Medicaid Dental Benefits: What’s Covered for Adults and Children (2026-2027)

Reviewed November 8, 2026. Medicaid dental benefits depend on your age. Every state must cover dental care for children under 21 through the EPSDT benefit, while dental coverage for adults is optional, so each state decides whether adults get no dental care, emergency care only, a limited package or extensive coverage. This guide explains what is covered, how to check your own state’s rules and how to find a dentist who takes Medicaid.

Quick answer: Children on Medicaid get dental care in every state, including treatment for pain and infection, fillings, preventive care and medically necessary orthodontics. Adults get whatever their state chooses to offer, and CMS says there are “no minimum requirements for adult dental coverage.” Your state Medicaid agency or your dental plan’s member handbook is the final word on what you can get.

Medicaid dental benefits at a glance

Children’s dental coverage under EPSDT

The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit covers children under age 21 who are enrolled in Medicaid. According to Medicaid.gov, covered dental services must, at a minimum, include care needed for relief of pain and infection, restoration of teeth, maintenance of dental health (starting as early as necessary) and medically necessary orthodontic services.

A few rules matter for families:

• No emergency-only limits for kids. CMS states that dental services “may not be limited to emergency services for children entitled to EPSDT.”
• A dentist referral is required. An oral screening during a well-child visit does not replace a dental exam. A referral to a dentist is required for every child according to the state’s dental periodicity schedule (the timetable for checkups).
• Treatment follows medical necessity. States must cover medically necessary services to correct or improve conditions found during screenings, though each state decides what counts as medically necessary. That is why braces are usually approved only for serious problems, not for cosmetic reasons.

For an example of how one state applies these rules to orthodontics, see whether MCNA Dental covers braces in Texas.

CHIP dental benefits

The Children’s Health Insurance Program (CHIP) also includes dental care. If your state runs CHIP as an expansion of Medicaid, the full EPSDT benefit applies. States with a separate CHIP program must cover dental services needed to prevent disease and promote oral health, either through a package that meets CHIP requirements or a benchmark dental plan that is substantially equal to a set comparison plan. Texas, for example, says all children enrolled in CHIP are eligible for dental benefits.

Adult dental coverage is optional for states

Federal law does not require Medicaid to cover dental care for adults. Medicaid.gov says states choose whether to provide adult dental benefits and have flexibility to decide what those benefits include. As a result, two adults with the same income can have very different coverage simply because they live in different states.

The four levels of state adult dental coverage

CMS groups state adult dental programs into four categories in its 2023 Medicaid & CHIP Beneficiaries at a Glance: Oral Health fact sheet, based on state policies as of October 20, 2022:

How many states fall in each group? The most recent official count we could verify comes from MACPAC, the congressional agency that advises Congress on Medicaid. Its January 2021 brief, reflecting state policies as of March 2020, found that three states provided no adult dental benefit and nine covered emergency services only, which means 38 states covered at least some care beyond emergencies. Several states have changed their adult benefits since then, so we do not list states by category here. Check your own state’s current rules using the steps below.

Adults with disabilities and other special groups

Some states give certain adults more dental coverage than the general adult population. MACPAC reported in 2021 that about 16 states had dental policies for adults with disabilities, and its June 2025 brief noted that 12 states covered one or more dental services for adults with intellectual or developmental disabilities in 2023 that other adults ages 21 to 64 did not get.

Dental coverage during pregnancy

Pregnancy often brings better dental coverage. CMS reports that most states offer more comprehensive dental benefits to pregnant enrollees than to the general adult population, and that pregnant people qualify for Medicaid at higher income levels than other adults in most states (2022 data). MACPAC’s 2021 brief counted 11 states that had expanded Medicaid dental coverage specifically for pregnant women as of March 2020.

Rules are not uniform, though. Texas, for instance, says CHIP perinatal coverage for pregnant women does not include dental benefits. If you are pregnant, ask your state Medicaid agency or health plan what dental care you can get and when it ends after delivery.

Typical covered dental services

For adults, what is “typical” depends on the state. MACPAC’s 2021 count (state policies as of March 2020) shows how often each type of service was covered for adults:

MACPAC also found that about 13 states put annual dollar or service limits on adult dental care. For children, coverage is broader in every state because EPSDT requires relief of pain and infection, restoration of teeth, maintenance of dental health and medically necessary orthodontics, with checkups on the state’s dental periodicity schedule. Your state’s dental plan or provider manual lists the exact procedure codes covered.

Dental managed care and dental benefit managers

Many states do not pay dentists directly. Instead, MACPAC explains that Medicaid managed care plans may provide dental services themselves or subcontract them to dental plans or dental benefits administrators. Some health plans also add extra dental benefits beyond what the state requires; MACPAC reported that 37 states had managed care plans offering such added services as of July 2018. Two state examples:

• Florida: The state’s Medicaid managed care site says Medicaid recipients are required to enroll in a dental plan, and the dental plans are DentaQuest, Liberty and MCNA Dental. Adults get State Plan dental services such as exams, screenings, X-rays and extractions, plus the plans’ expanded benefits with prior approval. Compare them in our Florida Medicaid dental plans comparison.
• Texas: Texas Health and Human Services names DentaQuest and MCNA Dental as the dental managed care organizations for CHIP, and lists DentaQuest, MCNA Dental and UnitedHealthcare Dental as dental maintenance organizations on its provider contact page.

In other states, dental care comes through your medical health plan. These carrier guides explain how that works plan by plan: UnitedHealthcare Medicaid dental coverage by state, CareSource dental in Ohio, Wellpoint dental, AmeriHealth Caritas dental and AmeriHealth Caritas NC dental. For adult benefits through one dental plan, see what MCNA Dental covers for adults.

How to check what your state covers

• Start with your state Medicaid agency. Medicaid.gov’s state help directory links to each state’s Medicaid office, where adult dental rules and covered procedure lists are published.
• Read your member handbook. If you are in a health plan or dental plan, the handbook lists covered services, annual limits, prior authorization rules and any extra benefits.
• Call member services. Use the number on your Medicaid or plan ID card to confirm coverage for a specific procedure before treatment.
• Ask about prior authorization. Dentures, crowns, root canals and orthodontics often need approval first, even where they are covered.

How to find a dentist who takes Medicaid

CMS requires states to post a list of participating Medicaid and CHIP dental providers. For children, the U.S. Department of Health and Human Services runs the InsureKidsNow.gov Find a Dentist tool. You choose your state and your child’s plan, enter an address or ZIP code and can filter by specialty, special needs support, language and dentists accepting new patients. The site advises families to call the office to confirm it is still taking new patients under their plan, and notes that some dentists require a referral first.

Adults should use the provider directory from their dental plan or health plan, or ask their state Medicaid agency for a list of dentists enrolled in Medicaid. Always confirm that the office accepts your specific plan before you book.

Medicare vs. Medicaid dental for dual eligibles

If you have both Medicare and Medicaid, it helps to know what each one does. Medicare.gov says Original Medicare doesn’t cover most dental care, such as routine cleanings, fillings, tooth extractions, dentures or implants. It may cover some dental services tied to a hospital stay or to certain covered medical treatments, such as an oral exam before a heart valve replacement or organ transplant.

Medicare.gov also says most Medicare Advantage plans offer extra benefits Original Medicare doesn’t cover, like dental. Dual Eligible Special Needs Plans (D-SNPs) are Medicare Advantage plans that help coordinate Medicare and Medicaid benefits, and like other Medicare Advantage plans they may include dental, but benefits vary by plan and county, so check the plan’s Evidence of Coverage. Your Medicaid dental coverage, if your state offers adult dental, can still apply to services Medicare does not cover. Learn more in our guide to Medicare Advantage dental coverage.

Looking for other Medicaid benefits? See what Medicaid covers for eye exams, glasses and contacts.

Frequently asked questions

Does Medicaid cover dentures for adults?

It depends on your state. MACPAC found that 31 states covered partial or full dentures for adults as of March 2020. States that cover dentures often limit how often they can be replaced and may require prior approval.

Does Medicaid cover dental implants?

Rarely for adults, and only where a state chooses to. Because CMS sets no minimum for adult dental benefits, implant coverage is entirely a state decision and is usually limited to cases of medical necessity. Check your state’s covered procedure list or your plan handbook.

Does Medicaid cover braces?

For children under 21, EPSDT requires coverage of medically necessary orthodontic services, so braces can be covered when a child has a qualifying condition. For adults, MACPAC counted only three states covering orthodontia for the general adult population as of March 2020.

Does Medicaid cover root canals for adults?

Root canals are restorative care, which MACPAC found 32 states covered for adults as of March 2020. In states with emergency-only coverage, adults may be limited to treatment for pain and infection, such as an extraction. Children’s root canals fall under EPSDT’s required restoration of teeth when medically necessary.

Can my child get dental care on Medicaid if I don’t have dental coverage?

Yes. Children’s dental care is required in every state under EPSDT, regardless of what the state covers for adults. A parent’s lack of adult dental coverage does not affect a child’s benefits.

Sources

• Medicaid.gov: Dental Care
• Medicaid.gov: Early and Periodic Screening, Diagnostic, and Treatment
• CMS: 2023 Medicaid & CHIP Beneficiaries at a Glance: Oral Health
• MACPAC: Medicaid Coverage of Adult Dental Services (January 2021)
• MACPAC: Access to Dental Services for Adults with Intellectual and Developmental Disabilities (June 2025)
• InsureKidsNow.gov: Find a Dentist
• Medicaid.gov: Where Can People Get Help With Medicaid & CHIP?
• Medicare.gov: Dental Services
• Medicare.gov: Your Coverage Options
• Medicare.gov: Special Needs Plans (SNP)
• Florida Statewide Medicaid Managed Care: Dental FAQ
• Texas Health and Human Services: Texas Works Handbook D-1750, Dental Benefits
• Texas Health and Human Services: MCO and DMO Provider Services Contact Information