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Medicaid Dental Insurance Plans

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Medicaid is the health insurance program run by the US government for people with low income across the nation. The program covers a wide range of health services including dental care and ensures that enrollees can afford it. Based on federal-state collaboration, the program covers 1 in 5 Americans.

Medicaid Dental Insurance Plans include medical assistance as part of a comprehensive set of advantages known as the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) advantage for all youngster registrants.

Dental treatment is a key piece of the EPSDT benefit for most Medicaid-eligible individuals under the age of 21. Let’s explore the dental care covered under Medicaid dental insurance plans.

Dental Coverage under Medicaid Dental Insurance Plans

Each state must create a dental consistency timeframe in collaboration with recognized dental organizations involved in child health care. Dental services for children eligible for EPSDT may not be limited to emergency services.

All services must be provided if clinically indicated, according to the EPSDT benefit. Healthcare requirements are decided by states. If a condition requiring treatment is

discovered during a screening, the state is required to provide the necessary services to treat that condition, regardless of whether these facilities are covered by the state’s Medicaid dental insurance plan.

Children’s dental facilities should include:

  • Pain and infection relief
  • Teeth restoration
  • Dental health maintenance

Dental services must be provided at appropriate intervals that meet dental professional standards, as well as at other intervals indicated by clinical indication, to confirm the presence of a presumed infection or disease.

Oral wellbeing is an essential part of overall well-being. Though oral screening may be part of a physical exam, it is not a substitute for a dentist-performed dental examination.

Every child must be referred to a dentist following the state’s periodicity schedule. The schedule for other EPSDT services may not be constrained by the time frame for dental services.

Adult Medicaid applicants receive dental coverage at the discretion of the states. While the various states offer urgent dental care to adults, less than half reportedly offer complete dental services. Adult dental coverage has no minimum requirements.

You can call the Medicaid helpline number directly to know more about the dental care coverage under your Medicaid program. You can also visit the official website of the Centers for Medicare and Medicaid Services (CMS) to connect with your local Medicaid office.