Does Maryland Medicaid Cover Dental Care?
Ever since 1965, Medicaid and Medicare have provided healthcare insurance to millions of Americans. Since its beginning, Medicaid’s main purpose has been to make healthcare available to individuals, families, children, pregnant women, seniors, and to people with disabilities who have few resources and low incomes.
Medicare Benefits Solutions
Dec 22, 2020
The Medicaid program is run by both the federal and state governments. Under federal law, Medicaid is required to provide a core set of health care services in every state. These mandatory services include inpatient and outpatient hospital care, physician’s care, laboratory and x-ray services, and home health services.
State governments have the right to choose the optional benefits the Medicaid program can provide to beneficiaries who qualify and live in the state. Because dental care services are on this optional list of benefits, not all states provide them to adult Medicaid beneficiaries or to dual-eligibles. Dual-eligible recipients qualify for healthcare insurance from both Medicaid and Original Medicare. However, Medicaid does require all states to provide dental care services to children who are covered by Medicaid and the Children’s Health Insurance Program known as CHIP.
Does Maryland Medicaid cover dental health services?Before June 1, 2019, Maryland Medicaid didn’t cover dental health services for adults (over the age of 21). The only exceptions were (and still are) for pregnant women, people who were in the Rare and Expensive Case Management and Emergency Services program, and for people who had dental emergencies in the hospital emergency department.
Although a dental care pilot program has since been put in place, in the instance of hospital emergency room visits for dental problems, extractions are not included in the emergency care for adults. The hospital emergency room can only treat the symptoms of pain and can’t treat the cause. Physicians and nurses in the emergency room can give the patient antibiotics, pain medication, and refer them to another medical professional.
This pilot program is valuable for dual-eligibles because Original Medicare Part B (medical insurance) does not cover routine dental care or procedures such as cleaning, fillings, or extractions. They do not cover dental supplies such as dental plates, partials, or dentures either. Original Medicare Part A (hospital insurance) only covers some dental services that you might need when you are a patient in the hospital.
If you live in Maryland and would like to see if you are eligible for the Medicaid dental care pilot program, you can visit Maryland’s Department of Health website, or call a local CMS office and ask an agent for information.
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