Medicaid is a taxpayer-funded benefit program designed to support low-income families. The federal government established a framework, and each state sets unique rules that apply to residents in their jurisdiction.
Medicaid offers three types of benefits with wide variation by state and age of the patient (adult versus children).
Low-income families enjoy dental insurance with Medicaid most frequently when needing treatment from an oral and maxillofacial surgeon because their procedures often fall into the medically necessary category.
However, finding an oral surgeon that accepts Medicaid gets tricky depending on the type of procedure needed and the benefits supported in your state. Learn the starting point.
Two factors determine whether you can find an orthodontist in your area that accepts Medicaid: the reason for treatment and the person’s age needing braces.
You will not find a provider if Medicaid does not pay for treatment. For instance, adults will need a medically necessary reason, while a handicapping malocclusion will suffice for your teenager or child.
Finding out that Medicaid may cover specific dental procedures is like winning the lottery! There are a few winners, with many walking away empty-handed. It takes detective work to figure out which group describes you.
Every state issues different rules. Certain principles apply across the country. Pregnant women, disabled adults, and low-income seniors enjoy expanded access.
The difference between paying for dentures with and without insurance is staggering. Low-income patients wanting to improve their smiles and employability might not afford to replace missing teeth.
Fortunately, Medicaid often covers dentures for adults, but the benefits range widely depending on the reason and state rules where you live.
The cost of wisdom teeth extraction without insurance impacts low-income families relying on Medicaid the hardest.
Fortunately, the health insurance component of this government program typically pays for the removal of bone-impacted third molars because the surgical procedure is medically necessary.
On the other hand, coverage for gum-impacted wisdom teeth varies by state under the dental insurance element.
Perhaps the easiest way for a low-income patient to afford dental implants without going broke is to get Medicaid to pay most of the costs. If only it worked!
Medicaid rarely pays for the most expensive treatment alternative to replace missing teeth unless you have a medically necessary reason that the health insurance component of the program might cover.
The best way to afford tubal ligation reversal is for a third party to pay the cost. Unfortunately, most health insurance companies rarely cover the surgical reversal of elective sterilizations.
Even when a legal mandate requires IVF, all bets are off after voluntary tubal ligation. However, you can still cover the intended outcome of a mom’s pregnancy, labor and delivery, and newborn baby.
Sometimes, low-income families do not have to worry about paying for dental care without insurance because Medicaid might pick up part of the tab.
However, finding a dentist that accepts patients with this government-funded entitlement is often very tricky.
Identifying the provider directory of the Dental Benefits Manager connected to your plan is the key – if your state supports the benefit.
Paying for orthodontic braces is expensive for any family regardless of the resources at their disposal. Therefore, low-income households will find the treatment costs unaffordable.
Fortunately, Medicaid covers dental braces throughout the country, but with two critically different standards, with plenty of variation state-by-state. Learn the rules in your region.
One critical factor determining your out-of-pocket costs for any elective eye surgery is whether your eye doctor participates as an in-network provider.
The equation gets even murkier for low-income families who rely on Medicaid for coverage. Now state rules might limit benefits for exams, glasses, and contacts. Plus, fewer providers accept these patients.
