Medicaid dentist

Deficiency in coverage of dental insurance remains one of the greatest threats to healthcare in the United States and Medicaid provides solution in order to fill this gap. Medicaid is a collaboration between states and federal governments catering for low-income children, the disabled, pregnant women as well as poor elderly. You can get a Medicaid dentist if you fall into any of these categories.


How It Works


Medicaid requires each state to provide a minimum of 50% coverage for medical care of affected people. However, dental benefits have suffered under this arrangement due to scarcity of funds. For children, Medicaid dental care is obligatory and it covers early screening, examination as well as treatment. However, coverage for people who are 21 years old and above is optional, which means you may not be able to access a Medicaid dentist if your state is not covering people who are 21 years old and above.

Every child requires a direct dental referral periodically and the periodic schedule will be fixed by each state. Early and Periodic Screening, Diagnostic and Treatment (EPSDT) recipients are entitled to access to a Medicaid dentist for all Medicaid covered services if the state determines that their conditions are medically necessary. The state is under obligation to treat any condition that is found to require treatment during oral examination, whether such services are contained in the state’s Medicaid plan or not.


How/Where to Apply


States are not under obligation to provide dental coverage for Medicaid-eligible adults. However, majority of the states provide emergency dental services for grown-ups but some of them provide extensive dental care. If you want to get access to a Medicaid dentist in order to get the benefits of Medicaid program, you can apply online if your state allows that, or through the telephone and you can visit designated locations in your area to apply. You can find your local Medicaid office by visiting Medicaid website at Medicaid. gov.


CHIP Dental Coverage


The Children’s Health Insurance Program (CHIP) provides medical care coverage for uninsured children and pregnant women. Whose family income is more than the Medicaid level but not enough for other health insurance coverage. The CHIP guidelines vary from one state to another. And your eligibility depends on your age, state, family size and annual income. If you are eligible for this program. You will get access to a network of healthcare professionals in your state, including a Medicaid dentist. However, during emergency cases, you have the opportunity of using any health facility closest to you.


How Can I Get a Dental Plan on Medicaid?


Getting a dental plan on Medicaid is dependent by age and your state of residence. All state are under obligation to cater for the dental needs of children under the CHIP, at least for dental health maintenance, tooth restoration as well as pain and infection relief. The extensive health benefits for children known as Early Periodic Screening, Diagnostic and Treatment (EPSDT) involves many stages.

The first stage covers the early identification of problems through constant screening which should start at an early age. The second stage covers periodic dental examinations, usually every six months. The third stage covers regular screening tests, including X-rays. So that doctors can identify potential problems quickly. The fourth stage covers diagnostic tests needed to confirm the potential risks. The fifth and final stage covers the treatment of the problems identified.

CHIP Coverage

States covering CHIP must also provide EPSDT benefits but CHIP is more comprehensive. There are several CHIP programs with some covering specific dental services while others cover all services that are essential in preventing diseases, promoting oral health, restoring oral structures and treating emergency situations. As a result of this, almost all dental procedures or services are under cover by CHIP.

States that have different CHIP programs have two preferences. They can either provide all the dental benefits as outlined in the CHIP federal regulations or use a benchmark for the dental package. The benchmark should be similar to the dental plan given to federal worker’s dependants, state employees or most famous plan provided by commercial insurance companies in the state.

These plans stand as a minimum criterion for dental provision so that CHIP children can get access to dental care that other insured children are getting. Each state will post a list of dental packages as well as network providers on its state Medicaid website so that it will be easy for you to find them.

There is a clear regulation for children’s dental health under Medicaid but this is not so for adults. Many states provide emergency dental services but not all of them provides extensive dental coverage for grown-ups. In a  situation like this, you will have to purchase dental packages from the open market. And the cost will be determined by your approximated income. Eligibility for dental coverage for children and adults is determined by eligibility for CHIP or Medicaid. If you are fit for Medicaid, you will have the opportunity of enjoying the benefits of dental services that are covered by your state.




Getting a Medicaid dentist is as easy as ABC if you are eligible for the program. There are lots of them around you. And a little check will give you the opportunity of discovering the right one for you. Your state should be able to give you all the necessary guidance. That will assist you in getting the optimum result from the program. If you cannot afford a dental insurance. You can take advantage of Medicaid in order to get the basic dental care that you require.

You should give your dental health top priority. And it is important for you to take advantage of state resources. So that you will not have financial trouble in fixing your dental issues. Dental issues can deteriorate if not properly handled on time. And that is why you need to be very proactive in regards to your dental health. Being proactive will keep a lot of diseases at a distance. And ensure that you enjoy the best possible oral health.

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