Medicaid, a government program which provides some health care services to low-income Americans, provides dental care in some cases, but not all. The coverage rules vary, depending on the age of the individual, and the state in which he or she resides. Several proposals to reform the Medicaid policies surrounding dental care have been presented, including a push for more complete coverage.
Proper dental care can be critically important. Oral pain cause extreme pain and suffering, along with lost productivity and missed days of work. Certain oral problems can also cause complications such as systemic infections which may turn deadly if not treated. In states which provide more extensive dental coverage, the focus is often on routine preventative care, as this saves money in the long term by addressing dental problems early or preventing them from emerging.
All individuals under 21 who are on Medicaid have their dental services covered. Individuals over 21 can access varying levels of coverage, depending on the policies in their state. Alaska, Arizona, Hawaii, Maine, Michigan, Nevada, New Hampshire, Oklahoma, South Carolina, Tennessee, Virginia, Wisconsin, and Wyoming provide care primarily in emergency situations. Some of these states cover emergency dental surgery, while others only cover basic critical care.
Residents of California, Connecticut, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Minnesota, Mississippi, Missouri, Montana, Nebraska, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, South Dakota, Texas, Utah, and Washington can access more extended dental services. Each state on this list has some specific restrictions, such as the number of visits in a year, or a copay requirement, but these states generally offer preventative care, such as regular dental exams and cleanings. Some states exclude emergency care, under the argument that dental emergencies should not occur with routine maintenance.
Specific details about the dental plan offered under a state's Medicaid plan can be obtained from social workers. As a general rule, patients must use a dentist who has been approved as a provider, and he or she may be expected to obtain a referral from another provider for specialty services such as dentures and orthodontic gear. A list of Medicaid-approved dentists can usually be obtained from the agency which handles Medicaid applications and claims, and it is a good idea to enroll early with a dental provider, since some dentists limit the number of new Medicaid patients they will accept in a year.