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Medicaid Adult Dental Coverage Checker

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 (please see below for further information). 

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.

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.

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.

Tools for Oral Health Advocates

Information Call: Improving Medicaid Adult Dental Benefits

In this recorded call, four experts share their successful strategies to improve dental coverage for adults in their states.

Image of opening slide of presentation Stronger Together: Advocates, administrators and providers working to improve Medicaid adult dental benefits

 

Medicaid Adult Dental Coverage Checker Tutorial

This brief tutorial shows how to use the features of the Medicaid Coverage Checker and provides links to related Medicaid dental coverage resources.

Image of title slide Medicaid Adult Dental Coverage Checker Tutorial

 

Medicaid Adult Dental Benefits Offered to Specific Beneficiary Groups

Which states provide Medicaid dental benefits to adults who are pregnant, have a disability, or are in long-term care? Get the latest information in this updated report.

Map of states that offer Medicaid adult dental benefits to specific groups

Acknowledging Our Partners

The Rubric for Assessing Extensiveness of State Medicaid Adult Dental Benefits was developed in partnership with a core group and an advisory committee of experts in the field. After significant expansion and restoration of Medicaid adult dental benefits in several states several years ago, CareQuest Institute and the ADA Health Policy Institute collaborated to update the ADA’s classification of states. 

Buoyed by these policy wins, CareQuest Institute shared that new round of classifications with grantees and partners and realized there was an appetite to form a larger workgroup. That workgroup quickly decided the oral health community would benefit from a new assessment tool, something that would move the industry beyond simply counting the number of procedures covered. The Coverage Checker is the output of that years long effort. 

Core Group Organizations

ADA Health Policy Institute logo
Center for Health Care Strategies logo
CareQuest Institute for Oral Health logo

Advisory Committee Members

Stacey Auger, MPH, Policy Consultant, CareQuest Institute for Oral Health 
Donna Balaski, DMD, Healthcare Administration Management, State of Connecticut, Department of Social Services Division of Health Services
Melissa Burroughs, Director of Public Policy, CareQuest Institute for Oral Health
Stacey Chazin, MPH, MSODL, Principal, Chazin Consulting
Dora Fisher, Formerly Director of Older Adult Programs, Oral Health America
Brittany Flynn, Manager of Digital Content & Editing, American Dental Association Health Policy Institute
Chelsea Fosse, DMD, MPH, Director of Research and Policy Center, American Academy of Pediatric Dentistry
Steven Geiermann, DDS, Retired, Senior Manager, Access, Community Oral Health Infrastructure and Capacity, American Dental Association Council on Advocacy for Access and Prevention
Tracy Gilman, CDA, MSM, Formerly Regional Director, MassHealth Contract at DentaQuest
Katie Greene, MPP, Director, Public Health, National Academy for State Health Policy
Carrie Hanlon, MPP, Formerly Project Director, National Academy of State Health Policy
Ian Hedges, Director of Medicaid and Medicare Program Policy, American Dental Association
Robert Isman, DDS, MPH, Formerly Dental Program Consultant, California Department of Health Care Services
Michael Monopoli, DMD, MPH, MS, FACD, FICD, Formerly Vice President for Grant Strategy, CareQuest Institute for Oral Health
Bianca Rogers, Formerly Advocacy Coordinator, Oral Health America
Andrew Snyder, MPA, Formerly Project Director, National Academy of State Health Policy
Madeline Steward, MPH, Program Officer, Center for Health Care Strategies
Nicole Taylor, MPH, Director for Population and Public Health, National Academy for State Health Policy
Marko Vujicic, PhD, Chief Economist and Vice President, American Dental Association Health Policy Institute
Cassandra Yarbrough, MPP, Formerly Lead Public Policy Analyst, American Dental Association Health Policy Institute