Does Medicaid Cover Partial Dentures [Get The Facts]

When you require partial or complete dentures, you may question if Medicaid would cover the cost or if you must pay the entire amount out of pocket.

Don’t worry, you’re not alone in being perplexed by Medicaid dental coverage. 

This is why you will discover all of the important information in this post, as well as some surprising facts concerning Medicaid and dental insurance.

So, stay tuned until the end and use your Medicaid benefits wisely.

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What is Medicaid?

Medicaid is one of the financial assistance programs that is funded in part by the federal government and in part by each state. This financial support is intended to assist needy families that are dealing with a medical emergency or seeking medical advice.

Because each state has the authority to adopt its own version of Medicaid, each state has its own set of laws and regulations. As a result, determining whether you are covered for specific medical help might be challenging.

However, we are here to give you all of the answers and information you need so that you don’t have to worry about the expense of the treatment and can concentrate solely on getting better.

Is this to say that Medicaid will pay everything, including partial dentures and other dental work? 

Continue reading to find out.

Does Medicaid Cover Partial Dentures?

Yes, Medicaid will pay the cost of partial dentures in some states if they are declared medically essential. This is established by your dentist and should be the outcome of a comprehensive examination.

While partial dentures are not as prevalent as complete dentures, they can be an excellent option for those who have some healthy teeth but need to replace some of them. 

Medicaid focuses on prevention, thus if the patient is a kid or young adult under the age of 21, they will be completely covered.

Other people enrolled in Medicaid must confirm their eligibility and payment restrictions with local Medicaid staff or their health insurance carrier. The employees there will be able to give you any further information that is applicable in your state.

Does Medicaid Cover Full Dentures?

Full dentures, like partial dentures, can be funded by Medicaid, but not in all states.

Dental coverage is regarded as one of the most difficult issues in medicine, as much dental work is not covered by insurance. This is one of the reasons why so many Medicaid recipients are concerned about their dental health and believe that nothing is covered.

But this is not the case.

Some jurisdictions will even permit thorough dental treatment, which includes not just examinations and cleanings, but also other procedures such as partial and complete denture replacement.

What states allow Medicaid to cover partial dentures?

Individuals are concerned if their government insurance will cover the cost of dentures because dental care and dentures are a contentious topic when it comes to Medicaid.

Fortunately, there is a list of states that allow Medicaid to pay for dentures; however, keep in mind that while all states cover dental care, they do not all regulate it in the same way.

Medicaid will fund your partial dentures if you live in one of the following states:

  • 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

Remember that each of the states on the list has its own set of regulations, limitations, and plans. As a result, it’s a good idea to check with your local Medicaid agent for further details.

How to get partial dentures with Medicaid?

Obtaining any type of dental aid begins with a visit to your dentist. You can select one or contact Medicaid staff to obtain a list of eligible dentists in your region who take Medicaid.

Once the doctor has determined that you are a good candidate for partial dentures, you may begin gathering all of the necessary papers and the process of regaining your gorgeous smile.

How much do a set of partial dentures cost?

One of the reasons people are concerned about dentures and their costs is that they are not inexpensive. The cost of partial dentures can range from $1.400 to $1.800 for each tray.

Fortunately, Medicaid will cover the whole cost of partial dentures in some circumstances. Even if your state does not provide full dental care, the cost can be significantly reduced.

It’s nice to know that even treatments like dentures and partial dentures are deemed necessary Medicaid coverage.

Does Medicaid replace partial dentures?

No, in most circumstances and states, you will not be reimbursed for partial denture replacement for 5 years or longer. This is true even if the dentures have been misplaced, damaged, or stolen.

In certain areas, however, Medicaid will pay the expense of fixing dentures.

What dental procedures does Medicaid cover?

This is established by your state, as each state has the possibility of controlling these laws. In most cases, Medicaid will only pay for required dental services like check-ups and tooth cleanings every six months.

Larger dental services are seldom reimbursed by Medicare, but you should always verify your local laws and limits.

What dental procedures Medicaid doesn’t cover?

Even though Medicaid helps millions of people with their daily lives and medical expenses, this government program has limitations. These limitations may vary depending on the state in which you live and get Medicaid.

In general, Medicaid will not cover:

  • Replacement of partial or entire dentures before the five years mark
  • Infections can be treated using molar root canal treatment.
  • Braces for adults (there are some exceptions)
  • Implants for teeth
  • Periodontal surgery is performed to reconstruct different parts of your gums or jaw bone.
  • Dental operations performed for aesthetics or cosmetics

Final Thoughts

Medicaid is a fantastic chance for low-income families and individuals to get medical assistance, including dental care. With the confidence that a fresh, dazzling smile will provide, you will be one step closer to a better job and financial independence.

David Duford
Author: David Duford