coverage can pay for your dentures to help manage complications like missing teeth.

Medicaid for Individuals Under 21

The Early Periodic Screening Diagnostic and Treatment is one of Medicaid’s child health programs. What does the program involve? This program focuses on early diagnosis, prevention, and treatment of a wide range of medical or health complications. The federal government reveals that this service is mandatory for children under every state Medicaid program.

The program states that the particular state must provide dental services at specific intervals. What is the best interval for the provision of these services? You must provide the services at proper intervals meeting reasonable oral practice standards. Remember, the particular state will set the standards after consulting with the appropriate organizations.

Experts reveal that the program doesn’t limit these services to EPSDT recipients. You can also get coverage for services like:

● Restoration of teeth

● Maintaining your oral health

● Relief of infections and pain

While oral screening can be part of the physical examination, it doesn’t offer a substitute for your dentist’s examination. You require a direct referral for your kid in accordance with your specific state’s periodicity schedule. However, under the Medicaid program, the state determines EPSDT as a medical necessity. If the experts discover a condition that requires treatment during the process, the state should provide appropriate services or things to treat it.

Medicaid Program for Individuals Above 21 Years

Besides children, some states may provide Medicaid coverage for residents above 21 years. Do all states provide the program? The federal government allows the states to choose whether to give or deny dental benefits to adults who are eligible for the program.

Studies show that most states provide their residents or adults with emergency oral services. Nevertheless, less than half of these states give adults 21 years and above comprehensive oral care. While providing these services, the state doesn’t provide minimum requirements for adult oral issue coverage.

How Does the Medicaid Dental Cover Work?

Across the United States, federal law requires that each state has a comprehensive Medicaid program. This coverage should meet the mandatory criteria that the federal government sets. Do the states have to follow all the set criteria? While federal law sets the minimum requirements, it doesn’t include dental care for adults. The qualification criteria focus on those below 21 years.

After passing this Affordable Care Act in all the states, the authorities can extend the benefits. Extending the benefits allows the state to offer benefits to a large group. Some of the numerous extensions include full oral health coverage, adult dental coverage, etc. Nonetheless, some states are yet to include adult oral health benefits in the policy. Depending on the type of care, and state of residence, you can choose either an emergency, limited, or comprehensive option.

How Can You Find a Dental Specialist Accepting Medicaid?

After being eligible for the program, it’s usually an uphill to find a dentist who accepts this coverage. Remember that not all dentists accept Medicaid patients. Thus, you’ll have to look for the appropriate one who accepts this coverage. Experts recommend that you search around for the appropriate one or ask your primary physician for a referral. Ensure you check credibility and reviews to get an expert who provides the best services.

Takeaway

Medicaid is a comprehensive federal coverage that caters to various health and emergency services. While it offers the best coverage for your needs, you may be wondering if it covers your dental treatment. The benefits of the coverage vary between states and the experts. While some states only offer coverage for individuals below 21 years, others include the adult oral health benefits. Thus, it’ll be important to seek clarification or research on your state-specific laws before you seek the services.