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Do public programs like Medicaid and Medicare cover dental care? 

Medicaid covers comprehensive dental care for children through the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit, which federal law requires all states to provide to children.

In 2009 a new requirement to provide dental coverage was also added to the Children’s Health Insurance Program that also allows a family to buy just dental coverage for their children if the family has medical coverage but no dental coverage.

Medicaid Adult Dental Coverage expansion map

While states are not required to provide adult dental services under Medicaid, most provide some level of dental services for adults. Only 3 have no coverage at all. (See attached chart from a webinar presentation by DentaQuest, an NADP member plan, in 2016.) There is a strong state-by-state effort to assure Medicaid dental treatment for adults at some level. The two million visits to emergency rooms annually for dental services costs over $1.6 billion; Medicaid pays for about 1/3 of these charges, i.e. $520 million[1].

Traditional Medicare does not cover dental procedures. However, about one-third of seniors buy Medicare Advantage plans rather than enroll in traditional Medicare. According to an analysis by Avalere[2], in 2017 about 63% of Medicare Advantage plans include some level of dental benefit, i.e. about 12 million seniors in MA plans. This is projected to grow to 14 million by 2019. There are also group benefits available to seniors such as AARP’s endorsed group dental program for their members.



[1] Cassandra Yarbrough, M.P.P.; Marko Vujicic, Ph.D.; Kamyar Nasseh, Ph.D.; Estimating the Cost of Introducing a Medicaid Adults Dental Benefit in 22 States, ADA Health Policy Institute, March 2016 Available at http://www.ada.org/~/media/ADA/Science%20and%20Research/HPI/Files/HPIBrief_0316_1.pdf?la=en.

[2] Analysis of CMS data by Avalere was funded by NADP for a webinar broadcast in June 2017.