Medicaid Dental Insurance in Georgia
Many people are interested in getting Medicaid dental insurance in Georgia, as dental care is a crucial part of maintaining one’s overall health. Yet, Georgia Medicaid dental insurance may not be available to everyone, as there are eligibility requirements that must be met before enrolling. Each state has slightly different enrollment processes and rules regarding adult dental coverage. Also, some types of services may be covered while others are not. If you are interested in Medicaid dental coverage and learning how to enroll in GA Medicaid dental insurance?” then read the outlined topics below.
Who is eligible for Medicaid dental insurance in Georgia?
Georgia Medicaid Dental Insurance Eligibility Requirements
Federal Medicaid dental insurance eligibility requirements do not mandate that Georgia provide coverage for adults older than 21 years of age. Those younger than 21 years of age will be eligible for Medicaid dental insurance in Georgia as long as they meet the Medicaid enrollment qualifications. Children enrolled in Medicaid dental benefits will lose cover after turning 21 years of age. Adult Medicaid participants may qualify for dental services if it is life threatening or in an emergency room, but this is on a case-by-case basis.
How to Apply for Georgia Medicaid Dental Insurance
Enrolling in Georgia Medicaid dental insurance is part of general Medicaid application process. Children can also obtain Medicaid dental coverage through the Children’s Health Insurance Program (CHIP). If you apply for either health care insurance program and are eligible for dental care, then you will automatically get dental coverage. There is no separate Medicaid dental coverage application. Petitioners can request basic coverage and Medicaid dental benefits online, in person and by mail. You will receive notice of acceptance via the postal service. This letter will also inform you if you qualify for dental coverage as well as the services covered. However, Medicaid will not cover any medical and dental services you receive before your enrollment date.
What is Covered by Georgia Medical Dental Insurance
If you have met the Georgia Medicaid dental insurance eligibility requirements, then you will be able to receive dental services. However, Medicaid dental insurance in Georgia does not cover every type of dental service and a limit to how many types of these procedures or services you can have each year. Most services covered by Medicaid include preventative treatments that maintain overall good oral health. Curative care services covered can include restoring teeth from damage, treating infection and relieving pain. As part of the Early Periodic Screening, Diagnostic and Testing (EPSDT) benefit of Medicaid dental insurance, Georgia must offer dental services to children in reasonable intervals. Some of the services covered by Medicaid dental insurance include:
- Cleanings (for a limited number annually)
- Fluoride treatments (for a limited number annually)
- Space maintainers
Once enrolled in GA Medicaid dental insurance, you will be able to have most services that do one of the objectives listed above covered by the Medicaid program. However, Medicaid does not cover all standard dental procedures. Some assessments and screenings not performed by a dentist will not be covered. Some dental services will require prior authorization before the program will cover the cost. Such services are typically curative such as root canals or supplemental to oral health like dentures.
Medicaid will also not cover elective treatments. Orthodontic treatments, like retainers, will be the financial responsibility of the patient unless the treatment can be proven to drastically impact health. For instance, if braces or treatment for a cleft palate are determined to be medically necessary, Medicaid dental insurance will cover the services. In most cases, Medicaid will cover approved services completely.
Learn more about services covered and not covered by Medicaid in our comprehensive guide.
Children’s Health Insurance Program Dental Coverage
If you are not eligible for Medicaid dental insurance in Georgia, then you have other options. Households that do not meet the requirements for Medicaid may be able to provide Medicaid dental coverage through the Children’s Health Insurance Program, which is technically not Medicaid. This program is only for children younger than 19 years of age who meet the income guidelines, are a Georgia resident and a U.S. citizen/legal immigrant. The income requirements for CHIP are higher than Medicaid, which means children whose families do not meet the Medicaid eligibility requirements can still be covered by low-cost health insurance. This government funded program also provides dental coverage to children along with other very important medical services. Many preventative medical services like checkups and immunizations are covered by this program as well as medically necessary services. In Georgia, the application process for Medicaid and CHIP are very similar but do differ slightly. Be sure to double check the eligibility and application procedures before you begin to apply.
Discover which program has the best services for your needs by reviewing the comprehensive information in our free guide.