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Dental
Dental Service category information for cost, eligibility, and frequency of services.
Dental

Braces

Who is Eligible? Individuals younger than age 21

How often? Braces are covered in extreme cases with prior authorization by the State.

Info: No additional information.

Copay: $0

Checkups and Cleanings

Who is Eligible? All Medicaid beneficiaries

How often? Every 180 days (6 months) for individuals younger than age 21; every 365 days (12 months) for individuals age 21 and older.

Info: There may be a copayment for dental services of $3 per visit for individuals age 21 and older.

Copay: $3 (individuals age 21 and older); $0 (individuals under age 21)

Dentures

Who is Eligible? All Medicaid beneficiaries

How often? Dentures may be replaced based upon medical necessity; dentures and partial plates must be prior authorized by the State.

Info: There may be a copayment for dental services of $3 per visit for non-pregnant individuals age 21 and older who are not residing in a nursing facility or intermediate care facility for individuals with intellectual developmental disabilities.

Copay: $3

Fillings, Extractions, and Crowns

Who is Eligible? All Medicaid beneficiaries

How often? Based upon medical necessity; may require prior authorization by the State.

Info: There may be a copayment for dental services of $3 per visit for non-pregnant individuals age 21 and older who are not residing in a nursing facility or intermediate care facility.

Copay: $3

Medical & Surgical Dental Services

Who is eligible? All Medicaid beneficiaries

How often? Based upon medical necessity.

Info: No additional information

Copay:

Root Canals

Who is Eligible? All Medicaid beneficiaries

How often? Based upon medical necessity.

Info: There may be a copayment for dental services of $3 per visit for non-pregnant individuals age 21 and older who are not residing in a nursing facility or intermediate care facility.

Copay: $3