When it comes to maintaining optimal oral health, dental care is not merely a luxury—it’s a necessity. However, for millions of Americans, accessing quality dental services can be an uphill battle, fraught with financial obstacles and insurance complexities. That’s where Medicaid comes into play—a beacon of hope for low-income families and individuals who might otherwise go without these critical services. But the question on many minds is, “Does Medicaid cover dental for adults in 2023?” This fundamental aspect of healthcare often remains shrouded in confusion, leaving beneficiaries uncertain about the breadth of coverage. In this blog post, we’ll dive into the nuts and bolts of Medicaid dental coverage, demystifying the details, exceptions, and variations across different states to ensure that those in need can harness the full benefits this program offers for a healthier, happier smile.

Medicaid Dental Coverage for Adults in Virginia

Medicaid dental coverage is a crucial aspect of healthcare for Virginia residents with low incomes, ensuring they have access to essential dental care without financial strain. In recent years, there have been significant changes and improvements to the Medicaid program in Virginia, particularly regarding dental benefits for adults. The state has expanded its dental coverage, offering a more comprehensive range of services to those eligible for Medicaid.

What Services Are Covered for Adults Under Virginia’s Medicaid Program?

Virginia’s Medicaid dental benefits for adults now include preventive services, such as exams and cleanings, which are essential for maintaining oral health and avoiding costly and complex procedures in the future. More than that, Medicaid recipients can access a variety of treatments, including:

  • Fillings
  • X-rays
  • Root canals
  • Dentures
  • Emergency dental care
  • Extractions

It’s important to note that while the expansion covers many routine and necessary procedures, some limitations and frequency caps may still apply. It is always wise for Medicaid beneficiaries to confirm details with their dental provider to understand the extent of their coverage fully. Are you looking for a dentist that takes Medicaid? Call us today to make an appointment!

Limited Adult Dental Care

While Medicaid coverage for children is quite comprehensive when it comes to dental care, adult dental benefits are often more limited. Here are the major areas of coverage for Medicaid dental services for adults:

1. Emergency Dental Services: At a bare minimum, many states provide coverage for emergency dental care for adults on Medicaid. This generally includes procedures necessary to alleviate pain, infection, or to prevent imminent tooth loss. For instance, extractions and treatment for dental abscesses may be covered.

2. Preventive Services: Some states expand their coverage to include preventive services such as cleanings, fluoride treatments, and dental exams. These services are vital for preventing dental diseases and ensuring the early detection of issues such as cavities and gum disease.

3. Restorative Services: Restorative services like fillings, root canal treatments, and crowns may be covered to a certain extent in some states. Medicaid may place restrictions on the types of materials used or the frequency of these services.

4. Dentures and Major Services: Coverage for dentures, bridges, and major surgical procedures varies widely. In states where these benefits are offered, they can make a significant difference in the quality of life for adults who have lost teeth due to decay or trauma.

Patients enrolled in Medicaid must be aware of the limitations and exclusions within their state’s dental program. Common limitations include annual caps on spending for dental services, limits on the number of certain procedures per year, or the requirement of prior authorization for specific treatments. Some services might be only partially covered, leaving the patient responsible for the remaining costs. Affordable Dental Solutions can help you navigate your Medicaid coverage for our services.

Affordable Dental Solutions for Medicaid Dental Treatment

At Affordable Dental Solutions, we provide care for patients with Medicaid coverage. We understand that dental issues can disrupt your everyday peace and diminish your self-esteem. That’s where our restorative dental solutions come into play, designed to not only address your immediate concerns but also to rejuvenate your smile and confidence.

Are you in search of reliable denture services within the Richmond, VA vicinity? Look no further! We’re here to assist you, irrespective of whether you’ve been enduring discomfort for an extended period or have found yourself amid an unexpected dental crisis. Our doors in Chesterfield are open to you, offering dependable care that you can trust time and time again. Don’t hesitate to reach out – we are ready to help you tackle your dental challenges head-on.


How do you find a dentist that accepts Medicaid?

Each state has its own Medicaid program and corresponding website where you can find a wealth of information. These websites often have provider directories or tools to help beneficiaries find local healthcare providers, including dentists, who accept Medicaid. Begin your search here, as it’s the most direct source of accurate information regarding in-network providers. If navigating online resources isn’t yielding results, or if you prefer speaking directly to a representative, your local Medicaid office is another valuable resource. Call us today to set up an appointment covered by Medicaid!

What dental services are covered by Medicare?

When it comes to dental services, the extent of Medicare coverage varies based on your specific plan and any additional coverage you might possess. For instance, patients with Medicare Advantage Plan Part C might have additional coverage. For those enrolled in Medicare and curious about whether our dental services fall under your plan’s benefits, we encourage you to get in touch with us for more information!

Can adults have Medicaid in Virginia?

In Virginia, Medicaid plays a vital role in providing healthcare coverage to low-income families, children, pregnant women, and eligible adults. Medicaid expansion under the Affordable Care Act (ACA) has made it possible for more adults in Virginia to qualify for Medicaid. As of January 1, 2019, Virginia expanded Medicaid eligibility to include adults aged 19 to 64 with income levels up to 138% of the Federal Poverty Level (FPL). This expansion translates into Medicaid coverage for hundreds of thousands of additional Virginians, ensuring that more adults have access to healthcare services, including dental care.

Does Medicaid Cover Tooth Extractions?

Tooth extractions are usually covered under Medicaid . At Affordable Dental Solutions, we know that the idea of tooth extraction can cause anxiety and we can help recommend treatment options to reduce stress. It’s imperative to seek emergency dental treatment immediately, as delaying care can lead to worse outcomes and more complex health issues. Medicaid recipients should not hesitate to seek care in the event of dental pain. 

Are root canals covered by Medicaid?

Medicaid in Virginia understands the importance of dental health and offers coverage for various types of dental care, including root canals, but with certain limitations. The Virginia Medicaid program recognizes that root canal treatments are a critical component of maintaining oral health, particularly when it comes to preventing the spread of infection or preparing the tooth for essential restoration work. In some cases, a root canal may not be necessary and a filling may be all that is needed. Call us today to see how we can help!