Locating a nearby dentist that accepts Medicaid for adults is a difficult challenge. It depends on the locality you are living, in and the type of treatment you need. Medicaid is a health insurance program provided by the state and federal government for children, teenagers, and elders with low income for free or discounted health treatment.
Medicaid covers a vast variety of health issues in the program that is free or at discounted prices. The various health issues covered under Medicaid include Dentistry, Chronic diseases, pregnant women, and disabled persons.
This affordable health care act was passed in 2010; expanding access to Medicaid was one of the goals of the law. Only 30 states decided to expand Medicaid although the individual physician and dentists of those states accepted the limited number of Medicaid patients.
Read Also: Does Medicaid Cover Dental Implants?
Why, is the real question?
The real reason behind this question is that privately insured patients are most likely to pay the dentists more than that of the Medicaid insured person. The dentists are paid just half the price of the general treatment for Medicaid patients as compared to the other insurance providers.
Medicaid acts as a challenge for doctors as well as patients in dentistry. Only the dentists that are affiliated with the state-funded Medicaid program accept the Medicaid, which unfortunately is very few. It also has other factors that make it more difficult.
First, the Medicaid program covers dental treatment during the time of medical emergencies like accidents or long-time diseases. On the second note, the Medicaid programs for children are easy as compared to the adults, as the state administration authorizes the outside companies to create more confusion.
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Dentist Centers That Accept Medicaid For Adults
The odds of finding a dental center that accepts Medicaid for adults has a success rate of 50% as compared to the children for which the people need to find an alternative. When searching for specific procedures, adults with Medicaid insurance face problems in finding the appropriate dental centers. The only solution that might be helpful for them is with Dental Assistance Program.
How to find Dental Centers for specific dentistry procedures which accept the Medicaid insurance program for adults is mentioned below:
Dental schools are one of the centers that take Medicaid recipients more frequently and more often. Because of the students studying, they provide them with the facility, so that future dentists can hone their craft before becoming a doctor. Sometimes, if you’re lucky enough you can find these schools in your area, especially in large urban areas.
Dental Clinics offer treatment to low-income adult patients frequently knowing they are unable to afford proper dental care. These services along with the pro bono services are offered by the dental charities which are spread all over the nationwide. However, there are some treatments which are needed to be paid for a very small amount of fees like dentures, and surgery on the gums.
This is a bit tricky and irrelevant as the pediatric offices offer dental treatment for children under the age of 21 but some pediatric offices across the country also take adult patients as a specialized service provided by the state insurance. The easiest way to search for these centers is online.
Like Medicaid, Medicare is another health insurance program provided by federal and state law, but it is not to be confused with Medicaid. The eligibility of this program differs from the others. Whereas, dual eligibility patients can have the benefits of these plans without doubling the benefits of it.
Dental Specialist Accepting Medicaid
Dental specialists accept Medicaid insurance for the treatment of several procedures. They are beyond the students of dental schools, their proficiency to diagnose the disease is better. Several specialists accept the Medicaid;
Oral surgeons are typically the most accessible ones because they offer the treatment that matches the claim accordingly to your Medicaid plan. A maxillofacial surgeon is a specialist in treating injuries, oral diseases, and unusualness in the head, neck, jaws, mouth, and face.
Oral surgeons might or might not sometimes be bound to perform dental procedures that may or may not be medically necessary but that covers under the state insurance program as a secondary mission in 24 states nationwide.
Orthodontists taking Medicaid for the braces treatment is most common amongst the children but to accept it from the adults is a bit challenging. The reason depends on the dual nature of either:
- It covers both age groups in all the states of the nation only when it is medically necessary.
- Medicaid pays the surgeons for the braces for correcting the asymmetrical jaws till 21. But, in some states, those children classifies as young adults are still being treated by the orthodontist.
A prosthodontist is a specialist in the treatment of the restoration of missing tooth and jaw structures of the face. Dentures and Implants are the main treatment provided by a prosthodontist, which is an expensive treatment that makes it more difficult to find a center that accepts Medicaid for adults.
Even some well-hearted prosthodontists are offering free tooth implants with Medicaid insurance. However, they have to wait in a long line.
Whereas the alternative to the tooth implants is dentures but they too are highly expensive, ranging from $500 to $8000 depending on the materials used. Around 75% of the dentures amount is covered under Medicaid.
Periodontists are less likely to be found when it comes to accepting Medicaid, which is just 40% of the time as Medicaid does not cover much of their expenses of them. They specialize in the diagnosis, prevention, and treatment of gum diseases. It is correlated with heart and diabetes. Only 19 states in the country cover the periodontal treatment costs under state insurance.
Same as the periodontists, the endodontist’s costs are less like to be covered under Medicaid and making it difficult to find them in your neighborhood. They are the specialists in diagnosing tooth pain and treating them along with root canal treatment. Root canals are rarely considered medically necessary, that is why endodontists don’t consider this under the coverage of the insurance.
Emergency dentists have the highest rate amongst all the specialist surgeons to be accepting Medicaid for adults. All the 50 states in the country cover the emergency care the Medicaid. Dental emergencies occurred due to accidents like falling, or any other instance that is medically necessary for a walk-in treatment. But, 9 states have limited the benefits of the state insurance like stopping bleeding, relieving pain; etc.
Dental Benefit Managers
Dental benefit managers (DBM) are the best and most reliable sources chosen by the Managed Care Organisation (MCO) of the state law which can provide a direct way to find the local dentists that accept the Medicaid for adults according to the specific plan of yours. These are the online directories with the data and information of the local dental centers accepting state insurance.
The most used online provider directory amongst the adults is Dentaquest to find the dentists that accept Medicaid insurance. It is the largest DBM in the country proving the directory of 30 states nationwide. Click on this link https://dentaquest.com/members/ and follow the steps to know more.
This is another popular directory that provides its user to locate the nearby dentists that accept Medicaid for adults. It has recipients from 10 states. Click on this link https://www.libertydentalplan.com/Find-a-Dentist/Find-a-Dentist.aspxto know the details of your nearest dentists.
Delta Dental :
This DBM directory is famous among the patients having Medicaid insurance, living in New York State. This DBM manages dental benefits for
- Capital District Physicians Health Plan (CDPHP Select)
- Essential Plan
- Health & Recovery Plans (HARP)
To know more about the nearest dental center click on the link https://www.deltadentalins.com/group_sites/allsmiles-ny/find-a-dentist.html