Under the Nevada Medicaid program for dental care, adults receive emergency services only, pregnant adults are eligible for specific periodontal benefits, and children are eligible for full coverage with limited orthodontia.
Note that Medicaid provides low-income residents access to healthcare services. Qualification is based on financial need as defined by federal and state law. This is distinguished from Medicare, which is a program for U.S. citizens and legal residents at least 65 years old or disabled according to the Social Security Administration.
Federal Law Protects Dental Health for Children
Tooth decay in children can result in school absences and infections, and if left unattended, manifest into more serious health issues. It is federally mandated that every state provide dental services to children with coverage under Medicaid and CHIP (Children’s Health Insurance Program). At minimum, pediatric dental services should include pain relief, teeth restoration and maintenance.
CHIPRA, which stands for the Children’s Health Insurance Program Reauthorization Act, took effect in 2009. The purpose of CHIPRA is to ensure that states have the capacity to continue their programs and to provide funding to further grow coverage for low-income uninsured children, including those eligible though not yet enrolled for CHIP or Medicaid. The Act includes a section that stipulates dental coverage be included in child health support as needed to prevent disease, promote oral health, restore oral structures and treat emergencies.
Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) is a comprehensive government program designed to protect the dental health of children. If medically necessary, all services must be provided to children in every state. Even if a condition is discovered in the course of a routine screening, the state is required to treat the child whether or not the service is part of the Medicaid program.
Nevada Medicaid Dental Services
In compliance with EPSDT, Nevada Medicaid renders dental care for the majority of those under 21 years old who are Medicaid-eligible. Services include dental checkups performed by a pediatric dentist to include a thorough exam and cleaning every six months. The dentist may seek approval for more frequent dental visits if needed. Also covered are fluoride treatment and sealants.
In addition to Medicaid dental care, Nevada has another program known as Nevada Check Up (NCU). A child who is age 18 or under, not eligible for Medicaid and living in a household with income at or below 200% of the federal poverty level can apply for this program. NCU bills a quarterly premium based on total gross income of household members.
Resources for Nevada Medicaid Services
There are many resources to learn more about Medicaid services. To apply for Medicaid, reach out to your local district office of the Division of Welfare and Supportive Services (DWSS). For additional information, contact the Nevada Department of Health and Human Services. To find a listing of Medicaid dental clinics in Nevada, visit FreeDental.org.