Medicaid Adult Dental Benefits Coverage by State
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See source for list of covered services.
www.medicaidinnovation.org/_images/states/New_Me
xico_Fact_Sheet_FINAL.compressed_.pdf
New York Extensive No spending limit; covers preventive, periodontal, dentures, and oral surgery services. No orthodontia. www.macpac.gov/wp-
content/uploads/2015/06/Medicaid-Coverage-of-
Dental-Benefits-for-Adults.pdf
North Carolina Extensive No spending limit; covers preventive, periodontal, dentures, and oral surgery services. No orthodontia. www.macpac.gov/wp-
content/uploads/2015/06/Medicaid-Coverage-of-
Dental-Benefits-for-Adults.pdf
Extensive “Covers exams, X-rays, cleaning, fillings, surgery, extractions, crowns, root canals, dentures (partial and full)
and anesthesia.” North Dakota does not offer adult dental benefit to its Medicaid expansion population.
www.nd.gov/dhs/services/medicalserv/medicaid/covere
d.html
Ohio Extensive Other than braces, adults are privy to the same services as children. See source for list of covered services. https://medicaid.ohio.gov/FOR-OHIOANS/Covered-
Services#1685616-root-canals
Emergency extractions only.
www.okhca.org/individuals.aspx?id=516&menu=48&par
ts=7461_7459
Oregon Extensive See source for list of covered services.
www.oregon.gov/oha/HSD/OHP/Tools/Covered%20and
%20Non-
Covered%20Dental%20Services,%20Effective%20Januar
y%201,%202019.pdf
Pennsylvania Limited “The dental services you may get are based on your eligibility category, age and need. Medical Assistance
covers all medically necessary dental services for enrolled children. This includes teeth cleaning, x-rays,
cavity fillings, crowns and other services. Adults enrolled in MA are eligible at a minimum for surgical
procedures and emergency services related to treatment for symptoms and pain. Some adults may be
eligible for other dental services.”
www.dhs.pa.gov/citizens/healthcaremedicalassistance/d
entalinformationforrecipientsandtheirfamilies/index.htm
Extensive Lists off umbrella eight categories of dental services covered. Doesn’t cover orthodontic or general
anesthesia services. See source for list of covered services.
www.eohhs.ri.gov/Portals/0/Uploads/Documents/Denta
l_Benefits_for_Adults_%202007.pdf
“Beginning in January 2014, all Rhode Island adults with incomes at or below 138% of the federal poverty
level became eligible through the ACA for Medicaid that includes a comprehensive adult dental benefit,
with diagnostic, preventive, restorative, periodontal, surgical, prosthetic, and limited endodontic services.”
www.rimed.org/rimedicaljournal/2017/10/2017-10-51-
health-zwetchkenbaum.pdf
South Carolina Limited “These new services are available to members age 21 and older who have full Healthy Connections
Medicaid benefits. There is a $3.40 copayment for adult Healthy Connections Medicaid members toward
the cost of preventive care. The new benefit does not cover crowns, root canals, periodontal scaling and
root planing, teeth whitening or dentures.”
www.scdhhs.gov/press-release/healthy-connections-
now-provides-adult-dental-benefits
“Adult dental coverage is limited to $1,000 each year (July 1 – June 30). Recipients must pay for services
over the $1,000 yearly limit. Medically necessary emergency services, dentures, and partials are exempt
from the $1,000 limit.” See source for list of covered services.
https://dss.sd.gov/medicaid/recipients/dental.aspx
Tennessee No
coverage
TennCare does not cover adult dental. www.tn.gov/content/dam/tn/tenncare/documents/ben
efitpackages.pdf