Are you planning on applying for Medicaid? Are you wondering if it pays or covers dental implants, or are you looking for a way(s) to access Medicaid for your dental implant needs?
This article will help. It mainly focuses on the question: does Medicaid cover dental implants?
Does Medicaid Assistance Cover Dental Implants?
This guide highlights the joint federal & state government healthcare program for low-income persons and their families.
Not only is the question answered, but we’ve also touched on other equally important and related aspects of oral care coverage. You’ll want to stick around for all the juicy details.
Medicaid: An Overview
Before we get into specifics on what aspects of oral health are covered by Medicaid, we must have an overview of the program. Under Medicaid, essential healthcare services, including home health services, preventive care, and doctor visits, are covered.
Medicaid also covers prenatal & maternity care, hospital services, vision & dental care, laboratory & X-ray services, and preventive care.
Based on the few coverage areas mentioned, it’s clear that oral health is one of several key areas covered by Medicaid.
What Dental Implant Procedures Entail
While discussing the extent of Medicaid coverage for dental implant procedures, it’s necessary to know what these procedures entail.
First off, there are two types of dental implant procedures; endosteal (which translates to “in the bone”) and subperiosteal (on the bone).
Of the two dental implant surgery types, endosteal is the most invasive as it requires the surgical insertion of titanium implants into the jawbone. Of course, holes will be drilled into the bone to fix the implant post.
Before the procedure, there’s careful planning.
One of the main reasons why people inquire about Medicaid coverage for dental implant procedures is the cost involved. Speaking of costs, they can vary widely between $1,500 and $15,000.
For many, this amount will be considered prohibitive. Programs like Medicaid significantly subsidize such costs.
Will Medicaid Pay for Dental Implants?
Now, are dental implants included or covered under Medicaid funding? There’s no straight answer to this question due to several reasons.
One of those concerns is the fact that coverage criteria vary by state. In other words, some states may have dental implant provisions under Medicaid.
With this explanation, we can say Medicaid coverage for dental implants depends on your state. You’ll recall that we mentioned earlier that federal and state governments jointly fund Medicaid.
Due to this fact, certain factors may come into play that might affect the level of funding or commitment by a state.
Budget constraints or state policies might affect Medicaid funding for dental implants. Also, each state has its public health priorities. With these factors in play, you may enjoy Medicaid funding for dental implants.
The opposite is also true for some conditions.
Does Medicaid Cover Dental Implants in My State?
It can be challenging when seeking information on states with comprehensive dental implant coverage provided by Medicaid. This is due to several reasons that include updated information which might be due to changes in policies, amongst other things.
You’ll need to contact your state’s Medicaid office for detailed information on oral care provisions.
While that is actual, states offering dental implants under the program (Medicaid) include Arizona, California, Colorado, Connecticut, Delaware, Florida, and Georgia.
More states offering dental implant procedures under their Medicaid programs include Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, and Maryland.
Others include Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Mexico, New York, and North Carolina.
You can also access dental implant procedures under the Medicaid program in states like Ohio, Oklahoma, Oregon, Pennsylvania, and Rhode Island.
More States include South Carolina, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, and Wisconsin.
Coverage for Dental Implants under Medicaid isn’t Automatic in States Mentioned
While getting access to dental implant procedures under Medicaid in the states mentioned is possible, we must state that this isn’t automatic. In other words, multiple factors will determine if you’re qualified or not.
First off, such coverage is usually limited.
Also, whether you belong to a vulnerable population such as pregnant women or children will be considered. Dental implant coverage under the Medicaid program may only be possible when the condition is medically necessary.
What are the Criteria for Accessing Medicaid for Dental Implants?
While requirements might vary by state, there are essential criteria you must meet to be considered for a dental implant procedure under Medicaid.
In no particular order, these include income eligibility, prior authorizations, proof of comprehensive treatment plans, and specific medical conditions.
Age restrictions and medical necessity are other general conditions to meet. So, what applies to your state?
To figure this out, you’ll need to visit the Medicaid site for further guidance. Here, you get to choose a State, after which you’re redirected to availability, specific requirements, etc.
Besides visiting its official website, you can get more information on the criteria for qualifying by contacting the Medicaid office, reviewing program documents, or consulting with a dental provider.
Any of these processes will lead to finding all the information you need to proceed.
Medicaid Dental Implants for Adults
Does Medicaid cover dental implants for adults? This is another vital question that needs to be fully answered.
Similar to what has been mentioned earlier, dental implants are also limited to adults. Not every state covers such dental implant procedures under its Medicaid program.
The reasons for such constraints in coverage range from states prioritizing essential care and budgetary limitations in addition to limited capacity.
Again, it would be best if you researched your state’s Medicaid funding provisions for dental implant procedures. This way, you have detailed information on what needs to be done.
Does your State’s Medicaid Coverage Include Dental Implants?
Sometimes, you may wonder if your state offers any form of coverage for dental implant surgery and whether you qualify. For the most part, you’ll have to figure out whether it does or not.
If such Medicaid provisions cover dental implants, to what extent does it go? As stated earlier, your best bet is to find out by making inquiries.
Does Medicaid cover dental implants? So far, we’ve seen that it does to an extent. However, not all states extend such coverage to dental implant procedures. So, you’ll need to make inquiries to find answers.