Does Medicaid Cover Dental 2025? 50-State Guide (Kids & Adults)

It depends. Medicaid always covers dental for kids under 21 in all states, but for adults, it varies by state and often covers only emergencies.

Adult Medicaid Dental Coverage by State (2025)

State	Covered?	Notes	Requirements
Alabama	❌ No	No dental care for adults.	None.
Alaska	⚠️ Maybe	Emergency pain relief only.	Prior authorization for preventive.
Arizona	⚠️ Maybe	Emergency care up to $1,000.	None.
Arkansas	✅ Yes	Up to $500 for basic care.	Approval for surgery/dentures.
California	✅ Yes	Full services, $1,800 limit.	Medically necessary.
Colorado	✅ Yes	$1,500 for various services.	None.
Connecticut	✅ Yes	$1,000 limit on services.	None.
Delaware	❌ No	No coverage at all.	None.
District of Columbia	✅ Yes	Full adult dental benefit.	None.
Florida	⚠️ Maybe	Emergency services only.	None.
Georgia	⚠️ Maybe	Emergency, recent funding boost.	None.
Hawaii	⚠️ Maybe	Emergency pain control.	None.
Idaho	✅ Yes	Full preventive and therapeutic.	None.
Illinois	✅ Yes	Preventive through plans.	None.
Indiana	✅ Yes	Comprehensive in Plus plan.	None.
Iowa	✅ Yes	Full in first year, $1,000 cap.	Healthy behaviors.
Kansas	✅ Yes	Some preventive care.	None.
Kentucky	✅ Yes	Exams, fillings, extractions.	None.
Louisiana	✅ Yes	Exams, x-rays, dentures.	None.
Maine	⚠️ Maybe	Surgery for pain/infection.	None.
Maryland	❌ No	No extractions covered.	None.
Massachusetts	✅ Yes	Wide range of services.	None.
Michigan	✅ Yes	Check-ups, fillings, dentures.	None.
Minnesota	✅ Yes	Medically necessary services.	Medically necessary.
Mississippi	✅ Yes	Extractions and treatment.	None.
Missouri	✅ Yes	Exams, cleanings, fillings.	None.
Montana	✅ Yes	$1,125 cap on treatment.	None.
Nebraska	✅ Yes	No cap after recent change.	None.
Nevada	⚠️ Maybe	Emergency exams/extractions.	None.
New Hampshire	⚠️ Maybe	Emergency trauma treatment.	None.
New Jersey	✅ Yes	Comprehensive benefits.	None.
New Mexico	✅ Yes	Wide list of services.	None.
New York	✅ Yes	Preventive, no limit.	None.
North Carolina	✅ Yes	Preventive, no limit.	None.
North Dakota	✅ Yes	Exams, crowns, dentures.	None.
Ohio	✅ Yes	Same as kids, no braces.	None.
Oklahoma	⚠️ Maybe	Emergency extractions only.	None.
Oregon	✅ Yes	Wide services covered.	None.
Pennsylvania	✅ Yes	Surgical/emergency minimum.	Based on need.
Rhode Island	✅ Yes	Diagnostic, restorative.	None.
South Carolina	✅ Yes	Preventive with copay.	None.
South Dakota	✅ Yes	$1,000 limit, exemptions.	None.
Tennessee	❌ No	No adult dental.	None.
Texas	⚠️ Maybe	Emergency coverage.	None.
Utah	⚠️ Maybe	Emergency, expanded 2025.	None.
Vermont	✅ Yes	$510 limit per year.	Prior authorization.
Virginia	⚠️ Maybe	Medically necessary only.	Medically necessary.
Washington	✅ Yes	Covered services, no crowns.	None.
West Virginia	⚠️ Maybe	$2,000 over two years.	Prior authorization.
Wisconsin	✅ Yes	Covered, no orthodontia.	Pre-approval for some.
Wyoming	✅ Yes	Preventive/emergency only.	None.

Medical Necessity Explained

Medical necessity means the care is needed to treat a real health issue. Medicaid uses it to focus on important treatments that help people stay healthy. For example, if a bad toothache could lead to a bigger infection, it’s necessary to fix it.

Real-Life Examples

Example 1: When Medicaid does cover it. Lisa, 28, lives in California. She has a cavity that hurts a lot. Her state has full coverage, so Medicaid pays for her filling and check-up.

Example 2: When Medicaid does not cover it. Mike, 42, in Alabama, wants a routine cleaning. His state has no adult dental coverage, so he pays out of pocket.

Step-by-Step Guide

1. Ask your doctor if the dental work is needed for your health.

2. Get a referral that says it’s medically necessary.

3. Fill out the form from your state’s Medicaid site.

4. Send the form and doctor note to Medicaid.

5. Wait for them to say yes or no.

6. Call Medicaid if denied: [1-800-541-2831](tel: 1-800-541-2831).

Documents Checklist

Your Medicaid ID card.
Proof of income like pay stubs.
Doctor’s note on why it’s needed.
Dental x-rays or photos.
ID like driver’s license.
Referral form from doctor.
Address proof like a bill.

Approval Timeline

Most approvals take 30 to 45 days. Delays happen from missing papers or too many requests. To speed it up, send all docs at once and call to check status after two weeks.

Coverage Summary Box

YES – Kids’ check-ups, cleanings, fillings; emergency care for all.

NO – Teeth whitening, braces for looks.

MAYBE – Adult cleanings, fillings, dentures; depends on state rules.

What Medicaid Does NOT Cover

Medicaid does not pay for things like teeth whitening, braces just to look better, or implants that are not needed for health. It skips cosmetic work or optional fixes that do not fix a real problem.

Alternative Options If Denied

– Free clinics at community health centers.

– Low-cost care at dental schools.

– Donated Dental Services nonprofit for free help.

– Check your state dental association for resources.

FAQ for Medicaid Dental Coverage 2025

Does Medicaid cover dental for adults in 2025?

Coverage for adults depends on the state, with some offering full benefits and others paying only for emergencies. Always check your state’s 2025 Medicaid dental policy for exact rules.

Are routine cleanings covered by Medicaid?

Kids get full preventive dental care in all states, but adults may only have access depending on state rules. Some states cover cleanings fully, while others limit them to emergency-only situations.

Does Medicaid require prior authorization for dental work in 2025?

Yes, many states require prior authorization for major services like dentures, crowns, or oral surgery. Your dentist must submit clinical notes or X-rays before Medicaid will approve the treatment.

Are dental emergencies covered by Medicaid?

Yes, all states cover emergency dental services such as severe pain, infections, swelling, or trauma. This is guaranteed even in states that do not offer routine adult dental benefits.

Does Medicaid cover dental care during pregnancy in 2025?

Many states expand dental benefits for pregnant women to protect maternal and fetal health. Coverage often includes extra cleanings, fillings, and infection treatment.

Are dentures covered under Medicaid?

Some states cover dentures fully, while others require prior approval or offer partial coverage. States with no adult dental benefits usually do not cover dentures at all.

Does Medicaid cover braces in 2025?

Braces are rarely covered for adults unless medically necessary and tied to a serious health issue. For children, orthodontic care is covered only when a doctor confirms that it’s essential for development.

How do I find a Medicaid dentist near me?

Use your state’s official Medicaid provider directory to locate dentists who accept your plan. You can also call your Medicaid office for a current 2025 list of approved providers.

Cost Comparison Table

Service	Cost with Medicaid	Cost without Medicaid
Cleaning	$0–$20	$100–$200
Filling	$0–$50	$200–$400
Extraction	$0–$30	$150–$300
Dentures	$0–$100	$800–$2,000