Does Medicaid cover dental for adults in Texas?

When a person has Medicaid coverage for their medical needs, they know that many of their medical needs can be covered at no cost or at little cost. However, Medicaid for dental needs may be vaguer as to what is and isn’t covered. In order for a person to receive the best dental treatment that is offered through Medicaid for adults, it’s essential for them to understand what treatment procedures are covered under their specific plan.

What’s Medicaid in Texas?

Medicaid is a joint effort between the federal government and the states that help poor people get medical coverage. The goal of Medicaid in Texas is to help people get medical care for themselves and their children who may not receive it otherwise.

The goal of the program is to make Texans healthier by:

  • Focusing on prevention.
  • Encouraging continuity of care.
  • Giving Medicaid recipients a medical home.
  • Making sure that each recipient can get high-quality, complete health care services in the patient’s community.
man experiencing tooth pain, Medicaid covers Wisdom Teeth Removal in Texas

Who is eligible for Medicaid in Texas?

To be eligible for Texas Medicaid, you must be a resident of the state of Texas, a U.S. national, citizen, permanent resident, or legal alien, in need of health care/insurance assistance, whose financial situation would be characterized as low-income or very low income. You must also be one of the following: Pregnant, responsible for a child 18 years of age or younger, Blind, or Have a disability or a family member in your household with a disability. Be 65 years of age or older. To be eligible, you must have an annual household income (before taxes) that is below the following amounts: Annual Household Income Limits (before taxes) Household Size* Maximum Income Level (Per Year) 1 $26,909 2 $36,254 3 $45,600 4 $54,945 5 $64,291 6 $73,637 7 $82,982 8 $92,328 *For households with more than eight people, add $9,346 per additional person. Always check with the appropriate managing agency to ensure the most accurate guidelines.

Medicaid offers low- or no-cost medical assistance to those who qualify based on their household income and the number of dependents.

To be eligible for Texas Medicaid, you must live in the state of Texas and be a U.S. national, citizen, permanent resident, or legal alien who needs help with health care or insurance and has a low or very low income. You also have to be one of these:

  • Be Pregnant
  • Be in charge of a child 18 or younger
  • Be blind
  • Have a disability or a family member with a disability
  • Be at least 65 years old

Medicaid differs slightly from state to state. People who live in Texas should talk to a Medicaid representative to find out if they are eligible for their benefits. Each representative can also help each person understand what dental procedures are provided in their state.

What does Medicaid cover for dental for adults?

Although Medicaid for adults does offer some dental coverage, it is unfortunately limited. Major procedures and cosmetic procedures are most likely not covered under adult Medicaid. However, instead of avoiding getting treatment done for fear it isn’t covered under Medicaid, each person should contact their local Texas dental office to learn more about what may or may not be covered. Most, if not all, Texas dental offices are knowledgeable about adult

Medicaid coverage and can answer most questions about each plan.

Some dental procedures that are usually covered under Medicaid for adults include dental x-rays, dental exams, and tooth extractions Medicaid (tooth removal covered by Medicaid). Each of these dental procedures is important and should be utilized. For example, dental x-rays are important for preventing disease and infection, finding decay, fractures, and other dental problems, and diagnosing them. Dental x-rays provide each dentist that accepts Medicaid and their team with a way to see inside the teeth and bone in the mouth. X-rays help every dental professional find small issues before they become worse.

Having a dental exam done on a regular basis is also important for diagnosing problems and treating them before they progress. If a person is in pain, the dentist can perform a dental exam to diagnose the issue and help relieve that discomfort. Dentists also use x-rays and dental exams to find problems that the patient may not know about, such as wisdom teeth that are stuck, gum disease, or cracks in the teeth.

If a person is suffering from significant dental issues but cannot afford recommended dental treatment, one option to eliminate the problem is to extract or remove the tooth or teeth causing the issue. Texas Superior Medicaid adult tooth extraction treatment is usually covered under Medicaid for adults.

Most dental professionals in the Texas area do accept Medicaid and can provide each patient with the dental care they need. If you or someone you know is covered under Medicaid and is in need of dental care, contact your Medicaid representative or local Texas dentist today to learn more about what dental procedures are covered under your plan.

The best way to do this is to contact their Medicaid representative before they see their dentist. This will help them know their options and avoid unexpected costs. Each representative can provide a list of treatment options that are covered or offered at a low cost.