Medicaid Adult Dental Services: Falling Off the Cliff

10-16-2017

by Julia Freeman-Woolpert, M.Ed., Disability Rights Center - New Hampshire

Yes, it’s true. Medicaid stops paying for almost all dental services when a recipient turns 21 years of age.   The only dental services Medicaid will continue to cover are relief of acute pain or infection, including extraction of the tooth causing pain, and treatment of severe trauma for emergencies such as hemorrhages, bone fractures, and severe abrasions needing debridement (removal of damaged tissue.)

Medicare also does not cover dental care, except for some limited services under Part A when a recipient is in the hospital, skilled nursing facility, hospice care, or in some home health care situations.  

However, if you qualify for both Medicare and Medicaid and live in Cheshire, Grafton, Hillsborough, Merrimack, Rockingham, or Strafford County, you may qualify for Anthem Mediblue Coordination Plus at no cost, including $0 copay for preventive dental care (2 exams and cleanings, and one x-ray) and dental services (dentures, crowns, and fillings) for up to $1500 per year.  This coverage may be subject to change, check the website to make sure it is still in place.

We know how important dental health is to overall health. We know that only 50% of people with disabilities see the dentist as often as recommended. That’s a lower rate than people without disabilities.  People without health insurance, not surprisingly, are less likely to have an annual dental exam.

What to do?

Here are some options to explore.

There are a few low cost dental clinics in New Hampshire. You can find a partial list here: http://www.nhds.org/for-the-public/low-cost-dental-care/clinic-listing.

Harbor Homes, which did not make the list above, has a reduced fee dental clinic in Nashua. http://harborhomes.org/dental-clinic/.

New Hampshire Technical Institute in Concord has a dental hygiene clinic with limited services at very reasonable fees ($20-$30 for a cleaning.) https://www.nhti.edu/community-visitors/dental-hygiene-clinic.

Donated Dental Services, run by the Dental Lifeline Network, has limited volunteer providers.  Unfortunately, due to lengthy waiting lists applications in New Hampshire are currently closed. You can continue to check to see if this changes - https://dentallifeline.org/new-hampshire/.

Some Area Agencies will assist with payment for dental services, others have done fundraising to cover dental expenses, and a few Area Agencies have coordinators for oral health. If you receive services from an Area Agency, work with your service coordinator to explore options for dental care.

If you receive Financial Assistance to Needy Families from DHHS (FANF – formerly TANF), there are some limited circumstances where funding is available for cosmetic dental care (up to $1500) to address dental problems that present obstacles to employment.

If you are a client of Vocational Rehabilitation, you may be able to get limited dental services if they are necessary to help you reach your employment objective.

Meanwhile, brush your teeth and floss!

updated October 16, 2017