Medicaid Adult Dental Benefits Increase Access and Reduce Out-of-Pocket Expenditures

Published 11/08/2019

In some U.S. states, Medicaid provides at least some dental coverage for adults. Does that coverage lead to better access and lower out-of-pocket costs for patients? A report from CareQuest Institute, the second in a three-part series, analyzes data from the Medicare Expenditure Panel Survey to explore that question. The report compares the experience of adults enrolled in Medicaid to adults with private coverage and to those who lack coverage.  

Key findings from the report: 

  • Medicaid, with its limited dental coverage, significantly improved adults’ access to and utilization of dental services, compared to those who lack medical coverage.  
  • Access to dental services for adults enrolled in Medicaid was nine percentage points higher than those who lack medical coverage but 23 percentage points lower than those with private medical coverage.  
  • The average annual out-of-pocket cost for dental care was $196 for those covered by Medicaid, $283 for those with private medical coverage and $466 for those without medical coverage.  

Medicaid improved adults’ access to dental services, compared with those who lack medical coverage. However, the report shows that significant gaps remained between adults enrolled in Medicaid and those with private insurance. Requiring states to offer comprehensive dental coverage as part of Medicaid would go far in closing these gaps. 

You may also be interested in: 

Part 1 of 3 Poor Families Spend 10 Times More of Their Income on Dental Care Than Wealthier Families analyzes oral health needs and financial implications for Americans of different income levels. 

Part 3 of 3 The Burden of Out-of-Pocket Expenditures for Dental Care on Medicare-enrolled Elderly and Disabled compares costs associated with different types of Medicare coverage and reveals a high burden of out-of-pocket spending for Medicare enrollees. 

Medicaid Adult Dental Benefit Coverage Checker, an interactive tool for policymakers, administrators, and advocates to easily understand where a given state’s Medicaid adult dental benefits package falls on a continuum from no dental benefits to extensive benefits, helping them identify areas for improvement and expansion.