Does Utah Medicaid Cover Dental?

Medicare Benefits Solutions
Jul 12, 2021

Does Utah Medicaid Cover Dental? Oral health is easy to overlook, especially when life gets busy or you don’t have coverage for routine dental care. Healthy teeth and gums can protect other oral tissue from injury and infection, so regular check-ups, cleanings, and care are important. Unfortunately, paying for dental care can be a challenge, especially for those on a fixed income.

Utah Medicaid May Provide Assistance

Does Utah Medicaid Cover Dental? In Utah specifically, assistance in paying for dental costs is addressed through Medicaid as an option for those with limited means. Medicaid is a federal program governed by the Centers for Medicare & Medicaid Services (CMS); however, it is regulated and administered on the state level. 

Utah residents can receive Medicaid benefits by qualifying for the program. Qualification is based on a number of factors, including income level, age, pregnancy status, and disability status. Seniors may qualify for Utah Medicaid as well as Medicare benefits as dual-eligible.

Someone who is dual-eligible for both Medicare and Medicaid in Utah can receive the benefits of both programs. This could potentially open up additional possibilities for dental care that would not be available with Medicare benefits alone.

Utah Medicaid Dental Coverage

Dental benefits within Utah’s Medicaid program are available to benefit recipients who fall into certain categories. For specifics, please visit the Utah Department of Health’s Medicaid website.

Some examples of the categories Utah uses to distribute dental benefits include adults over the age of 65, children under the age of 18, individuals who have a substance use disorder, pregnant women, and those who are disabled.

Covered services are typically provided by the Utah School of Dentistry Network. Some services provided include exams, x-rays, and fillings. Your choice of service provider may be different based on the specifics of your healthcare needs and the Medicaid options available to you.

Non-Qualified Medicaid Recipients

If you’re a Utah resident who does not fall into a dental-eligible category but still receives Medicaid, you may be able to obtain dental coverage through a Family Dental Plan. These are Medicaid plans that offer coverage for things like preventative dental care and orthodontics as well as major dental work.

Utah currently offers four different plans within the Family Dental Plan option: Choice PPO High, Choice PPO, Advantage PPO, and Advantage Copay. Each plan has its own coverage amounts, but you could reduce your dental care costs by as much as 80% for some services while others may be covered at 100%.

Keep in mind that PPO plans require you to use service providers within a specified network. You may also see an out-of-network provider, but there may be higher out-of-pocket costs associated with doing so.

To learn more about Utah Medicaid and dental coverage options, please contact the Utah Department of Health. You can also seek answers through your local Medicaid office.