What if Medicaid won't cover your dental care?

If Medicaid won't cover your dental care, you can still find affordable treatment through Federally Qualified Health Centers, dental school clinics, community programs or private payment plans. Because adult dental coverage isn't federally required, state benefits vary widely.  

What you will learn in this article: 

• Medicaid dental coverage for adults varies by state, and in many states it covers little to nothing beyond emergencies. 

• Free and low-cost dental care exists even without coverage, through Federally Qualified Health Centers, dental school clinics and nonprofit programs. 

• Payment plans, sliding-scale fees and dental savings plans can make care accessible even if you are uninsured. 

• Skipping the dental provider leads to bigger, more expensive problems. One visit a year can make a significant difference. 

If gaps in your coverage have you worried, you don't have to figure it out alone. Schedule an appointment with an Aspen Dental provider to talk through your care options and find a payment path that works for you. 

Why Medicaid often doesn't cover adult dental care 

According to the Centers for Disease Control and Prevention (CDC), states are not required to provide dental benefits to adult enrollees.¹ That means coverage rules change depending on where you live. The National Institute of Dental and Craniofacial Research confirms adult dental coverage is thin in most states, with only a handful offering more complete benefits.² Some states offer more. Some offer almost nothing. 

The CDC evaluated state coverage in 2023, reporting that adults in only 28 states and Washington, D.C., had access to full Medicaid dental benefits.¹ If you live outside those states, your options through Medicaid may be very thin. 

Older adults with low incomes feel this gap the most. A study published in PubMed Central found that low-income older adults in states with no Medicaid dental coverage had the lowest chance of seeing a dental provider.³ The study also revealed that financial cost is a major barrier, with low-income older adults being three times more likely to name cost as the reason they skipped care.³ 

Where to find care when coverage falls short 

A few options can fill the gap, depending on your budget, your location and how quickly you need care. 

Federally Qualified Health Centers 

These are clinics that get federal funding to serve people with low incomes. They must offer dental care on a sliding fee scale. That means your cost is based on what you earn. You don't need insurance to go. 

You can find one near you through the Health Resources and Services Administration finder tool at findahealthcenter.hrsa.gov. 

Dental school clinics 

Dental schools train new dental providers. Students do the work. A licensed dental provider watches every step. Fees are lower than a private office. Care still meets the same standards. 

Call a dental school near you and ask if they take walk-in patients or new patients with no insurance. 

Nonprofit and community dental programs 

Some nonprofits run free or reduced-cost dental clinics. Local health departments sometimes run them too. Search for "free dental clinic" plus your city or county name. Your local library can also help you find these programs. 

Sliding-scale private dental providers 

Some private dental offices offer payment plans or sliding-scale fees. It never hurts to ask. Call the office before your visit. Tell them you don't have dental coverage. Ask what options they have for uninsured patients. 

How to make care more affordable 

A little planning ahead can stretch your budget further, whether or not you have any coverage at all. 

Ask about payment plans 

Many dental offices let you spread the cost over time. Ask about this before any work starts. Get the terms in writing so you know what to expect. 

Look into dental savings plans 

These are membership plans you pay for directly. They are not insurance. You pay a yearly fee and get discounts on care at offices in the plan's network. They can cut costs on exams, cleanings and some procedures. 

Focus on prevention first 

Catching a problem early costs less than treating it later. A cleaning and exam costs far less than a root canal or an extraction. Even one visit a year can help you avoid a bigger, pricier problem down the road. 

Research shows that access to full Medicaid dental benefits led to more dental visits among vulnerable older adults.³ More consistent visits can help you catch small problems before they become bigger ones. 

What to do right now 

Start with one phone call. Contact a Federally Qualified Health Center or a dental school in your area. Ask what they charge and how they bill. If cost is still a barrier, ask the office about payment plans or savings programs. 

Don't wait for pain to push you. Dental problems that are caught early are almost always easier and cheaper to fix. 

Don't let a lack of coverage stand between you and a healthy smile. Contact your dental provider today to talk through your options and explore flexible payment solutions. 

What to do when Medicaid won't cover your dental care FAQs  

Here are answers to a few common questions about managing dental care without Medicaid. 

Does Medicaid ever cover dental emergencies for adults? 

It depends on your state. Some states cover emergency dental visits even when they don't cover routine care. Call your state Medicaid office or your caseworker to find out what your plan includes for emergencies. 

Can I use Medicaid and a dental savings plan at the same time? 

It depends on the plan. Some dental savings plans allow you to layer discounts on top of whatever Medicaid does cover. Others don't. Call the savings plan's member line before you sign up and ask whether their discounts apply when Medicaid is also involved. Your dental office can also help you figure out how to stack benefits. 

Are dental savings plans worth it if I have no insurance? 

They can be. They are not insurance, so they don't pay claims. But they do give you a set discount at member offices. If you need regular cleanings or have a known dental issue, the yearly fee can pay for itself quickly. Ask any dental office if they accept a savings plan before you sign up for one. 

What if I can't afford care even at a low-cost clinic? 

Tell the clinic. Many have hardship programs or can connect you with local assistance. Some states also have programs run through health departments or dental associations. Your care team may know of local resources too. 

Sources 

¹ Centers for Disease Control and Prevention: “Health Equity and Oral Health Disparities.” https://www.cdc.gov/oral-health/health-equity/index.html 

² National Institute of Dental and Craniofacial Research: “Finding Dental Care.” https://www.nidcr.nih.gov/health-info/finding-dental-care 

³ National Institutes of Health, PubMed Central: “Medicaid Adult Dental Benefits and Oral Health of Low-Income Older Adults.” https://pmc.ncbi.nlm.nih.gov/articles/PMC8330417/