Do Medicare & Medicaid Cover Dental Care?

Currently, 55 million older Americans access healthcare services through Medicare, of which 4.6 million are also Medicaid participants.

But did you know that traditional Medicare does not cover routine services such as screenings, exams, cleanings, fillings, extractions or dentures?

For Medicaid, the dental coverage for adults varies by state — many states will only cover emergency dental services, and 4 provide no dental coverage whatsoever.

Medicare Advantage & Private Dental Insurance

If you were unaware that Medicare doesn’t include a dental benefit, you’re not alone: Oral Health America’s 2015 Public Opinion Poll found that 52% of people aged 50 and older — regardless of income or education — either didn’t know dental wasn’t covered under Medicare or incorrectly believed that it was.

This means that most seniors must rely on either Medicare Advantage plans or private insurance to get dental coverage. However, these insurance plans (both Medicare Advantage and any private plan) won’t always save you money.

If you’re considering private insurance, research the available discounted and Medicare Dental Advantage plans in your area to see if they are affordable. Look closely — many plans won’t cover enough dental services to justify what you pay in yearly premiums. These plans may also require waiting periods before you can receive coverage.

Your plan may also limit your choice of dentists. When shopping for insurance, talk to your dental office about what plans they accept so you won’t be surprised.

Medicaid Dental Coverage: Different in Every State

Medicaid is a Federal-State partnership that provides healthcare coverage for about 4.6 million low-income seniors under federal law.

Dental benefits are not covered nationally in Medicaid, and are optional in state programs. This means that states may choose to include (or not include) dental benefits for adults in their Medicaid programs, and also decide what level of coverage they will provide.

Most states provide emergency dental services, but 4 states provide no dental coverage whatsoever and only 17 states provide comprehensive dental coverage.

Contact your state Medicaid office to find out if you are eligible for dental benefits under Medicaid.

State coverage of Adult Medicaid Dental benefits. Produced by the Center for Healthcare Strategies.

Visit Medicaid.gov for official information on dental coverage in Medicaid. This article was informed by Oral Health America’s A State of Decay report and the May 2017 fact sheet, “Medicaid Adult Dental Benefits: An Overview” produced by the Center for Healthcare Strategies.

About the Author

Oral Health America
Oral Health America’s mission is to change lives by connecting communities with resources to drive access to care, increase health literacy, and advocate for policies that improve overall health through better oral health for all Americans, especially those most vulnerable.

The information on this article is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Tooth Wisdom® and Oral Health America do not recommend or endorse any specific dentists, products, procedures, opinions, or other information mentioned. See full Terms & Conditions.

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