Identify Areas to Strengthen Adult Dental Benefits
The Medicaid Adult Dental Coverage Checker is an interactive tool for policymakers, administrators, and advocates to better understand where a given state’s Medicaid adult dental benefits package falls on a continuum from no dental benefits to extensive benefits, helping identify areas for improvement. It looks at coverage of specific procedures and services, including allowed frequency, in eight service categories.
The Coverage Checker displays results that were self-reported by state Medicaid dental programs in a survey conducted in the spring of 2025. The data represent a snapshot in time and are reflective of the benefit package in place as of December 31, 2024. It’s important to note that several states have implemented new and expanded benefits for all adults in early 2025, which are not captured in the Checker. Please continue reading below for more information.
The survey mentioned above was developed in partnership with the American Dental Association Health Policy Institute (ADA HPI), Center for Health Care Strategies (CHCS), CareQuest Institute, and an advisory committee of experts in oral health care and state policy.
Data visualization by Madison Vinson, MSHI and Adrianna Sonnek, MPH, Analytics & Data Insights, CareQuest Institute
Consumer Disclaimer: This dashboard is intended as a resource for Medicaid agencies, legislators, policymakers and advocates. It is not intended as a resource for consumers or Medicaid beneficiaries. The procedures and dental codes included and assessed in the survey — and displayed here — are intended to be representative of the hundreds of dental procedures contained in the ADA’s Current Dental Terminology code set. The sample is not exhaustive and should not be considered as constituting a complete benefits package. We encourage you to contact your state’s Medicaid agency for information regarding the Medicaid adult dental benefit.
States That Have Improved Medicaid Adult Dental Benefits in 2025
Utah
After years of expanding Medicaid adult dental benefits incrementally by population group, Utah expanded dental benefits to all adults effective April 1, 2025. All adult beneficiaries are now covered for exams, x-rays, cleanings, fillings, crowns, root canals, dentures, and extractions. More information can be found here.
This expansion was initiated in 2023 when the Utah legislature passed Senate Bill 19 which directed the state to pursue federal Medicaid waivers to extend Medicaid dental care to all adults 21 years of age and over. Utah’s 1115 Waiver was approved on January 8, 2025, and expanded dental benefits took effect April 1, 2025.
Learn more in the case study, From Innovation to Impact: Utah’s Institutional Model for Medicaid Dental Expansion
Virginia
Since 2015, Virginia has provided comprehensive Medicaid adult dental benefits to pregnant beneficiaries. In 2021, this coverage was extended from two months to 12 months postpartum. New legislation was signed into law in March 2025 that codifies the dental benefits provided to pregnant and postpartum beneficiaries.
The bill — one of several this session aimed at improving maternal and child health outcomes — specifies that pregnant beneficiaries will be eligible for at least four dental visits during their pregnancy, with the possibility of additional visits recommended by a licensed dentist or obstetrician.
Additionally, and for the first time since extending benefits to pregnant beneficiaries, the bill requires the Department of Medical Assistance Services to submit an annual report to the Governor and General Assembly detailing the implementation of these dental services, including the number of pregnant women who used the services, the impact on maternal and infant health outcomes, any access barriers, and recommendations for future improvements. The first such report is to be submitted by November 1, 2026, providing an opportunity to evaluate the effectiveness of the expanded dental care coverage for pregnant beneficiaries.
Learn more in the case study, Persistence Meets Opportunity: Virginia’s Journey to Comprehensive Medicaid Adult Dental Benefits
Nevada
In 2019, the Nevada legislature passed AB223 which directed the state to pursue federal Medicaid waivers to expand Medicaid dental benefits to non-pregnant adults diagnosed with diabetes. Approved on July 19, 2024, the 1115 Waiver will allow beneficiaries to receive a limited dental benefit package, including diagnostic and preventive, restorative, endodontic, and periodontic dental services through the provider network of selected federally qualified health centers (FQHCs) and participating Tribal Health Centers with dental clinics. The new benefits are expected to take effect later this summer.
As noted in the approval letter, “this demonstration furthers the objectives of Medicaid by improving access to dental services in Nevada for certain Medicaid-enrolled adults. Through these efforts, the state will be able to test the value of improved access to oral health care on enrollee health outcomes and in controlling expenditures for a high-risk adult diabetic population in Medicaid. Nevada does not currently cover non-emergency dental benefits for its nonpregnant adult or parent population; this demonstration is a helpful tool to test the potential return on investment of providing dental benefits for this population.”
Arkansas
New legislation was signed into law in April 2025 to increase the annual benefit maximum (ABM) for adults with special needs. The ABM will be increased from $500 to $1,000 effective September 1, 2025. Additionally, the legislation increases reimbursement rates for oral and maxillofacial surgeons’ dental services, pediatric dental services, and dental services for adults with special needs.
More information can be found here.