Paying for Dental Care

Dentistry, unlike medicine, is still a profession in which most service providers practice in separate, self-financed offices with their own highly expensive equipment. Although dentists generally don’t use centralized treatment sources such as hospitals and other institutions, an increasing number in recent years have begun to practice in Health Maintenance Organizations (HMOs) and other group practice associations.

There are a variety of ways to pay for dental care today, among them being private health insurance plans and supplements, self-payment, and public assistance programs such as Medicaid. Persons who cannot afford the first two options may contact their local dental society for information about dental programs for which they may qualify. Usually listed in the yellow pages under “dentists” or “associations”, the dental society knows what assistance programs and dental care centers, such as dental school clinics and public facilities, are locally available. These dentals schools may charge low-cost fees for checkups and cleaning because care is provided by graduate dentists and dental students under the strict supervision of faculty experts. The federal government provides limited dental coverage. For instance, Medicare generally does not cover dental care services. It does, however, cover hospitalization for non-covered dental services when the severity of the procedure or the condition warrants it. On the other hand, Medicaid, which is a public assistance program financed by federal, state, and local governments, offers more preventive-care services. Each state designs its own plan according to federal guidelines. Low-income people who fit into the following categories receive Medicaid coverage: the aged (sixty-five years or older), the blind, the disabled, members of families with dependent children, and some other children. Some states provide coverage for other groups of low-income people who, although qualified for welfare, aren’t able to afford medical care.

Because each state designs its Medicaid program to meet the needs of its own residents, and because Medicaid is subject to funding problems, states that might have covered a benefit at one period of time may no longer do so. Consequently, it’s prudent to ask your state or county department of public welfare whether the Medicaid program in your state covers dental care services, for children as well as for adults over the age of twenty-one. Dental care under the Medicaid program is an optional service for the adult population, which includes individuals twenty-one years of age and older. However, dental services are a requirement for most Medicaid-eligible individuals under age twenty-one, as a mandatory component of the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) benefit. States may elect to provide dental care services to their adult Medicaid-eligible population, or elect not to provide dental services at all as a part of their Medicaid program. Most states provide at least emergency dental services for adults, but less than half of all states provide comprehensive dental care. There are no minimum requirements for adult dental coverage.

Your local dental society, county health department, or the American Dental Association (ADA) website can provide you with further information about your oral healthcare concerns and treatment options.