Though Medicaid is a United States government program, it is run by the states. The program is operated within federal guidelines and is federally funded in part. However, the guidelines are somewhat broad, which leads to nuances in services provided by each state. To serve the needs of its residents, each state is given some latitude in administering Medicaid services.
One of the requirements imposed on the states is to offer dental benefits to children who are covered by Medicaid and the Children’s Health Insurance Program, otherwise known as CHIP. The state determines the specific dental care schedule with minimum visits to include pain and infection relief, teeth restoration and dental maintenance. Coverage for adults is at the state’s discretion.
Medicaid Adult Dental Coverage in Florida
Florida Medicaid covers the following emergency-based dental Medicaid services: Limited exams and X-rays, dentures, teeth extractions, sedation, problem-focused care and pain management. The dental practitioner must substantiate medical necessity and, in some cases, obtain advance authorization.
Effective December 1, 2018, Florida Medicaid demonstrated support for adult oral health by expanding adult dental services to include additional exams, X-rays and extractions as well as screenings, cleanings, fluoride sealants and fillings. Additionally, services are available to expectant women to support a healthy pregnancy. For the disabled, a free visit to the facility prior to dental work is covered as an opportunity for people with disabilities to become comfortable in the environment before undergoing the procedure.
How to Find a Dentist That Accepts Medicaid
To find a dental provider in your Medicaid dental network, contact the State of Florida Agency for Health Care Administration, and ask for Member Services. The phone number is 1-877-711-3662, and the hours are Monday through Thursday, 8 a.m. to 8 p.m., and Friday, 8 a.m. to 7 p.m. The agency can confirm if a service is covered and can also provide referrals for adults and children.
If you have a child or grandchild in need of a pediatric dentist who accepts Medicaid, another helpful resource is InsureKidsNow.gov, which is an official website of the United States government. This resource includes a user-friendly dentist locator tool. A drop down menu enables you to select your state and the child’s dental plan. Enter the street address or zip code where you need proximity, and choose a preferred distance. Use the additional search criteria for other preferences such as an oral surgeon or a dentist with a specific language proficiency. The search results include the dentist’s profile, specialty and languages spoken. It even links to driving directions.
If you require a ride to the dentist, contact your health plan to inquire about transportation. For those who receive Medicaid services, Florida Medicaid includes a provision for transporting people to their dental appointments if needed.
The Importance of Dental Care
According to Mayo Clinic, oral health is the window to your overall health as it can reveal clues about what is going on in the rest of your body. The mouth is full of bacteria, and although most of them are harmless, this orifice is the gateway to digestive and respiratory tracts, increasing exposure to disease. Brushing and flossing daily, and committing to dental checkups twice yearly are recommended lifestyle behaviors that promote good dental hygiene.