Can You Get Dentures on Medicaid?
This information is current as of June 22, 2022.
Dentures, also called fake teeth, help improve your bite and enhance your smile. What’s more, they can allow you the ability to eat certain foods.
If you receive healthcare through Medicaid services, you may be asking if you can get dentures on Medicaid. Read on to find out more about dentures and learn if dentures are covered by Medicaid.
What Are Dentures?
Dentures are usually made from a bacteria-resistant composite material. Dentures can be resin-based or consist of a mix of resin with metal attachments. The teeth are usually made up of porcelain or ceramic which looks like natural tooth enamel.
Three Popular Types of Dentures
Complete Set of Dentures: A complete set of upper and lower dentures replaces all your teeth. A complete set can use implants that keep the dentures in place. The alternative to implants is a special adhesive that prevents the teeth from shifting.
Partial Set of Dentures: If you’re only missing a few teeth, a partial denture can help prevent the remaining teeth from shifting and keep your jaw properly aligned. Partial sets of dentures are typically made from a metal wire and resin plate that holds the false teeth in place.
Implants/Permanent Set of Dentures: If you need a few or even all your teeth extracted, implants or permanent dentures help replace independent teeth. A proper fit does require your gum tissue and bone to be fully healed and strong enough to support the implants.
Who Needs Dentures?
Dentures help people who have lost some or all their teeth either from decay, an accident, or disease. The American College of Prosthodontists says there are 156 million people in the U.S. who are missing at least one or more teeth. Dentures help if you have lost teeth. There are many reasons people lose their teeth. This could be due to tooth decay or perhaps having poor oral hygiene due to unforeseen circumstances.
According to the American Academy of Periodontology, about 64 million Americas suffer from periodontal disease also known as gum disease – another reason you may need dentures. Gum disease begins as a buildup of bacteria, plaque, and tartar along the tooth and gum lines which worsens when left untreated. Ignoring cavities can turn into bad tooth decay which also creates the need for dentures.
Some think dentures require a lot of maintenance or that they’re uncomfortable. This isn’t always the case. Yes, dentures take some getting used to, but the benefits are much greater than any temporary discomfort. However, opting for dentures is a decision only you can make along with the advice of a dental professional.
What Is Medicaid?
80.4 million Americans are covered by Medicaid health coverage. Those eligible for Medicaid are:
- Low-income adults and children
- Pregnant women
- Elderly adults
- People with disabilities
Medicaid is managed by states, according to federal requirements. The Medicaid program is funded by both states and the federal government.
What’s the Difference Between Medicare and Medicaid?
Many people are easily confused by the terms Medicare and Medicaid. The difference between Medicaid and Medicare is that Medicaid is managed by your local state government and is based on your income. Medicare is handled by the federal government and is based primarily on your age. If you become disabled or have other special circumstances, younger adults can receive Medicare.
Can You Get Dentures on Medicaid?
Depending on the state, some Medicaid plans pay for dentures, also known as restorative care or false teeth. However, there are limitations. About 17 U.S. state Medicaid plans will not cover or pay for dentures. Here is a list of which states cover dentures on Medicaid.
Can You Get Dentures on Medicare?
Most dental care—like cleanings, fillings, tooth extractions, dentures, dental plates, or other dental devices—isn’t covered by Medicare. Certain dental services you receive while in a hospital will be covered and paid for by Medicare Part A, which is Hospital Insurance. If you need emergency or complicated dental procedures, even though it doesn’t cover dental care, Part A can pay for hospital stays.
For example, effective December 1, 2018, Florida Medicaid covers the following dental care:
- Additional exams
- X-rays
- Extractions
- Screenings
- Cleanings
- Fluoride sealants and fillings
According to the Florida Medicaid site, “For the disabled, a free visit to the facility prior to dental work is covered as an opportunity for people with disabilities to become comfortable in the environment before undergoing the procedure.”
How Much Do Dentures Cost?
Without insurance, the average cost of dentures is approximately $2,000 for a traditional, full set of dentures. Depending on the dentist, lower-priced dentures can cost anywhere between $300 and $500 per plate. A complete set of lower and upper dentures can cost between $600 to $1,000. Lower-cost dentures are made with inexpensive materials and will not look as realistic as your teeth.
A complete set of higher-quality dentures can cost between $1,000 and $3,000—a single denture plate is typically priced between $500 to $1,500. The materials are higher quality, last longer, and look more authentic and closer to your real teeth.
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