If you are eligible for Medicaid benefits, make sure to take advantage of it since it is offered freely by the federal and state governments.
Medicaid is a nationally offered benefit package.
It doesn’t matter where you live; you can enjoy free dental benefits with Medicaid. You just need to look for the Medicaid center in your location and go through a screening process where your eligibility will be evaluated.
The Medicaid Dental Benefits Package
- Covered Procedures
- Medicaid Laws for Low-Income Families
- Additional Stipulations Regarding Low Income Children
- Medicaid Laws for the Elderly and Disabled
1. Which Procedures Are Covered?
Before you go to a dentist thinking that you can just get Medicaid coverage for the treatment you need, first make sure that the procedure you want are really covered by Medicaid. Medicaid can shoulder the costs of your basic to specialist dental treatments as well as laboratory fees as well as dental medications prescribed by the doctor. This means it is a complete dental care benefits package. This is the usual package, although some states may also place additional conditions for Medicaid benefits.
As for special procedures such as jaw reconstructions or oral repair surgery, states usually have a conditional approach. For example, if the treatment is necessary because the patient suffered from an accident that led to an injury affecting the teeth and jaw, Medicaid can cover that. But if it is jaw reconstruction simply to improve the appearance of the person or other esthetic treatments, procedures may not be covered.
2. Medicaid Laws for Low-Income Families
Since most dental procedures that are necessary for patients are more or less covered by Medicaid, the one possible hindrance in your getting covered by Medicaid is eligibility. Medicaid offers a wealth of benefits but is very choosy as to whom it bestows these benefits upon. One of the priorities of Medicaid is low-income families. You have to be financially eligible, which means that you have to prove that you cannot ordinarily pay for dental care on your own.
Through strict income eligibility laws, Medicaid makes sure that its benefits go to those who are really in need and who don’t have other resources available to them.
3. Additional Stipulations Regarding Low-Income Children
However, when it comes to children who are under age 21 and who come from low income families, Medicaid has some special rulings. These children have to first submit to an Early and Periodic Screening, Diagnostic, and Treatment or EPSDT. This is Medicaid’s way of helping children start on a clean and healthy slate when it comes to dental care. The objective of EPSDT is to detect any dental problems at their onset so they can be immediately treated. Since this is a periodic requirement, each child should use his or her Medicaid coverage every six months.
4. Medicaid Laws for the Elderly and the Disabled
Aside from low income families, those who are already senior citizens and those who are disabled are also allowed to enjoy Medicaid dental benefits. However, this is a matter of state discretion; each state gets to decide differently as to how far the Medicaid benefits will extend and to whom they will be entitled. In some states, even pregnant women are given access to Medicaid dental benefits.
Limitations in Dental Care from Medicaid
The Medicaid dental program seems useful enough, but what’s the catch? Medicaid has not run an entirely smooth operation all this time. Despite its many benefits, a lot of Medicaid members do not maximize these offers and end up not going to scheduled appointments. This has been a constant source of problem for Medicaid as a growing number of dentists are now opting out of the program. This is a huge blow for the program as it weakens its base of dental care providers, making it difficult for Medicaid beneficiaries to access dentists who still honor Medicaid benefits.
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