- The Medicaid dental program varies from state to state. Currently, ten states provide coverage for dentures.
- In some states, Medicaid has limitations on the types of dentures it covers. To receive dental coverage, you may need to obtain your dentures from a specific provider.
- If you cannot get your dentures through Medicaid, you can consider other alternatives. These include dental insurance, senior discounts, and dental school programs.
Use Authority Dental to find and book an economical denture dentist near you, or sign up for a dental discount plan and save big on all dental procedures, including dentures.
How can you get dentures through Medicaid? Here's everything you need to know.
Medicaid coverage of dentures
Picture by Authority Dental under CC 2.0 license
The adult dental benefits provided in the Medicaid program vary across the country. If you are wondering if Medicaid covers dentures, the answer is not always straightforward.
Different from state to state
Since each state administers its own Medicaid program, denture coverage varies from one state to another.
There are currently ten states that provide coverage for dentures: Alaska, Idaho, Louisiana, Michigan, Montana, Nevada, New York, North Carolina, North Dakota, and South Dakota. These states all have their own limitations and requirements.
Dedicated to selected types of dentures
You may also find that if your state’s Medicaid program does allow for denture coverage, there are limitations on the type of appliance that is included. Partial dentures and complete dentures are both included in the benefits, but they may be limited to one set every ten years; some are even limited to one set per lifetime. This could be a problem for someone who starts with a partial denture and then needs other teeth replaced or requires complete denture replacement before the ten years have lapsed.
Your dentist might discuss the option of an implant-retained denture. These appliances snap onto the implants placed in the jaw, providing a more stable fit. Even if your Medicaid program covers a traditional denture, it may not include coverage for one that incorporates implants.
Provided by certain specialists
However, another requirement you will need to determine is whether the Medicaid program in your state only provides denture coverage if you get the denture from a specific type of dental provider. Both general dentists and prosthodontists can fabricate dentures. Individuals on Medicaid will also need to find a dental provider who accepts Medicaid insurance.
Alternatives to Medicaid denture coverage
Picture by Authority Dental under CC 2.0 license
If you live in a state that does not provide denture coverage as part of its Medicaid benefits, there are other ways to get financial assistance.
Lee notes: "I speak with colleagues nationwide, and we all face the same reality: low reimbursement rates and excessive bureaucratic complexity deter many dentists from accepting Medicaid at all."
"This shortage restricts patient choice, forces patients to travel long distances, and delays essential care," he adds.
"That is why I always stress the alternatives. Dental school programs, for instance, offer excellent, supervised care at a lower cost. Ultimately, my goal is to restore patients' ability to eat, socialize, and smile confidently—a fundamental aspect of overall health that should not be a luxury restricted by geography or insurance fine print," Lee concludes.
Dental insurance
One way to do this is to enroll in a dental insurance plan. Private insurance companies offer individual or family plans and often include denture coverage. The plans will vary in their premiums, deductibles, and coinsurance amounts, so be sure to read the policy summary to find out the details of your plan.
Dental schools
Another great option to get affordable dental care is through a dental school. Dental programs need patients for their students to care for, and they often have lower prices because they are learning facilities. Be prepared to spend more time at each appointment, but you can save hundreds by going to a dental school.
Senior discounts on dentures
Lastly, check with your current dental provider’s office to see if they offer any senior discounts. If they do not offer a senior discount, they may provide a reduced fee for pre-paying for services or paying with cash or check. It will save them a credit card processing fee. Many dental practices also utilize third-party financing, often with 0% interest for a limited period.
FAQ
How much do dentures cost with Medicaid?
The cost of dentures with Medicaid will depend mainly on the state you live in. Medicaid dictates the prices for dental services, including what the individual pays. Providers who are not contracted with Medicaid do not have to accept the program’s fees.
Are Medicaid dentures benefits the same in all states?
Medicaid denture benefits vary significantly from one state to the next. Currently, ten states include denture benefits in their programs. The annual maximums and frequencies vary significantly in those ten states.
Who is eligible for Medicaid dentures?
Any person on Medicaid is eligible for dental services, including dentures. Individuals and families with low incomes, pregnant women, the elderly, and those with certain disabilities are all eligible for Medicaid. The specific income limits are set by the federal government and are adjusted annually to reflect the cost of living.
Harry Lee, DMD
When patients ask me about getting dentures through Medicaid, I start by being honest: it is rarely a simple yes or no. In my practice, I have seen firsthand how the patchwork of state-level policies creates immense barriers to comprehensive oral health.