Finding A Dentist Medicaid And The Challenges Of Dentists Medicaid


Many Medicaid recipients probably have trouble locating dentists who accept their insurance. The American Dental Association discovered that in 2015, only 38% of dentists accepted Medicaid. Even when a certain dentist accepts Medicaid, this does not imply that they take part in a particular Medicaid plan. (Medicaid insurance companies frequently offer dental referrals.)

And while the majority of dentists in some states are technically enrolled in the state Medicaid program, an analysis conducted in 2021 by the ADA revealed that a sizeable portion of them either do not treat Medicaid patients or have a very low number of Medicaid patients who are actively seeking care.

To begin with, you must ascertain whether your state has expanded Medicaid eligibility to include adult dental care. Given that Medicaid expansion occasionally appears on election ballots, you might even hear about this on the news.

It is important to get in touch with the Medicaid office in your state or visit their website because each state's coverage varies differently. You should be able to obtain specific details on what is and is not covered there. And keep in mind that only adults are subject to coverage limits. The federal government mandates that all states provide for the dental requirements of children.

The dental element of Medicaid benefits is frequently handled by a managed care program. For instance, DentaQuest is a business that collaborates with Medicaid in more than 30 states. If your state makes use of one of these outside services, they can give you a list of nearby dentists who can assist you. The appropriate program will be put in touch with you by your state's Medicaid office.

When you learn which dentists accept Medicaid patients, you should do some investigating to discover the ideal fit. Based on where they are located and the services they can offer, the list can be trimmed down. Call them and ask any queries you may have. Knowing whether they would assist you in submitting the treatment charges to Medicaid or whether you will have to do it yourself, for instance, is important. Finding someone who is hospitable and kind is also important, especially if you want to bring your kids to the doctor's office for treatment.

Challenges Of Dentists Medicaid
Medicaid does not cover adequate dental care for kids and adults. According to the ADA Health Policy Institute, just 50% of Medicaid-eligible children between the ages of 3 and 17 had recently visited a dentist. According to the National Institute of Dental and Craniofacial Research, one in five adolescents in the US have untreated dental decay, with the majority of them African-American, Hispanic, or from low-income households.

The following are some of the problems:

  • Lack of awareness

Those on Medicaid frequently aren't aware of the dental benefits available to them. According to the ADA Health Policy Institute (HPI), 37.7% of Medicaid enrollees had a misleading impression of what their benefits were in their assigned state, and 31.3% of them were unaware of their dental benefits while on Medicaid.

  • There aren't enough dentists who accept Medicaid

The absence of enough dentists who accept Medicaid is the second problem. According to the ADA, 38%, or around 75,000, of the 200,000 dentists in the US with licenses accepted Medicaid in 2018. According to dentists who participated in a poll by The Wealthy Dentist, Medicaid customers are sometimes reluctant to see dentists because Medicaid can only cover as much as 50 percent of the costs of similar operations as private insurance. Additionally, according to these dentists, Medicaid doesn't provide adequate dental coverage.

Dentists may not be very knowledgeable about Medicaid dental coverage, just as patients may not be. Although Medicaid often pays dentists less than private insurance, this disparity may have little impact on a dentist's revenue. According to the HPI, there is less than a 10% gap between Medicare rates and private insurance reimbursements in places like New York, Delaware, and Nevada.


Post URL:

Back to blog

Isabella Baxter

Written by Isabella Baxter

Expert in the medical industry. Writer | Blogger | Dreamer.