Individual state Medicaid programs aren’t required to offer any dental coverage to adults. So the question of whether or not Medicaid covers the cost of dentures will depend on the state in which you live.
Some states offer no dental coverage at all to adults or only in emergency situations. Some states provide some basic services, while a dozen state Medicare programs offer some more advanced dental benefits that include dentures.
Below is a look at the 12 states where Medicaid may cover the cost of dentures.
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Medicaid covers dentures when prior authorization is granted.
Arizona Medicaid beneficiaries have a $1,000 annual allotment for preventative care services, which includes dentures.
Medicaid beneficiaries in Arkansas can receive one set of covered dentures (partial or full) in their lifetime.
Dentures are categorized as a therapeutic device in the state of Idaho and are thus covered by Medicaid.
Both partial and complete dentures are covered by Medicaid in Louisiana.
Partial and full dentures are covered by Michigan’s Medicaid program.
Montana’s Medicaid program covers dentures, and the cost is not applied to the program’s annual spending limit.
Dentures are covered by Medicaid in Nevada when determined to be an emergency service.
Medicaid beneficiaries in New York can have dentures, oral surgery and periodontal services covered.
Dentures are a covered expense in North Carolina with no annual spending limit.
Dentures are covered in North Dakota, but only for children under the age of 21.
Dentures are covered in South Dakota and are exempt from the annual spending limit.
Each state Medicaid program is required by the federal government to provide a minimum set of dental benefits for children under the age of 21. These federal minimums do not include dentures.
However, each state may offer additional dental benefits to children on top of the federal requirements. While only North Dakota explicitly mentions dentures being included in its child dental benefits, there may be other states where dentures may be covered. If your child needs dentures, it’s recommended that you contact your state Medicaid program directly for assistance.
Medicaid beneficiaries who are also eligible for Medicare may be able to enroll in a certain type of private Medicare plan called a Medicare Advantage Special Needs Plan. These plans are designed for people with certain health, living or financial circumstances, and one of the available plans is a Dual-eligible Special Needs Plan (D-SNP).
These plans are designed for people on both Medicare and Medicaid and feature a set of benefits that cater to those specific needs.
If you are eligible for Medicare, speak to a licensed insurance agent to find out if Dual-eligible Special Needs Plans are available in your area and how they might cover dentures and other dental benefits.
Speak with a licensed insurance agent
Christian Worstell is a senior Medicare and health insurance writer with MedicareAdvantage.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.
Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.
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