Medicaid in Texas covers several dental services for children, pregnant women, and adults with specific disabilities. For children, Medicaid provides preventive, restorative, and emergency dental services. These services aim to promote good oral health and prevent future problems. Pregnant women are eligible for dental services related to their pregnancy, including exams, cleanings, fillings, and extractions. Adults with specific disabilities may also qualify for dental services if they meet certain criteria. These criteria include having a disability that affects their ability to care for their teeth and being enrolled in a Medicaid managed care plan. The specific dental services covered by Medicaid in Texas may vary depending on the individual’s eligibility and the type of plan they are enrolled in.
Medicaid Dental Coverage for Adults in Texas
Medicaid is a government-sponsored health insurance program that provides coverage to low-income individuals and families. In Texas, Medicaid dental coverage for adults is limited, but there are some options available.
Who Is Eligible for Medicaid Dental Coverage in Texas?
- Pregnant women
- Children under the age of 21
- Adults who are receiving Supplemental Security Income (SSI)
- Adults who are eligible for Medicare and Medicaid (dual-eligible adults)
There are some additional eligibility requirements that may apply, such as income and asset limits. To learn more about Medicaid eligibility in Texas, visit the Texas Health and Human Services website.
What Dental Services Are Covered by Medicaid in Texas?
- Exams
- Cleanings
- X-rays
- Fillings
- Extractions
- Root canals
- Crowns
- Bridges
- Dentures
The specific services that are covered may vary depending on the individual’s age and eligibility category. To learn more about the dental services that are covered by Medicaid in Texas, visit the Medicaid website.
How Do I Find a Dentist Who Accepts Medicaid in Texas?
There are a few ways to find a dentist who accepts Medicaid in Texas.
- You can call the Texas Medicaid Customer Service Center at 1-877-541-7905.
- You can search for dentists on the Medicaid website.
- You can ask your doctor or other healthcare provider for a referral.
What If I Need Dental Care That Is Not Covered by Medicaid?
If you need dental care that is not covered by Medicaid, you may be able to get help from a community health center or free clinic. These clinics often offer dental care on a sliding scale, based on your income and family size. To find a community health center or free clinic in Texas, visit the Texas Health and Human Services website.
| Eligibility | Services Covered | How to Find a Dentist | What If Care Is Not Covered? |
|---|---|---|---|
| Pregnant women, children under 21, adults receiving SSI, dual-eligible adults | Exams, cleanings, X-rays, fillings, extractions, root canals, crowns, bridges, dentures | Call Medicaid Customer Service, search on Medicaid website, ask for referral | Community health centers, free clinics |
Medicaid Dental Coverage for Children in Texas
In Texas, Medicaid provides comprehensive dental benefits to children under the age of 21. This includes preventive, basic, and major dental services. Medicaid also provides coverage for orthodontic services for children with severe malocclusions.
- Preventive Services:
- Regular checkups
- Cleanings
- Fluoride treatments
- Sealants
- X-rays
- Basic Services:
- Fillings
- Extractions
- Root canals
- Crowns
- Bridges
- Major Services:
- Hospitalization for dental care
- Surgery
- Orthodontics
Medicaid also provides coverage for orthodontic services for children with severe malocclusions. Orthodontic services are not considered medically necessary, but they can be covered if they are deemed to be necessary for the child’s overall health or well-being.
To qualify for Medicaid dental coverage in Texas, children must be under the age of 21 and must meet certain income and asset limits. Children who are eligible for Medicaid may also be eligible for the Children’s Health Insurance Program (CHIP). CHIP provides dental coverage to children who are not eligible for Medicaid. For more information on Medicaid dental coverage in Texas, please visit the Texas Health and Human Services website.
| Covered Services | Age Limit | Eligibility |
|---|---|---|
| Preventive Services | Under 21 | Medicaid or CHIP |
| Basic Services | Under 21 | Medicaid or CHIP |
| Major Services | Under 21 | Medicaid or CHIP |
| Orthodontic Services | Under 21 | Medicaid or CHIP, if medically necessary |
Medicaid Dental Coverage in Texas
Medicaid offers comprehensive dental coverage to eligible individuals in Texas. The benefits include preventive, basic, and emergency dental services. The coverage is available to children, adults, and seniors who meet the eligibility criteria.
Medicaid Dental Services and Procedures Covered
- Preventive Services:
- Regular checkups and cleanings
- Fluoride treatments
- Sealants
- Oral hygiene instructions
- Basic Services:
- Fillings
- Extractions
- Root canals
- Crowns
- Bridges
- Dentures
- Emergency Services:
- Pain relief
- Infection control
- Extraction of a tooth
| Age Group | Preventive Services | Basic Services | Emergency Services |
|---|---|---|---|
| Children (0-18) | Covered | Covered | Covered |
| Adults (19-64) | Covered | Limited Coverage | Covered |
| Seniors (65+) | Covered | Limited Coverage | Covered |
Eligibility for Medicaid Dental Coverage in Texas
To be eligible for Medicaid dental coverage in Texas, you must meet certain requirements. These include:
- Being a Texas resident
- Being a U.S. citizen or qualified noncitizen
- Meeting income and asset limits
- Being enrolled in Medicaid
How to Apply for Medicaid Dental Coverage in Texas
To apply for Medicaid dental coverage in Texas, you can:
- Apply online at the Texas Health and Human Services Commission (HHSC) website
- Call the HHSC Medicaid Customer Service Center at 1-877-541-7905
- Visit your local HHSC office
You will need to provide proof of your identity, residency, income, and assets. You will also need to provide proof of your Medicaid eligibility.
What Dental Services Are Covered by Medicaid in Texas?
Medicaid in Texas covers a wide range of dental services, including:
- Routine preventive care, such as cleanings, exams, and x-rays
- Restorative care, such as fillings, crowns, and bridges
- Oral surgery, such as tooth extractions and root canals
- Periodontal care, such as gum disease treatment
- Orthodontic care, such as braces
The specific services that are covered may vary depending on your age, income, and other factors.
How to Find a Medicaid Dentist in Texas
To find a Medicaid dentist in Texas, you can:
- Search the HHSC website for a list of participating dentists
- Call the HHSC Medicaid Customer Service Center at 1-877-541-7905
- Visit your local HHSC office
You can also ask your friends, family, or neighbors for recommendations.
Medicaid Dental Coverage in Texas: A Summary
| Eligibility | How to Apply | Covered Services | Finding a Dentist |
|---|---|---|---|
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