Medicaid Dental Care Coverage
Your Medicaid benefits include dental care coverage. Your dental benefits are not administered by Sunshine Health. When you enroll in Medicaid, you can select from these three statewide dental plans:
Dental Health Is Important
See your dentist twice a year for regular cleanings and checkups.
Regular visits with a dentist can help keep your teeth and gums healthy. They can also help prevent oral health problems before they begin. If some oral health issues are not treated, they can cause pain. Some issues can also make it difficult to chew or speak.
You can help keep your teeth healthy:
- Brush and floss twice a day
- Make sure your teeth are clean before bed
- Avoid sugary food and drinks
- Schedule dentist appointments for babies (by age 1), children and adults twice a year
What Is Covered under Florida Medicaid Dental Care?
Here is a list of services that will help children have healthy teeth at no cost:
- Dental Exams
- Dental Screenings
- Dental X-rays
- Teeth Cleanings
- Fluoride
- Sealants
- Oral Health Instructions
- Space Maintainers
- Fillings and Crowns
- Root Canals
- Periodontics
- Prosthodontics
- Orthodontics
- Extractions
- Sedation
- Ambulatory Surgical Center or Hospital-based Dental Services
Some services may require permission from a dental plan before the dentist performs the service. This is called a prior authorization. Services must be medically necessary in order for dental plans to pay for them. Your child’s dental plan can help you understand what is covered.
Your dental plan will cover emergency-based dental services, including:
- Dental exams (limited)
- Dental X-rays (limited)
- Dentures
- Extractions (removal of teeth)
- Sedation (dental services while asleep or partially asleep)
- Problem focused
- Pain management
Some services require your dental plan’s permission. This is called prior authorization. Services must be medically necessary for a dental plan to pay. Your dental plan can help you understand what is covered.
Dental health is an important part of prenatal care. Pregnant women are more likely to get gum disease or cavities. Below are additional goods or services for pregnant adults (ages 21 and older):
- Additional dental exams
- Dental screenings
- Additional dental X-rays
- Teeth cleanings (basic and deep)
- Fluoride sealants
- Oral health instructions
- Fillings (silver and white)
- Additional extractions
- Dental consultations
- Dental office diabetic testing
- A visit to the dental office to get comfortable with the office and the dentist before dental work, for people with disabilities
Visit the Florida Agency for Health Care Administration for more information about Medicaid Dental Care Coverage.
Please contact Sunshine Health Member Services at 1-866-796-0530 (TTY 1-800-955-8770), Monday through Friday from 8 a.m. to 8 p.m., if you need help with:
- Finding a provider other than a dentist
- Have a question about your Medicaid coverage (not dental)