Medicaid Dental Insurance in Arizona

In 2017, changes were made to Arizona Medicaid dental insurance that allowed adults who are 21 years of age and older to receive emergency dental services. Before, Arizona did not provide Medicaid dental insurance of any kind to beneficiaries who are in that age range. With the recent change in Medicaid dental coverage, it is important to review Medicaid-covered dental services. Additionally, it is worth noting what services are available to those who are younger than 21 years of age. For more information on Medicaid dental insurance in Arizona, including eligibility requirements and coverage, continue reading.

Medicaid Dental Insurance Eligibility Requirements in Arizona

In order to better understand Arizona Medicaid dental insurance, it is first important to understand who is eligible to receive this type of coverage. Fortunately, you are eligible for Medicaid dental insurance in Arizona so long as you meet eligibility requirements for Medicaid in Arizona. Therefore, you can generally receive Medical Assistance dental insurance in AZ if you:

  • Are a United States citizen, a permanent resident or a non-citizen who has a lawful presence within the United States.

  • Are a resident of Arizona.

  • Meet Medicaid income requirements.

Medicaid Dental Coverage in Arizona

New laws regarding AZ Medicaid dental insurance have added Medicaid dental coverage to adults who are 21 years of age or older, but only in an emergency situation. The state of Arizona refers to a dental emergency as an acute disorder of oral health in which the result is severe pain and/or infection. Therefore, an emergency must not only be one of the Medicaid covered dental services, but it must include infection and/or pain in order to be covered by Medicaid. Emergency procedures that may be covered by Medicaid dental insurance in Arizona include, but are not limited to, the following:

  • Emergency oral diagnostic examination

  • Radiographs and laboratory services

  • Prefabricated crowns, if used to eliminate pain due to a recent tooth fracture

  • Root canals and vital pulpotomies when used for the treatment of acute infection or to eliminate pain

  • Cast crowns, limited to the restoration of root canal treated teeth

Medical Assistance dental coverage includes emergency dental services up to $1000 per Medicaid member, per contact year. Services must be related to the treatment of a condition or acute pain in order to be covered. While the $1000 limit applies to most dental services, it is not applied to Medicaid beneficiaries who are receiving dental services as a pre-requisite to a covered organ or tissue transplant or towards prophylactic extraction of teeth in preparation for radiation treatment of cancer of the jaw, neck or head.

To learn more about dental services covered by Medicaid in AZ, you can download our comprehensive guide today.

Services Not Covered by Arizona Medicaid Dental Insurance

It is crucial that you understand what is not covered by Medicaid Dental Insurance in AZ in order to avoid out-of-pocket costs after a dental procedure. Arizona Medicaid dental coverage does not include:

  • Maxillofacial dental services, except to the extent prescribed for the reduction of trauma

  • The diagnosis and treatment of temporomandibular joint dysfunction, except for the reduction of trauma

  • Routine restorative procedures, including root canal therapy, that is not part of an emergency dental service

  • Treatment for the prevention of pulpal death and imminent tooth loss

  • Fixed bridgework to replace missing teeth

  • Dentures

Arizona Medicaid Dental Coverage for Those Younger Than 21 Years of Age

Unlike the Medicaid Dental Insurance that is provided to adults who are 21 years of age or older, those younger than 21 years of age can receive additional dental coverage through their Medicaid coverage. For these beneficiaries, Medicaid dental coverage will also include regular dental screening and dental treatment, even if the dental services that are performed are not part of a dental emergency.

Once a Medicaid beneficiary receiving these dental treatments has reached 21 years of age, he or she will no longer be able to receive AZ Medical Assistance dental coverage for regular dental screening and treatments, and will only receive coverage for emergency dental services.

How to Enroll in AZ Medicaid Dental Insurance

“How do I enroll in AZ Medicaid dental insurance?” is a common question. You are automatically enrolled in Medicaid dental insurance once your Medicaid application is accepted and you begin receiving Medicaid benefits. If you have not yet completed an application for Medical Assistance, you can do so either online by fax, by mail or by visiting your local office or community assistor location. For more information on Arizona Medicaid dental insurance, including the coverage that is available to both individuals who are at least 21 years of age and those who are younger than 21 years of age, you can download our comprehensive guide.

Who Is Eligible to Get Health Services in Arizona?

Residents must meet the eligibility requirements established by the Arizona Health Services Department in order to quality for programs such as Medicaid and Medicare. Your income and age might be significant factors regarding your eligibility, but requirements vary. To learn more about AZ medical assistance, download our guide today.

What Kinds of Health Care Services Can I Receive in Arizona?

Arizona health care services differ significantly in regards to price and coverage. A resident’s eligibility might also play a role in the cost of each service. To learn about how you can apply for these health services, please download our guide now.