Medicaid doesn't cover the cost of dentures in most states. However, in just over a few states, the cost of dentures or partial dentures is covered. In states where denture coverage is available, there are generally specific guidelines that govern which Medicaid beneficiaries qualify. Because each state administers its own Medicaid program, dental prosthesis coverage varies from state to state.
This is true for both dentures and general dental benefits. Most states include at least emergency dental care benefits, but there are no established requirements for adults receiving Medicaid. This is different from children receiving Medicaid, who are guaranteed certain dental benefits. Dentures can offer a great opportunity to restore your smile, improve bite alignment, and help you regain the ability to eat certain foods.
Implants may require a longer wait time than removable prostheses because gum tissue must recover and strengthen for implants to work. In addition to dental prosthetics for low-income members, Medicare Advantage may cover other services that are not part of standard Medicare coverage. Another requirement you'll need to determine is whether your state's Medicaid program only offers denture coverage if you get it from a certain type of dental provider. Dentures for low-income patients may not be covered by basic Medicare, but you may be able to get coverage if you have Medicare Advantage.
You may need a set of removable prostheses between the time the extractions are performed and the first implant procedure. Keep in mind that Medicaid programs are administered by each state, and some decide to expand coverage to include dental services, such as dentures, while others don't. The only time Medicare will cover your dental procedures is if they are related to a health problem covered by Medicare, such as the exam required before heart valve replacement surgery. Dentures, which may also be referred to as false teeth, are usually made of a composite material that can resist bacteria and breakage.
For example, Medicaid in Alabama doesn't cover any type of dental care for adults, while Florida's Medicaid covers only emergency dental services. If you live in a state that doesn't offer prosthetic coverage as part of your Medicaid benefits, there are other ways to get financial assistance. The structure of dentures can be based on resin or on a mixture of resin-based material with metal accessories. However, even if you're not covered, you may be able to get help through denture grants and other resources.
You can compare the plan's benefits, costs, coverage, and more online, or you can call to speak with a licensed insurance agent who can help you compare plans. With Medicare Advantage, you get your benefits through a private insurer, but you include the benefits you would have covered in Parts A and B. Both partial dentures and full dentures are included in the benefits, but may be limited to one set every ten years; some are even limited to once a lifetime.