Does Medicaid Cover Crowns [Get The Facts]

Have you ever wondered what your Medicaid would cover if you require dental work? Don’t worry, you are not alone.

This is one of the reasons why we will go over all of the crucial aspects of Medicaid and dental coverage, with a specific emphasis on crowns. Because this procedure is so crucial for preserving a healthy and beautiful smile, you should discover all of the fascinating facts about it.

So, without further ado, let’s get started with today’s topic.

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What exactly is Medicaid?

Medicaid is one of the government-created financial support programs in the United States for low-income households. This program, unlike others, concentrates on medical requirements and covers the bulk of expenditures for those in need and their family members.

However, as fantastic as this program is, there are a few ambiguities that leave consumers wondering what is and is not covered by this medical insurance.

There are some standard and obligatory treatments that are covered in all states, but the amount that Medicaid will fund in most circumstances is determined by the state in which you live. Because each country has the authority to implement the Medicaid program as it sees suitable, there are numerous laws and regulations.

Dental coverage under Medicaid

Medicaid dental benefits are one of the most contentious issues surrounding this insurance since some states provide full coverage while others do not. 

The good news is that children under the age of 21, pregnant women, and the elderly are normally covered for all medical expenditures without having to make a co-payment.

In terms of adults, different states will enable Medicaid to cover a variety of services. In general, Medicaid covers everything that is deemed medically essential. Does this, however, include crowns?

Continue reading to learn more.

Does Medicaid cover crowns?

Crowns are often covered in states that provide comprehensive dental care. However, like with other Medicaid-related insurances, you must first ensure that your state is on the list (which we will supply later) and then contact your local Medicaid reps.

Most dental procedures that are deemed medically essential will be paid by Medicaid, and crowns are no exception. Although they may serve an aesthetic purpose, the primary reason for getting one is typically medical and required.

Who Requires a Dental Crown?

Since we previously said that crowns are most of the time required and therefore covered by Medicaid, we will discuss a few instances where a crown must be fitted:

  • To aid in the protection of a weaker tooth that is about to break or is already damaged;
  • To aid in the restoration of a fractured or worn-down tooth;
  • To keep your prosthesis in a place as a bridge;
  • To conceal discolored or damaged teeth;

Your dentist can advise that all of the aforementioned scenarios are medically required. In some circumstances, you will either be fully covered by Medicaid or will be required to pay a co-payment, depending on your state of residency.

Does Medicaid cover crowns for children?

Yes, crowns are always covered for children under the age of 21. Although it may appear unusual to some, there are several situations with children that necessitate crowns, such as:

  • Saving a baby tooth that has become damaged due to deterioration
  • Children with poor dental hygiene should have their teeth protected with crowns
  • Reduce the chance of anesthetic being used in little children.

One of the best aspects of Medicaid is that children under the age of 21 are always covered, so you don’t have to worry. This is an excellent approach for them to maintain their oral health while also saving money in the future.

Which Dental Services Does Medicaid Cover for Children?

In addition to crowns, Medicaid covers a variety of other dental procedures for children, including:

  • Dental restoration;
  • Infection treatment and pain alleviation
  • Upkeep of dental health
  • Any medically required service

Maintaining healthy habits with children is critical, and excellent oral hygiene is only one of them.

Medicaid dental coverage by state

Various states have different forms of dental coverage. Some provide significant coverage, while others do not. So, the easiest method to ensure that you are covered is to look up your state on the provided lists or call your Medicaid agent.

States that provide extensive Medicaid dental coverage

  • California
  • Colorado
  • Connecticut
  • District of Columbia
  • Idaho
  • Illinois
  • Iowa
  • Massachusetts
  • Montana
  • New Jersey
  • New Mexico
  • New York
  • North Carolina
  • North Dakota
  • Ohio
  • Oregon
  • Rhode Island
  • Washington
  • Wisconsin

States that provide limited Medicaid dental coverage

  • Arkansas
  • Hawaii
  • Indiana
  • Kansas
  • Kentucky
  • Louisiana
  • Michigan
  • Minnesota
  • Mississippi
  • Missouri
  • Nebraska
  • Pennsylvania
  • South Carolina
  • South Dakota
  • Vermont
  • Wyoming

States that only cover emergency Medicaid dental services

  • Alaska
  • Arizona
  • Florida
  • Georgia
  • Maine
  • Nevada
  • New Hampshire
  • Oklahoma
  • Texas
  • Utah 
  • Virginia
  • West Virginia

States that don’t provide any Medicaid dental coverage

  • Alabama
  • Delaware
  • Tennessee

How do I find a Medicaid dentist near me?

Finding a doctor who accepts Medicaid is typically simple. You may verify the availability of dentists in your region by calling your Medicaid representative, contacting your health insurance agent, or even going online in certain states.

You can select your own dentist; just make sure to ask the staff whether they take Medicaid before making an appointment.

Final Thoughts

While Medicaid is a wonderful government program that provides much-needed financial support to low-income families, it can be extremely complex. One of the most common issues people have is not knowing whether or not medical treatment will be funded by Medicaid.

This is why you must visit our website frequently and get all of the necessary information. Furthermore, bear in mind that various states have different rules and regulations, so check with local Medicaid reps to see if the treatment you want is covered.

David Duford
Author: David Duford