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Availability of Medicaid Coverage for Dentures by State – Ways to Make Dentures Afforable

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It may appear that dentures seem like a cosmetic luxury and out of reach to low income individuals. Depending on the type of dentures, the cost can range anywhere from $300 to $5000 per plate.


For both top and bottom plates, an individual could be looking at $600-$10,000. A steep cost for one to be able to eat and speak properly.Regardless of the price point, there are various ways to make dentures affordable.

The go-to way is usually through one’s private or government offered dental insurance which normally will only contribute a partial cost of the dentures that could still pose a significant out of pocket cost for a low-income individual on top of the monthly premium.

Dentures Through Medicaid

Another considerable alternative is through Medicaid. Some Medicare Advantage Plans offer dentures coverage through Medicare Part C. Since coverage can vary from plan to plan, always double-check with the Medicare Advantage plan you’re considering to see if a specific benefit is included. However, coverage for dentures is NOT Available under standard Medicare plans. Although Medicare may cover a dental related emergency room visit, Medicare typically stays away from dental assistance in general.

As for Medicaid, dental assistance is much more achievable for medicaid enrollees. Some states do offer coverage of dentures through Medicaid, but not all. As this is considered an optional category. If coverage for dentures is available in your state, simply an elderly individual would need to meet the requirements for medicaid and be dually enrolled in both Medicaid and Medicare. Unlike other medical needs such as wheelchairs and durable medical equipment, only medicaid would cover the cost of dentures. Instead of Medicare and medicaid paying jointly.

Availability

Unfortunately dentures through medicaid is not available in every state. As it is considered an optional category that each state is free to expand their coverage beyond federal minimums. To find out if dentures are covered by Medicaid in your state. An individual should first determine if they are eligible for medicaid, then apply.

If an individual, regardless of age is eligible for medicaid and the state offers coverage for dentures. The individual is eligible for dentures as well. There is no extended qualifications for dentures or dental coverage. An important fact to keep in mind though is that dentures is an individual coverage IN ADDITION to dental coverage.

Therefore, some states may offer dental coverage but coverage may not be available for dentures. Currently 26 states offer dentures under medicaid. Those states are Alaska, Arkansas, California, Colorado, Connecticut, District of Columbia, Florida, Illinois, Iowa, Louisiana, Massachusetts, Minnesota, Nebraska, Nevada, New Jersey, New York, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, South Dakota, Washington, Wisconsin, and Wyoming.

PACE Program

PACE, also known as Program of All-inclusive Care for the Elderly, is a program that is jointly run by Medicare and Medicaid is also another option that can help individuals get the dentures they need as PACE provides all services that are covered by Medicare or Medicaid, and dental services may be covered under your state’s Medicaid program.

The program is focused on helping senior adults remain independent and prolong nursing-home care for as long as possible. If coverage of dentures is available in your state, dentures would be included in this program as well.

Alternatives For States Where Coverage For Dentures Is Not Offered

As stated, there are variety of ways to make dentures affordable. If coverage for dentures is not available in your state. An individual can explore some of the alternatives below.

    • Dental insurance: Many major medical health plans include dental coverage with monthly premiums as low as $5 , stand-alone dental plans may also be available in your state. These plans typically cover oral exams, cleanings, X-rays, fillings, and other preventive dental care. Plans may also help with some of the costs for oral surgery, implants, and dentures. Benefits will vary by plan, so check with the specific plan for more details.
    • Dental schools: Some dental schools may run low-cost clinics as a way to give back to the community and train dentists. Find dental schools near you to see if programs are available in your location.
    • Community health clinics: Local community centers may provide dental services for low-income individuals. The National Council on Aging can help you find resources for seniors in your area.
    • Dental Lifeline Network: This program provides free dental services to vulnerable groups who can’t afford care, including seniors. Find out if you’re eligible and look up the program for your state by visiting the Dental Lifeline Network website.
    • Third Party Financing: If the full cost of dentures is out of your budget but a low monthly payment is feasible, third party financing is likely available with low interest rates, and possibly even interest free for senior citizens and lower credit requirements (if any). Most dentists usually offer financing options through the office themselves or through a third-party to allow an individual to get dentures quickly without having to wait.