Medicaid Dental Insurance in Pennsylvania
Pennsylvania Medicaid dental insurance is run by the state but funded by the federal government. Medicaid dental insurance in Pennsylvania is officially called Medical Assistance. The goal of Medical Assistance in Pennsylvania is to provide low-income residents with comprehensive medical care. Medicaid dental coverage is one way that Pennsylvania Medical Assistance provides health care coverage to eligible enrollees. Applicants who enroll in PA Medicaid dental insurance will completely cover certain services while others may have a nominal fee. Continue reading the outlined topics to find out about Pennsylvania Medicaid dental insurance eligibility requirements, the covered services and how to enroll.
Who is eligible for Medicaid dental insurance in Pennsylvania?
Pennsylvania Medical Assistance dental insurance eligibility requirements are consistent with the qualifications for other program services. Eligibility for Medicaid dental insurance will depend on your personal category, which is determined by your age, income and household composition. Depending on the programs you qualify for, you may also be eligible for additional dental services. You must apply for Medical Assistance to find out if you are eligible for Medicaid dental insurance in Pennsylvania and for which services. Medical Assistance eligibility depends on income, resources, household composition, residency and other factors. However, income is the primary factor in determining who is eligible for Medical Assistance dental insurance in Pennsylvania.
Download our free health care guide for comprehensive information on the eligibility requirements for Medicaid and discover more medical assistance programs in Pennsylvania.
What services are covered by Medicaid dental insurance in Pennsylvania?
Pennsylvania Medicaid dental insurance is a fee-for-service program. Medical Assistance dentists who participate in the program will accept your Medical Assistance Access Insurance card. Medical Assistance dental insurance covers all necessary dental services for children who are enrolled in the program, including teeth cleaning, regular exams, x-rays, filling crowns and other needs. Adults eligible for Medicaid dental insurance in Pennsylvania can receive coverage some surgical procedures and emergency care for pain. Some adults are eligible for other dental care as well. Typically, dental services available to adults enrolled in PA Medical Assistance coverage are more restricted than the range of services available to beneficiaries 21 years of age or younger. If you have special needs, then you may meet the Medicaid eligible requirements for a full range of dental services.
There are limits to the amount of dental benefits enrollees can receive per year. It is important to understand the restrictions on the dental plan policy, as some procedures need prior authorization.
How to Enroll in Pennsylvania Medicaid Dental Insurance
You can apply for Medicaid dental insurance in Pennsylvania through several methods. To enroll in Medicaid dental insurance, you must first find out if you qualify for PA Medical Assistance. You can sign up for Medical Assistance and request dental benefits online, by mail, by phone or in person. The fastest way to enroll in PA Medicaid dental insurance is to set up an online account on the state's website. In addition to being the fastest application method, the online site allows users
to apply for benefits in one central online location in a quick, easy and secure way. You can sometimes get immediate notification if you are eligible for Medicaid dental insurance by applying online. In some instances, your file will need to be reviewed by a county representative in order to determine your Medicaid eligibility. If this is the case, you should receive notification by mail within 30 days.
You can also apply for Medicaid dental coverage by downloading the application to fill out and mail to the address noted on the form. If you cannot enroll in PA Medical Assistance online because you do not have a computer or online access, then you can also call your local County Assistance Office or call the Pennsylvania Department of Health Services helpline. You can also visit your local office to pick up an application or apply in person.
Find out more about enrolling in Medicaid in PA by reviewing the comprehensive information in our health care guide.
How to Use Pennsylvania Medical Assistance Dental Benefits
Once you receive notification that you are eligible for Medicaid dental insurance in Pennsylvania, you will be able to use any dentist who signs up with the managed care organization in your county. A Medicaid dental insurance provider can schedule your first appointment when you contact the office. Write down the date, time and location of your appointment if you schedule an appointment. If you are unable to make your dental appointment for some reason, then it is important to call the office to let them know and you do not get charged for the visit.
If you meet the eligibility requirements for Medicaid dental coverage, then you should be certain to see your dentist two times per year for both regular check-up exams and cleaning. If there are costs associated with a Medicaid-covered dental service, then the provider will discuss the copayment with you before rendering the service. You will be responsible for all costs associated with care.