Medicaid

Ohio

• Department of Medicaid
• Healthchek (Early and Periodic Screening, Diagnosis and Treatment) Program Rules
• Medicaid Dental Services Handbook
• Medicaid Fee Schedule (to find dental codes, search for “D0110”)
• Medicaid Rules for Ambulatory Health Care Clinics
• Medicaid Rules for Dental Providers
• Ohio Medicaid Basics 2013, from the Health Policy Institute of Ohio
  • Ohio Medicaid Expansion Study reports
• Provider Technical Assistance and the Ombudsman Unit
• Provider Manuals from Managed Care Plans
  • Care Source
  • DentaQuest

National

• Centers for Medicare and Medicaid Services, Medicaid Dental Coverage

Highlights

• Ohio’s Medicaid Expansion: Beginning January 1, 2014, a new group of Ohioans are eligible for Medicaid coverage in Ohio. For more information, see Changes to Medicaid Coverage FAQs: Extending Medicaid to more Low-Income Ohioans

Medicaid & Dental Care Coverage in Ohio

Below you can see each branch of dental care to find out what Medicaid in Ohio covers and does not cover.

• Braces – covered if they are medically necessary. Medicaid covers medical braces but does not cover cosmetic braces;
• Checkups and Cleanings – 2 cleanings per year are covered for adults. Adults may have a copay of $3 per each visit;
• Dentures – dentures that are medically necessary are covered;
• Dental Implants – not covered by Medicaid;
• Dental/Oral Surgery – covered by Medicaid if it is medically necessary;
• Fillings, Extractions, and Crowns – extractions that are medically necessary are covered, at a cost of $3 copay per visit;
• Teeth Whitening – not covered by Medicaid;
• Root Canals – covered if they are medically necessary, at a cost of $3 copay per visit;
• X-rays – 2 x-rays per year together with checkups and cleanings.

Important: Medicaid in Ohio covers not only dental care for those emergency situations.