What Is Dentists' Medicaid?


Medicaid is a health insurance scheme that provides low-income individuals and their families with free or low-cost coverage. It is supported by the federal government as well as individual states. The federal government dictates which healthcare expenses must be covered. Adult dental care, on the other hand, depends each state.

Anyone younger than the age of 21 who is on Medicaid and lives in any state can obtain most dental services. It offers a comprehensive set of benefits to children known as EPSDT (Early and Periodic Screening, Diagnosis, and Treatment). Dental needs can be met once a parent locates a Medicaid dentist for their child.

What Are The Benefits of Dentists' Medicaid?
Before enrolling in any health plan, it's a good idea to understand the coverage and benefits. Here are some examples of dental care that you should check to see if your plan covers:

  • Silver fillings for back teeth
  • Dentures, partial dentures
  • Root canal treatment for certain teeth
  • X-rays, check-ups, and cleanings every six months
  • Pulling teeth
  • Crowns (porcelain crowns for certain populations)
  • Removal of the pulp (soft inner part of the tooth) when infected
  • Space maintainers for minors with missing teeth
  • Some orthodontic care for children
  • Emergency exams for immediate onset of pain

What Are The Limitations of Dentists' Medicaid?
Oral health is an important component of overall health, but low-income people face significant barriers to dental care when compared to high-income people. When compared to medical care, prescription drug services, mental health care, and eyeglass services, more people, regardless of age or income, reported not receiving needed dental services due to cost.

Racial disparities in dental care available for children have shortened over the last decade, but Black and Hispanic children are somewhat less likely than White children to visit a dentist.

Limitations of Being A Dental Medicaid Beneficiary
The majority of Medicaid recipients are unaware of their dental benefits. According to the ADA Health Policy Institute (HPI), 31.3% of Medicaid enrollees were unsure of their dental benefits while on Medicaid, and 37.7% had a misconceived notion as to what their benefits were in their designated state.

Challenges Dentists Face in Medicaid
Earning good pay while caring for Medicaid patients can be difficult for the average dentist. Numerous private practices are not able to admit Medicaid patients because the reimbursement rate remains significantly lower than that of private insurance. Furthermore, the Medicaid training, certifications, and the claims process is extremely time-consuming and it would necessitate an additional trained team to manage the administrative aspects. In addition to these challenges, small practices with a limited number of Medicaid dentist find it difficult, if not unattainable, to bear the losses from missed appointments, which occur at a significantly higher rate for Medicaid enrollees than for commercial patients. This is mostly because the targeted population most likely does not have the resources to be present all the time. Dentists want Medicaid to help with this by providing care management, which reminds them of their appointments with their dentist and ensures they have transportation.

1. https://pubmed.ncbi.nlm.nih.gov/27920304/
2. https://www.dentaleconomics.com/practice/article/16389731/how-to-make-medicaid-dentistry-work

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Isabella Baxter

Written by Isabella Baxter

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