The state of Texas has very little Medicaid benefits for adults. The coverage is limited to emergency treatments and surgeries only which makes dental care very expensive. This is not the same for children who can get a wider range of treatments with Medicaid support. You have to specify your main dentist when applying for coverage.
For specialized care, your main dentist can give you a referral to a specialist. You can apply for Medicaid benefits for your treatment with a specialist. There are provider organizations as well that you can employ to get more benefits on expensive dental treatments if they are not covered by Medicaid or your other dental insurance plans.
ABC 123 Dental has most of its emergency treatments, including non-routine surgeries, covered by Medicaid. You can apply for coverage at the center itself. The policy works best for pediatric care as the number of treatments are limited for adult dental care.
Medicaid for Dental Surgeries in Children
Medicaid has revamped their childcare policies and you can now get a wider range of dental care benefits for your child. Medicaid policy requires you to have a general dentist for regular checkups and basic treatments. You can get Medicaid benefits for regular visits as well.
In case of serious dental problems, your dentist can give you a referral to consult a specialist. You can contact with your Medicaid provider to find out if your active plan can be extended to the recommended specialist. As per general Medicaid policy,
- If the specialist provides urgent care, you can get a consultation within 24 hours from the time you ask for the referral from your Main Dentist.
- If the specialist provides therapy or your child needs to get a diagnosis from the specialist first, your consultation will be within 14 days from the time you ask for the referral.
- If the specialist provides preventive care for teeth problems, the consultation will be no later than 30 days from the request for referral.
Medicaid Coverage for Adults
In Texas like Keller and Fort Worth area, this is limited to emergency cases only. However, the coverage extends to a wide range of treatments inside your emergency consultation. Medicaid support for adults in Texas is available for the following emergency cases:
- Dislocated Jaw
- Traumatic Damage to teeth and supporting structures
- Removal of cysts
- Treatment of abscess of tooth or gum origin
- Treatment and devices for craniofacial anomalies
- Drugs for any of the above conditions
Medicaid for Dental Surgeries
Dental treatments can have routine cases like teeth cleaning, whitening, extractions, root canal therapy, fillings, sealants and certain non-surgical cosmetic treatments like veneers, bridges, and Invisalign. Dental treatments that require surgeries are considered non-routine and are typically covered by all insurance plans.
Medicaid support for surgeries is conditional depending on whether it is a part of a non-routine treatment. Consult with your dental care provider to find out if your current treatment will be covered by Medicaid support. You can try a preferred provider organization for cheaper dental plans with a larger coverage for general treatments considering your dentist is supported by PPO plans.
ABC 123 Dental has their treatment covered by a wide range of insurances and their pricing is guaranteed to make the dental treatments cheaper by at least 5%. You can get an overview from the following.
You can also get a FREE insurance benefit check with our Aetna and other insurance providers
Call us today at 817-656-1215
Source: www.oda.org, www.medicaid.gov, hhs.texas.gov
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