Does Medicaid Cover Dentures [Get The Facts]

You’ve come to the correct spot if you’re wondering if Medicaid will pay the cost of your dentures.

Many individuals are unsure what the state legislation says regarding dental procedures and are even covered by Medicaid. We investigated every state and put together a thorough guide to help you figure out what the best dental plan is and how to get it.

So, read on until the conclusion to discover all of the fascinating facts regarding Medicaid and dentures.

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What is Medicaid?

Medicaid is a federal medical insurance program designed to assist low-income households by covering a portion of their medical expenses. This is intended for all citizens, regardless of age, who have modest earnings.

Medicaid typically pays all of the expenditures, although, in rare circumstances, the patient must pay a co-payment.

Medicaid has a yearly restriction or limit, which varies depending on the state you live in. Is this, however, a guarantee that dentures and other dental operations would be covered?

Continue reading to learn more.

Does Medicaid cover dentures?

Dentures are covered by Medicaid in certain states but not all of them.

While Medicaid is accessible in all states, the laws and regulations vary greatly and are determined by the local government.

So, there is no easy answer to the question of whether you can get dentures with Medicaid because it is mostly dependent on the state in which you live.

Furthermore, each state that allows dentures to be paid by Medicaid has various programs and limitations, so it’s always better to contact your local officials and ask for more information.

What states allow Medicaid to cover dentures?

Dental care and dentures are a heated subject when it comes to Medicaid, so individuals are unsure if their government insurance would cover the expense of dentures.

Fortunately, we have a list of states that allow Medicaid to pay dentures; however, bear in mind that while all states include dental care, they do not all regulate it in the same manner.

If you live in one of the following states, Medicaid will cover your dentures:

  • Alaska
  • Arkansas
  • California
  • Connecticut
  • Florida
  • Idaho
  • Indiana
  • Iowa
  • Louisiana
  • Maine
  • Massachusetts
  • Michigan
  • Minnesota
  • Missouri
  • Montana
  • Nebraska
  • Nevada
  • New Jersey
  • New Mexico
  • New York
  • North Carolina
  • North Dakota
  • Ohio
  • Oregon
  • Pennsylvania
  • Rhode Island
  • South Dakota
  • Texas
  • Utah
  • Washington
  • Washington DC
  • Wisconsin
  • Wyoming

Keep in mind that each state on the list has its own set of rules, restrictions, and plans. As a result, it’s a good idea to consult your local Medicaid agent for further information.

Will Medicaid pay for dentures?

Dentures are not a cheap investment, which is one of the reasons we’re looking at whether Medicaid would cover them.

The average cost of a full set of dentures is about $1.800, however, this is only an estimate because the price might vary greatly based on your state and your dentist.

Some states that enable Medicaid to pay for dentures will impose an annual restriction or limit. This amount varies by state, but in most situations, it will be sufficient to pay the typical cost of dentures.

If you exceed your Medicaid limit, you will be alerted and will be required to pay the difference in the final amount.

Does Medicaid replace dentures?

No, in most states, Medicaid will not cover the cost of denture replacement for at least 5 years, and in some cases much longer. 

It makes no difference why you need new dentures; they might be broken, stolen, or misplaced.

In most situations, however, Medicaid will cover the cost of repairing your broken dentures.

Are there any exceptions?

Yes, Medicaid will most likely replace the dentures even if the 5 or more years have not passed, but only if the dentures cannot be repaired or you lose a tooth needed to support your denture, as well as any other significant changes in your mouth.

However, as previously said, this is dependent on your state, so make sure to verify before scheduling an appointment.

Can you choose the dentist?

Yes, in most places, you have the right to pick your dentist. Of course, the dentist must be licensed and registered.

Furthermore, before providing you with dental procedures, your dentist must get a “service authorization.” This may appear to be a lot of paperwork, but with the number of people on Medicaid and the costs involved, it’s necessary to ensure that everything is in order.

What dental procedures does Medicaid cover?

This is determined by the state in which you live, as each state has the option of controlling these laws. In most situations, Medicaid will only pay the necessary dental procedures, such as check-ups and teeth cleaning every six months.

Larger dental services are seldom covered by Medicare, but you may always double-check your local rules and restrictions.

What dental procedures Medicaid doesn’t cover?

Despite the fact that Medicaid assists millions of individuals with their everyday lives and medical costs, this government program has restrictions. These restrictions may change based on the state in which you live and get Medicaid.

Medicaid will not, in general, cover:

  • Implants for the teeth
  • Adult orthodontics, such as braces (there are some exceptions)
  • Replacement of partial or complete dentures before the five years or more
  • Bridgework that is permanent (with exceptions for cleft palate)
  • Molar root canal therapy to fix infections
  • Periodontal surgery is used to remodel various portions of your gums or jaw bone
  • Dental procedures that are done for the sake of aesthetics or cosmetics

Final Thoughts

Medicaid assists a large number of people who have low incomes and require financial support to meet their fundamental medical requirements. Fortunately for many, some states will cover even dentures, so as long as you don’t go over the limit or cap, you may get this dental procedure done quickly and easily.

Keep checking back for updates, since the rules governing dental treatments are always changing, and the number of states that cover them is growing.

David Duford
Author: David Duford