Does KY Medicaid cover dental for adults?
Asked by: Zion Dietrich | Last update: January 8, 2026Score: 4.4/5 (29 votes)
Does Medicaid cover teeth for adults?
States may choose whether or not to provide dental benefits to their adult Medicaid-eligible population as part of its Medicaid program. While most states provide at least emergency dental services for adults, less than half of the states provide comprehensive dental care.
What does Medicaid cover for adults?
Mandatory benefits include services including inpatient and outpatient hospital services, physician services, laboratory and x-ray services, and home health services, among others. Optional benefits include services including prescription drugs, case management, physical therapy, and occupational therapy.
What is covered by Kentucky Medicaid?
Our enrollees get dental, hearing, medical, and vision coverage, and prescription drug and behavioral health benefits.
Does KY Wellcare Medicaid pay for dentures?
Kentucky has more than 900,000 residents insured by Medicaid. The dental services covered include dentures, implant therapy, two prophylaxes per year, endodontic therapy, extractions, restorative care, and periodontal treatment.
Making the Case for Adult Dental Coverage in Medicaid
What does Medicaid cover for dental for adults in KY?
- 1 cleaning every 12 months PLUS 1 additional cleaning every 12 months.
- 1 set of standard X-rays every 12 months.
- Dentures, implants, and root canals.
- Preventive care, like oral health screenings.
- Restorative care, like fillings and crowns.
How often will Medicaid pay for a set of dentures?
For States That Offer Dental Benefits Under Medicaid
For instance, some states have disclaimers stating that Medicaid enrollees can receive one or more of the following: $2,300 in dental services per year. One upper and lower denture per lifetime. A denture reline or adjustment every 3 years.
What is not covered by Medicaid?
Medicaid coverage can vary from state to state, but here are some common services and items that are typically not covered: Elective cosmetic procedures: Cosmetic surgeries and procedures, such as cosmetic dentistry and non-medical weight loss procedures, that are not medically necessary are typically not covered.
Does KY Medicaid pay for glasses?
KY Medicaid reimburses for no more than one pair of eyeglasses per beneficiary per the calendar year unless: the eyeglasses are broken or lost during the calendar year or. eyeglass prescription changes during the calendar year.
What programs and services are available from KY Medicaid?
Programs and Services
Kentucky Medicaid provides partial financial assistance with Medicare premiums, deductibles or coinsurance. Medicaid Works is a program for people with disabilities who work. School-Based Health Services must be included in the child's individual education plan.
What are the disadvantages of having Medicaid?
- Lower reimbursements and reduced revenue. Every medical practice needs to make a profit to stay in business, but medical practices that have a large Medicaid patient base tend to be less profitable. ...
- Administrative overhead. ...
- Extensive patient base. ...
- Medicaid can help get new practices established.
What happens if you make too much money while on Medicaid?
If you're over the Medicaid income limit, some states let you spend down extra income or place it in a trust to help you qualify for Medicaid. If you receive long-term care but your spouse doesn't, Medicaid will allow your spouse to keep enough income to avoid living in poverty.
What are the four types of Medicaid?
- State-operated fee-for-service (FFS)
- Primary care case management (PCCM)
- Comprehensive risk-based managed care (MCO model)
- Limited-benefit plans.
How can I fix my teeth if I don't have money?
- Nonprofit clinics. Some cities have dental clinics that specifically serve people with low incomes, no insurance, or who otherwise can't afford care.
- Donated services. Some state or national charities use donated labor and materials to give free care. ...
- Private dentists.
How to get straight teeth with Medicaid?
Medicaid will typically cover children 21 and under with orthodontic needs, that are deemed medically necessary. Scheduling a no-cost consultation can help you find out if this is an option for your family and if Medicaid can help with the cost of braces.
Why don't dentists take Medicaid?
Numerous studies on access to dental care for Medicaid-insured children have been completed, including those of dentists, who consistently provide 3 major reasons for their lack of participation in the Medicaid program: low reimbursement rates, broken appointments and patient noncompliance, and burdensome paperwork ...
How many pairs of glasses can you get on Medicaid?
Typically, Medicaid covers the cost of one pair of replacement glasses per year. If you are 21 or younger, you are allowed two pairs of replacement glasses per year. Glasses may be replaced if they are broken, lost, or stolen.
What assets are exempt from Medicaid in KY?
Exemptions include personal belongings, household furnishings, an automobile, and generally one's primary home. In Kentucky, IRA's / 401K's are exempt. All assets of a married couple are considered jointly owned (regardless of the long-term care Medicaid program for which one or both spouses is applying).
How do I get free stuff from WellCare?
As part of your plan, you have an Over-the-Counter (OTC) benefit where you will receive a fixed dollar amount preloaded into your Wellcare Spendables™ Card. You may use the Wellcare Spendables™ Card OTC dollars to purchase everyday items like bandages, pain relievers, cold remedies, toothpaste and much more.
How often does Medicaid check your bank account?
Medicaid agencies can check your account balances for bank accounts at any financial institution you've used in the past five years. They will check when you submit an application and on an annual basis, but checks can occur at any time.
What are the 6 things Medicare doesn't cover?
- Eye exams (for prescription eyeglasses)
- Long-term care.
- Cosmetic surgery.
- Massage therapy.
- Routine physical exams.
- Hearing aids and exams for fitting them.
What is exempt from Medicaid?
Certain types of income, such as Supplemental Security Income (SSI), veteran's benefits, and some forms of child support, are exempted from the spend down calculation. These exemptions ensure that individuals with limited income sources can still qualify for Medicaid.
How to get new teeth with Medicaid?
If you're wondering how to get Medicaid to pay for dental implants, your first step is to get a doctor to declare the procedure medically necessary. This may require some back and forth with your state's Medicaid office. One easy way to lower your dental surgery and treatment bills is to get separate dental insurance.
Does Kentucky Medicaid cover dentures for adults?
Effective January 1, 2023, Kentucky Medicaid has covered for a range of new dental services, including cleanings, crowns, root canals, and dentures for all adult beneficiaries. Previously, the state provided only diagnostic services, limited preventive and restorative services, and extractions.
How to get dentures with no dental insurance?
- Local Health Departments. ...
- Community Health Centers. ...
- Dental Schools. ...
- Clinical Trials. ...
- Dental Lifeline Network. ...
- Medicare. ...
- PACE (Program Of All-Inclusive Care For The Elderly) ...
- Medicaid Coverage.