Dental Plans – An Alternative or a Supplement to Medicaid

What is Medicaid?

Don’t confuse Medicaid with Medicare. While both of them are federal health insurances by the government, there are differences in the target audience, income-class and coverage offered to patients under each program.

Medicaid is:

  • A state health program which aims to provide necessary medical attention to people with low income families. Medicaid is more comprehensive in its coverage; it offers several benefits that Medicare doesn’t such as nursing home facilities and some dental work.
  • Funded by both the federal government and state governments. The services, coverage, and eligibility for Medicaid is up to the states to decide which is why there is a vast difference in the packages provided under Medicaid in different states.
    Speaking specifically of dental benefits,
  • Can generally only be used to pay for emergency procedures, while 17 of the states provide comprehensive dental care under Medicaid.

This means that the benefits you can gain from Medicaid are entirely dependent on the state you live in.

Woman getting an oral exam by a dentist

Medicaid for Children

States are required to provide dental care to all children enrolled in the program. Children enrollees are eligible to receive basic oral screening under a physical exam, as well as a proper dental checkup when deemed necessary.

The basic dental facilities that have to be provided to children include dental pain relief, teeth restoration, and oral health maintenance. If a serious condition is observed in a screening, the state is bound to treat that condition.

Medicaid for Adults

While it is required by the law to provide nearly all medical care procedures to children under Medicaid, states are given the liberty to decide if the benefits are to be extended to adults or not. In case they are, what sort of coverage Medicaid gives to adults is also the state’s decision. That is why Medicaid coverage differs a lot across the country.

If you were planning on enrolling on one, you should read about the Medicaid package in your particular state first. Some provide almost all dental work under the program, while most just provide emergency work.

Dental Works Covered by Medicaid

As discussed earlier, Medicaid provides emergency dental care in almost all states.

This includes emergency extraction or pain relief, treatment for infections, or bleeding gums. Any dental emergency arising due to injury or the presence of another disease elsewhere would also fall under emergency dental work.

In the states that do provide somewhat comprehensive treatments, the dental works that are available under Medicaid are as follows:

Basic Care – Medicaid pays for basic dental care across the country.

Preventative – Works like regular visits to the dentist, checkups, cleaning, X-rays, and sealants are covered by Medicaid in 27 states.

Crowns – Crowns are covered by Medicaid in 26 states, however only the least costly type of crowns are included in the treatment.

Braces – Medicaid pays for braces if they are needed because of a disease or injury.

Periodontal – Medicaid covers periodontal treatments in about 18 states. Bone grafting and gingivoplasty are offered to enrollees in those states.

Root Canal – Up to a certain monetary limit or with some specific teeth, root canals are covered by Medicaid in 26 states.

Oral Surgery – Corrective jaw surgery or wisdom tooth extractions are just some of the procedures that you can utilize under Medicaid if your state allows oral surgery.


The Coverage Gap

There is a big chunk of society that is left without any support in their dental works. This is called the coverage gap.

A lot of states have expanded their Medicaid coverage to include more and more people who might be in need and deserving of it, but were not covered by it due to the previous cut off of 133% poverty. Various states have adopted the expansion, but some still haven’t. This creates a coverage gap, where the people who can afford it opt for expensive dental treatments and the ones below the cut off are covered by Medicaid. The group in the middle, however, is left to its own devices. These include people those who are not poor enough for Medicaid and not wealthy enough to afford regular treatments.

Additionally, if we take into account people who live in states that do not pay for dental works beyond emergency treatments, you might be wondering who looks out for them?

The unfortunate answer is that most of them eventually start to overlook their oral health and avoid treatments merely because of the costs involved that are too heavy on their pockets.


Dental Plans As An Alternative, Or Supplement To Medicaid

Fortunately, there are still several options for those in the coverage gap to choose from. Various types of dental plans exist that serve to facilitate the people who are not covered by government aided insurances so that they can maintain their oral health without having to worry about inflated dentist fees.

Dental discount plans or dental savings plans make your life easier by taking some of the load off the dental charges. This way you can keep up with your regular dental checkups and not compromise on your dental needs.

  • Dental plans are convenient and have no lengthy processing times.
  • It is as simple as enrolling into a dental plan, going to dentist who accepts the discount plan, and receiving your needed treatment at discounted rates.
  • The discounts vary from 10%-60%, depending on the complexity of the dental work. An annual, reasonable charge applies that you need to meet.

Dental plans are the answer to the people who lie in the coverage gap. You can also subscribe to a dental plan even if you are already receiving Medicaid. The plan could be used to supplement Medicaid in states that do not pay for more than emergency dental procedures. Dental plans can help you save hundreds of dollars in a year, and you would not need to skip on your dentist visits because of the dreaded dental charges.

Here at Dental Plan Provider we can help you look for affordable dental plans in your area and weigh them against each other to decide on one that is best suited to your needs.

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