Dental Insurance for Medicaid: What You Need to Know

The information in this post is accurate as of October 20, 2021.

Did you know that the health of your mouth and the health of the rest of your body are closely related? Good dental care is essential to the overall well-being of a person.

Regular dental check-ups, in combination with brushing and flossing your teeth, help keep all kinds of painful, expensive, and debilitating conditions at bay.

Unfortunately, gaining access to dental care is a huge challenge for many Americans. Going to the dentist is costly, and not everyone can afford this basic care. This lack of access can form a vicious cycle as problems that could be avoided with routine care can become much larger and more complicated. Up to eighty percent of Americans delay dental care, even with the knowledge that doing so will cost more in the long run.

The good news for those who are unable to access care due to financial reasons is that there are some grants and programs that may assist in providing dental insurance and services, including Medicaid. 

Read on to get information about receiving dental care through Medicaid, as well as some other suggestions for getting your oral health or that of someone you love back on track.

Can You Get Dental Insurance Through Medicaid?

This is the big question. Dental insurance is a bit tricky through Medicaid. 

For most individuals under 21 years old on Medicaid, dental services are an essential part of the program’s Early and Periodic Screening, Diagnostic and Treatment (EPSDT) component. This means that if you have a child or children, you can probably access dental care for them.

Each state guides how often a child should see a dentist under Medicaid. You can ensure that your child is receiving all available benefits by checking out your state’s Medicaid profile

Regarding adults aged 21 years and older, this is where it can be complicated. That’s because each state determines whether or not their residents receive dental coverage through Medicaid. 

Most states provide emergency dental services, but very few states provide a comprehensive dental plan.

Children Dental Benefits

Before diving deeper into the dental benefits a child receives through Medicaid, it’s important to note an oral exam during a visit with a physician isn’t considered for the child’s mandatory oral check-up. To cross this off the list, the child must visit a state-approved dentist

Dental services provided to children through Medicaid include services needed to maintain proper oral health, tooth restoration, and pain relief. In addition, other specific benefits are provided if ‘medically necessary.

States determine what specific services are deemed medically necessary. If a medical issue is discovered during an official Medicaid screening, the state must provide treatment even if the service isn’t a Medicaid benefit.

Critique Around the Policy

Understanding how to get medical insurance and dental coverage is a frustrating process for many. Many low-income families on Medicaid have discovered an extra layer of frustration around the lack of dental services for adults. 

If you’re critical of your state’s Medicaid dental coverage, you’re not alone. As a result, there’s a significant push for Medicaid to extend its dental coverage. Health Policy Hub even showed that Medicaid could save $273 million in healthcare spending by extending dental services. 

A lack of adult Medicaid dental services leads to many dental emergencies, including infections. Some dental infections are life-threatening, sending individuals to the ER. Patients are then left with the question, “How do you bill medical insurance?”

Many believe this situation can be avoided by states providing better dental coverage.

Why is Oral Health Important?

Oral health includes care of the teeth, jaw, and craniofacial bone structures. This area of our body allows us to chew food, smile at friends, speak properly, and swallow our favorite drinks. 

Preventative and treatment services are needed to address gum disease, cavities, mouth cancer, tooth pain, and tooth decay. If these things are left unaddressed, their effects could be lifelong and fatal. 

What’s Preventing Many Individuals From Receiving Oral Care?

When understanding the importance of oral health, it’s also essential to consider the factors prohibiting many individuals receiving preventive and treatment services. 

One of the most significant factors keeping Americans from care is the cost of dental services. Having a tooth pulled or receiving jaw surgery is incredibly expensive. 

If you don’t have insurance or dental benefits on your insurance plan, you either go without care or pay out-of-pocket. Paying out-of-pocket often includes taking out a loan or borrowing money from a friend or family member. 

Other factors keeping many Americans from receiving proper dental care may include lack of education regarding oral health, dental anxiety, and racial inequality

What Can I Do at Home to Improve My Oral Health?

Luckily, there are simple things everyone can do at home to improve their oral health and avoid serious issues. Even if you haven’t kept good habits before, there’s no time like the present to start.

Getting into the habit of brushing your teeth twice per day and flossing daily improves oral health. Make your teeth and gums happier by avoiding tobacco of any kind, large amounts of sodas and sweets, and too much wine. In the case you do indulge, it’s best to brush your teeth shortly after eating. 

Making a daily habit of these good practices will pay huge dividends over time by preventing future problems.

Medicaid Eligibility and Enrollment

Do you need to enroll in Medicaid? Or do you need a little bit more information? Then, let’s dive deeper into Medicaid. 

Who is Eligible?

Those eligible for Medicaid enrollment include citizens 65 years and older, low-income adults, pregnant women, and people with disabilities. Checking to see if you’re eligible is as simple as hopping online. Even if you’re not eligible for the federal program, you may want to go ahead and apply anyway. You may still be eligible for a state program. 

How Do I Apply?

There are two different ways to apply for Medicaid. 

Your first option is contacting your state’s Medicaid agency. They’ll answer your questions and aid in the application process. 

The second option for applying is completing an application through the Health Insurance Program. Start by setting up an account and login information. 

Other Ways to Receive Dental Assistance

If you’re not approved for Medicaid, don’t lose hope! There are other routes to take for receiving dental assistance or help with paying dental bills. 

Dental Grants

Low-income adults can apply to a variety of dental grants.

When researching grants, it’s essential to understand all of the requirements and needed documentation. 

Does your child need dental work? Then, you’re able to apply to the Access to Care Grant. Families can receive up to $20,000 to care for their children’s dental health. 

A multitude of states offers state-exclusive dental grants. Google the name of your state alongside the phrase ‘dental grants’ to see what’s available. Local dentist offices may also have information regarding available grants. 

Help From the NAFC 

The National Association of Free & Charitable Clinics offers dental care as a part of their clinic services. They also offer mental health care, vision care, immunizations, physicals, and testing. 

If you need healthcare services, including dental services, use their online tool to find a nearby clinic. 

Other Helpful Resources

An excellent online resource for finding free or low-cost dental care is the NeedyMeds site. All you need to do is provide your state and address to locate clinics near you. 

To find dental student programs that may be able to provide free or low-cost help, look at the American Dental Education Association’s state directory. In addition, some students need supervised hands-on practice and can offer assistance. 

If you or your child needs braces, some orthodontists offer free or highly discounted services through foundations such as Smiles Change Lives.

With some research and a little help, you may even locate pro bono dental services in your area!

Saving Money in Other Areas of Life

Have you been spending money on other emergency expenses? This cuts down on your dental budget. 

Finding resources to help with areas outside of dental care will provide more financial freedom when a dental disaster strikes. Search out free baby supplies, food assistance, and utility bill money by turning to community-based charities. 

If charities such as Catholic Charities, Salvation Army, United Way, and Feeding America are near you, speak to a company representative about the help they’re able to offer. Many of these charities offer grant opportunities and free resources. 

The internet also provides free financial resources on how to budget and build your credit! Again, small steps foster significant results. Great online financial resources include free financial courses on Coursera and Clever Girl Finance.

Your nearest community center may even offer free courses on building credit and managing debt. It never hurts to ask.

Dental Assistance Made Affordable

Are you struggling to pay for much-needed dental services? There’s help available with options such as receiving health insurance through Medicaid or pro bono dental services.

The resources mentioned above can help you locate accessible and affordable dental resources for you and your family. In addition, some state and federal programs even offer dental assistance grants. 

When creating a better future for yourself, investing time into the small steps now will move mountains down the road. No effort is wasted when flossing your teeth or learning to build your credit, create a budget, and get rid of debt.

Save Money on Your Wireless Phone Service

If you qualify for Medicaid, you also qualify for Lifeline service. Lifeline is a federal benefit program that makes it possible for low-income consumers to receive access to free or heavily discounted communication services. Click here to find out more and apply for this valuable benefit.

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