Does Medicaid Cover Tooth Extraction [Get The Facts]

Medicaid is one of the best programs for medical help for families in need, but because it varies by state, many users are unsure of what is covered.

This is why we will concentrate on tooth extraction today and become acquainted with all of the laws and regulations. This way, we’ll know for sure if Medicaid covers tooth extraction and what your best alternatives are.

So, whether you need an update or are new to Medicaid, keep reading to learn more.

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What is Medicaid?

Medicaid is a federal health insurance program that was created to assist low-income households. This program differs in each state, which might be perplexing for most users.

It is difficult to determine what is deemed required coverage and what is left up to different governments to decide. 

This is why you can:

  • Visit our page for all the relevant information;
  • Call your insurance company and ask them;
  • Contact your Medicaid representative and find out all the details.

Whatever you pick will most likely provide you with the most up-to-date information. Keep in mind that all states prioritize children under the age of 21, so you don’t have to be concerned about the youngest members of your family.

Adults fall into a distinct category, and each state has the authority to compel the majority of Medicaid coverage depending on population and budget.

Does Medicaid Cover Tooth Extraction?

The basic simple is that most states will allow Medicaid to cover the expense of tooth extraction. However, as previously said, this is very dependent on the state in which you reside.

Some are more aware of the oral issues that children and adults face, and they seek to find the best solutions. However, some jurisdictions are quite stringent and will only allow tooth extraction if it is deemed medically essential.

Once again, this need is mostly determined by local legislation and dentists’ opinions on the best therapy for your problem.

What states allow Medicaid to cover teeth extraction?

There is usually some form of conflict between individuals and state lawmakers when it comes to dental benefits and Medicaid. As a result, states often provide three sorts of benefits:

1. Extensive Benefits:

  • 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

2. Limited Benefits:

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

3. Emergency-only Benefits

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

If you live in a state with comprehensive coverage, you are almost certainly covered for all dental services, including tooth extraction. Even if you fall into the third category of emergency-only care, you may still be eligible for Medicaid coverage; however, your dentist must indicate this.

Does Medicaid cover tooth extraction for children?

Yes, children and young people under the age of 21 are generally covered for complete dental benefits in all states. This includes the following:

  • Restorative dentistry
  • Pain and infection relief
  • Dental health maintenance

Given that children are always included, this is by far one of the most useful aspects of having Medicare coverage for your family. This is done to avoid future issues and, as a result, to reduce the expense of any treatments that may be required.

Is wisdom tooth extraction covered by Medicare?

This is a unique problem that must be evaluated by your dentist. 

Wisdom teeth can cause major issues and infections in some circumstances, hence they are considered a medical emergency. As we now know, Medicaid covers all medical emergency extractions.

On the other side, in certain cases, the wisdom tooth grows regularly and does not create any problems, therefore extraction is not necessary or supported by Medicaid.

How to use Medicaid for tooth Extraction?

It is simple to use your Medicaid for tooth extraction; all you need to do is find a dentist that is willing to analyze the issue and takes Medicaid. You can go to the dentist of your choice or discover one from the list of physicians that take Medicaid.

All of the information you want will be available from your insurance representative and local Medicaid agent.

What dental benefits does Medicaid cover for adults?

This is determined by the state in which you reside. Some states allow all dental procedures with a co-payment, while others only allow those that are medically essential. This is why it’s critical to gather all relevant information before scheduling the appointment.

What dental procedures does Medicaid not cover?

Even the most liberal states will not allow some operations to be funded by Medicaid. Most of the time, they are aesthetic alterations that are not regarded as required or medically necessary.

Here are a couple of such examples:

  • Braces for adults are an example of adult orthodontics (there are some exceptions)
  • Implants for teeth
  • Dental operations performed for aesthetics or cosmetics
  • Permanent bridge construction (with exceptions for cleft palate)
  • Replacement of partial or entire dentures before the age of five years
  • Periodontal surgery is performed to reconstruct different parts of your gums or jaw bone.

Final Thoughts

Many individuals are unfamiliar with Medicaid benefits, but even those who have used it for a long period have some questions. As a result, we will concentrate our articles on presenting you with the most up-to-date and relevant information.

Given that each state has the authority to enact legislation as they see fit, consult with your local healthcare leaders for further guidance.

David Duford
Author: David Duford