Medicaid Dental Providers Near Me - The Medicaid Adult Dental Coverage Checker is an interactive tool for policymakers, administrators, and advocates to easily understand where a state's adult Medicaid dental coverage ranges from no dental coverage to significant coverage, helping to identify areas for improvement and expansion. It considers the coverage of specific procedures and services including the frequency allowed in eight categories of services.
The Coverage Checker reflects self-reported results from state Medicaid dental facility managers or their equivalent in a survey conducted in the spring of 2023. The data is a snapshot in time and reflects the benefits package effective December 31, 2022. It's important to note that as early as 2023, many states implemented new and expanded benefits for all seniors who don't appear on the checker. Find information about these newly expanded benefits in the pop-up tool for each state on the dashboard below.
Medicaid Dental Providers Near Me
Consumer Disclaimer: This dashboard is intended as a resource for Medicaid agencies, legislators, policymakers, and advocates. It is not intended as a resource for consumers or Medicaid beneficiaries. The procedures and dental codes included in the survey and evaluated—displayed here—are intended to represent the hundreds of dental procedures contained in the current ADA Dental Terminology code set. The sample is not exhaustive and should not be considered a complete package of benefits. We recommend that you contact your state Medicaid agency for information on Medicaid benefits for seniors.
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In 2008, during the recession, the state eliminated all non-emergency dental benefits for adult Medicaid beneficiaries. After that, adult beneficiaries only do pain management and tooth extraction. Human rights activists have long called for the restoration of benefits and have repeatedly worked to improve legislation to do so.
Hawaii's new Medicaid dental coverage goes into effect on January 1, 2023. The Hawaii Department of Human Services, a division of Med-QUEST, announced that it will cover oral disease prevention and control, including dental procedures such as cleanings and X-rays and fillings. Coverage will also include masticatory restorations, which may include root canals, crowns, and/or dentures, depending on the individual case.
After years of hard-fought advocacy and incremental expansion, the Maryland Legislature approved SB150 on April 6, 2022, establishing Medicaid for all adults. The Legislature included a fiscal note of $66 million for the first six months of the program and $132 million for fiscal year 2024. Governor Larry Hogan signed the bill into law on May 12, 2022. Effective January 1, 2023, all adult beneficiaries will now have access to diagnostic, preventive, restorative, endodontic, periodontal and oral surgical services.
**Until January 1, 2023, the State of Maryland provided a wide range of dental benefits to pregnant adults and foster care individuals under the age of 26 participating in a rare and expensive treatment program. The state also provided a limited payment ($800 per year) through the Medicaid Adult Dental Waiver Program for adults dually enrolled in Medicaid and Medicare.
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In October 2022, the Michigan Department of Health and Human Services (MDHHS) submitted a proposal to redesign Medicaid's dental benefits for adults. In December 2022, the Legislature approved the design change, and in January 2023, MDHHS began implementing improvements by significantly increasing provider reimbursement rates. Effective April 1, 2023, senior dental benefits have expanded to include coverage for X-rays, cleanings, fillings, crowns, root canals, periodontal services, prosthetics, and tooth extractions.
Changes to the program design reflect lessons learned from the Healthy Michigan Plan and dental programs for pregnant women and input from a wide range of stakeholders. In addition to expanded services, MDHHS has made changes to improve beneficiary access and provider engagement, and to expand access to robust care coordination services that ensure beneficiaries are supported in accessing the services they need.
Historically, the state offered Medicaid dental care to its adult beneficiaries only in emergencies. After years of constant advocacy, starting April 1, 2023, the state began offering expanded benefits to all seniors. Diagnostic, preventive, reconstructive surgery, oral surgery and dental are also covered with a maximum annual benefit of $1,500.
The New Hampshire Legislature passed a companion bill in the House and Senate that created dental benefits for all seniors. The new facility is expected to cost approximately $24 million ($6.9 million in state funding and $17 million in federal funding). Part of the state funding will come from a $21 million state settlement with Centene Corp., as outlined in the bills. Governor John Sununu signed the bills into law on July 1, 2022, and the new exemption went into effect on April 1, 2023.
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** Not all adult partners will benefit from dentures. Adults with developmental disabilities, cerebral palsy, seniors, and adults with chronic illnesses or disabilities who participate in the Choice for Independence program can get dental coverage.
Historically, the state has not offered dental care to senior beneficiaries. In January 2022, the state announced that it would provide comprehensive dental care to pregnant and postpartum women from April 1, 2022. In February, Governor Bill Lee released his budget recommendations, which included $75 million ($25 million from general funds and $50 million from the budget). federal funds) to provide dental benefits to all adult beneficiaries. Effective January 1, 2023, beneficiaries of legal age have access to diagnostic, preventive, restorative, endodontic, periodontal, orthopedic services, extractions, and oral surgery.
In addition to including the Governor's recommendation in the approved budget, the Legislature also included funding for dental rate increases and $11.8 million (general funds) to support dental schools to ensure an adequate network of senior care providers from recently purchased dental coverage. The funds will be used to hire and retain dentists through loan repayment and expand orthopedic services at the state's two existing dental schools (Meharry Medical College School of Dentistry and the University of Tennessee College of Dentistry). Additionally, Lincoln Memorial University (LMU) will open a dental school in fall 2022, and the budget includes $3 million to partner with the LMU College of Dental Medicine to establish a pilot program to serve East Tennessee.
**Beginning April 1, 2022, TennCare provides beneficiaries with a pregnancy and postpartum dental care package (12 months after pregnancy). Benefits include diagnostic x-rays and tests; preventive cleaning; topical treatment with fluoride and drugs to prevent caries; restoration (sealing); Endodontics (1 root canal per participant during the relevant period); Peeling of roots, planing; Complete processing of the oral cavity; Crowns (2 per participant during qualifying period); complete set of teeth; direct full teeth, complete teeth; Tooth extraction; Alveoloplasty; Removal of lateral exostosis; removal of the palatine torus; removal of the torus mandibularis; and palliative care. (source)
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*Based on service and procedure codes evaluated in the 2022 rubric. Please note that the procedures and dental codes included and evaluated in the survey are intended to represent the hundreds of dental procedures contained in the current ADA Dental Terminology code set. The sample is not exhaustive and should not be considered a complete package of benefits.
This toolkit includes resources that explain why dental insurance is so important to low-income Americans and materials to review and share with policymakers.
Cuts to Medicaid dental benefits could hurt job growth, increase spending, and affect states in other unexpected ways. Providing dental insurance to adults can improve employment prospects, reduce costly hospital visits, save the state money, and increase children's access to dental care.
"Failure to treat periodontal disease is tantamount to allowing a person's lower limb infection to progress to gangrene, where the ultimate treatment is amputation." Donna Balaski, MD, hopes her analogy — and her research-backed advocacy — will soon reach the ears of state leaders and lawmakers, inspiring them to strengthen Medicaid dental benefits for Connecticut seniors. She knows she can make a far-reaching impact on access, equity and health for people in every corner of the state.
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The Medicaid Adult Dental Coverage Checker doesn't just provide numbers — it tells a story that oral health leaders can tell state legislators. “I think when you first see it, it's kind of shock and awe. It confirms where you are. But once you get past that, you start to imagine how you can use this tool to make a difference,” Jason Roush, MD, director of dentistry in West Virginia, says of the Medicaid Adult Dental Coverage Checker in a new blog post.
It was the tragic death of 12-year-old Damont Driver — a boy who died from an untreated dental infection where deadly bacteria spread to his brain — that first inspired advocates in Maryland to begin the fight to extend dental care to the underprivileged. Children in 2007. As they made significant progress in expanding dental coverage for children in Maryland, the Maryland Dental Action Coalition (MDAC), the leading organization for this effort, then turned their attention to expanding Medicaid dental coverage for adults.
The rubric of the sector has developed a core group and the adviser committee of a core group and the adviser committee of the expert dental benefits of the state Medicaid program. After extensive expansion and restoration
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