NC Medicaid Dental Coverage for Adults Generally, you can receive exams, cleanings, fillings, sealants, x-rays, extractions, and dentures. Surgeries and periodontal services are available when medically necessary, and root canals are available for those under 21.
Medicaid will NOT pay for the following dental services: Dental implants • Permanent bridgework (except for cleft palate cases) • Same-day full or partial dentures • Molar root canal therapy to fix infections (there are exceptions) • Crown lengthening to help fix a tooth • Replacement of partial or full dentures before
Medicaid covers dental services for all child enrollees as part of a comprehensive set of benefits, referred to as the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit. A referral to a dentist is required for every child in accordance with the periodicity schedule set by a state.
If you need dental treatment, you will need to go to a dentist who is enrolled in the NC Health Choice Program. The following providers offer dental services: General Dentists – Provide exams, X-rays, preventive services, fillings, complete and partial dentures, and simple extractions to patients of a wide age range.
Medicaid Dental Providers General Dentists – Provide exams, X-rays, preventive services, fillings, complete and partial dentures , and simple extractions to patients of a wide age range. Pediatric Dentists – Provide exams, X-rays, preventive services, fillings and simple extractions for children.
Medicaid is a health insurance program for low-income individuals and families who cannot afford health care costs. Medicaid may help pay for certain medical expenses including: Personal Care Services (PCS), Medical Equipment, and Other Home Health Services. In-home care under the Community Alternatives Program (CAP)
As do many commercial dental benefit providers, state Medicaid programs commonly limit examinations and cleanings to one or two per year. Connecticut and Illinois limit fillings to one per year, limit crowns to one per tooth every five years, and limit root canals to one per tooth per lifetime.
Unfortunately, neither Medicare nor Medicaid covers dental implants for low-income families or seniors in our state. This is a major problem as many seniors suffer from severe dental problems and have no means of remedying them without health insurance covering them.
North Carolina Medicaid is very strict on who they will cover for orthodontic treatment costs. We are required to submit your models, x-rays, pictures, and treatment plan to the main Medicaid office for approval. If they feel your case is not severe enough, they can deny treatment coverage.
Many private practices are unable to accept Medicaid patients because the reimbursement rate still lags far behind private insurance. Also, the Medicaid credentialing and claims process is so burdensome that it would require extra dedicated staff just to manage the administrative aspects.
Who’s entitled to free dental care ? aged under 18, or under 19 and in qualifying full-time education. pregnant or have had a baby in the previous 12 months. staying in an NHS hospital and your treatment is carried out by the hospital dentist .
In January 2014, the state restored comprehensive dental benefits for all adults enrolled in the Medicaid program. Drastically reducing the Medicaid adult dental package in 2012, Pennsylvania left most adults in the program with limited benefits primarily covering x-rays, cleanings, fillings, and extractions.
View coronavirus (COVID-19) resources on Benefits.gov. Visit Coronavirus.gov for live updates. Who is eligible for North Carolina Medicaid Program?
|Household Size*||Maximum Income Level (Per Year)|
Does NC Medicaid cover eye exams and glasses for adults? Starting January 1st of 2019, NC Medicaid covers eye exams and glasses for adults. If you’re 21 years of age or older, and have NC Medicaid , you can also be seen by Medicaid eye care providers for medical eye exams.
Who is eligible for NC Medicaid/Health Choice?
|Family Size||NC Medicaid (Children under 6)||NC Health Choice (CHIP) (6-18 years old)|