Oral Health Coverage for Low-Income Adults Postcard

4/15/2016

Oral health is a vital component of overall health. Low-income adults are less likely to have visited a dentist within the last year than those with higher incomes, and they are more likely to have untreated tooth decay.

A growing number of adults forego preventive care due to cost, lack of dental coverage and other barriers. Complications from dental disease are associated with increased risk for diabetes, heart disease, stroke, and preterm birth and other pregnancy problems.

States have taken different approaches to address cost and coverage barriers.

Although dental coverage is not a required benefit for adult Medicaid enrollees under federal law (as it is for children), most states provide at least some dental benefits for this group. Fiscal pressures have led some states to reduce or eliminate Medicaid dental benefits or consider other short-term cost-containing policies.

Some states provide Medicaid dental benefits to all qualified adults, while others cover targeted groups, such as pregnant women or those with developmental disabilities. Since 2013, several states, including California, Colorado, Idaho, South Carolina and Washington, added or restored dental benefits to adults enrolled in Medicaid.

According to a February 2016 report from the Center for Health Care Strategies, 46 states and the District of Columbia currently cover at least emergency dental services (e.g., relief for uncontrolled bleeding or trauma) for adults with Medicaid. Of those, 13 states cover emergency care only, 18 states and the District of Columbia cover certain limited services such as preventive and restorative procedures), and 15 states offer extensive coverage to their base Medicaid adult population.

United States map of State Medicaid Coverage of Adult Dental Benefits