Medicaid Adult Dental Coverage Checker

The Medicaid Adult Dental Coverage Checker is 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 identify areas for improvement and expansion. 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 dental directors or their equivalent in a survey conducted in spring 2020. The survey, known as the Rubric for Assessing Extensiveness of State Medicaid Adult Dental Benefits, was developed in partnership with the American Dental Association Health Policy Institute (ADA HPI), Center for Health Care Strategies (CHCS), National Academy for State Health Policy (NASHP), CareQuest Institute, and advisory committee members. 

The survey defined an extensive dental benefit and evaluated coverage within eight service categories — annual benefit maximum, diagnostic, preventive, restorative, endodontic, periodontal, prosthodontic, and extraction services — which are evaluated with a point system.

The data below represent a snapshot in time and are reflective of coverage offered by each state at the time of completion. It is important to note that several states have significantly increased their Medicaid adult dental benefit offerings since the survey was completed. (Note: The following Tableau dashboard renders best on a desktop.)

August 25 Webinar: A New Tool for Tracking Medicaid Adult Dental Benefits Across States

Join the architects of the tool to learn more about why it was created and the goals for its use within the oral health community. They’ll also provide an overview of how to use the tool and discuss practical applications, including comments from an advocate on how she and others can use the tool to improve oral health for adults across the country.

Featured Resources

An Overview of the Medicaid Adult Dental Coverage Checker 

Providing a clear and consensus-driven definition of an extensive Medicaid adult dental benefit, the Coverage Checker is designed as a resource for a wide range of audiences, including Medicaid agencies, advocates, legislators, and other policymakers.

A New Look for Medicaid Adult Dental Benefits

Why did CareQuest Institute lead the effort to create a new classification system to better understand Medicaid adult dental benefits? Michael Monopoli, DMD, MPH, MS, FACD, FICD, vice president for grant strategy at CareQuest Institute and Stacey Auger, a policy consultant at CareQuest Institute, share more about the origins and goals of the new tool.

Rubric for Assessing Extensiveness of State Medicaid Adult Dental Benefits

Learn more about the rationale and purpose of refining the definition of "extensive" Medicaid adult dental benefits, the makeup of the Core Group and Advisory Committee members, and the details of the survey state dental directors completed to create the Coverage Checker.

A New Oral Health Outlook for 2 Million Americans 

Nearly 2 million people will soon be gaining access to Medicaid dental benefits. How? Hard-fought legislative wins, thanks to the persistence of community members, advocates, and legislative champions, have changed the oral health landscape in the US. A CareQuest Institute blog post provides a rundown of the latest developments in Hawaii, Kansas, Maryland, New Hampshire, and Tennessee from the 2022 legislative session and explains what's next for the ongoing expansion efforts in other states.

adult dental patient and provider

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 yearslong effort. 

Core Group Organizations:

American Dental Association Health Policy Institute (ADA HPI)
Center for Healthcare Strategies (CHCS)
National Academy for State Health Policy (NASHP)
CareQuest Institute for Oral Health

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
Stacey Chazin, MPH, MSODL, Health Policy and Leadership Consultant, formerly with the Oral Health Progress and Equity Network
Dora Fisher, Formerly Director of Older Adult Programs, Oral Health America
Mary E. Foley, RDH, MPH, Executive Director, Medicaid Medicare CHIP Services Dental Association
Chelsea Fosse, DMD, MPH, Senior Health Policy Analyst, American Dental Association Health Policy Institute
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, Regional Director, MassHealth Contract at DentaQuest
Carrie Hanlon, MPP, Project Director, National Academy of State Health Policy
Robert Isman, DDS, MPH, Formerly Dental Program Consultant, California Department of Health Care Services
Michael Monopoli, DMD, MPH, MS, FACD, FICD, 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
Cassandra Yarbrough, MPP, Formerly Lead Public Policy Analyst, American Dental Association Health Policy Institute

Cutting Medicaid Adult Dental Benefits Would Hurt States in Unexpected Ways

Cutting Medicaid adult dental benefits could harm job growth, increase costs, and harm states in other unexpected ways. 

Providing adult dental coverage can improve job prospects, reduce costly visits to hospitals, preserve dental services that can save states money, and increase the likelihood of children getting dental care. 

Explore CareQuest Institute's report on how cutting Medicaid adult dental benefits would hurt states to learn more.