Georgia Medicaid Dental Coverage (Find Dentist)
If you are enrolled in the Georgia Medicaid program and want to find out your plan includes dental coverage, we can help you. In this post, we will explain Georgia Medicaid Dental coverage for adults and children, including those covered by CHIP.
This post on “Georgia Medicaid Dental Coverage” will cover:
- Medicaid and Dental Coverage
- Georgia Medicaid Dental Coverage
- How to Find a Medicaid Dentist in Georgia
- 5 Things Every GA Medicaid Recipient Should Know
Medicaid and Dental Coverage
Dental health is an important part of healthcare. Under Medicaid, while health coverage is extensive and comprehensive, dental coverage is different.
Under Medicaid, states are required to provide dental benefits to children covered by Medicaid and the Children’s Health Insurance Program (CHIP).
According to the Centers for Medicare & Medicaid Services, Dental services for children must minimally include:
- Relief of pain and infections
- Restoration of teeth
- Maintenance of dental health
If your child has Medicaid dental coverage, many of your child’s necessary dental care treatments may be covered. This includes:
- Annual dental exams
- Regular dental checkups
- Fluoride treatments
However, when it comes to dental coverage for adults, states choose whether to provide dental benefits for adults or not.
This means that Medicaid dental coverage varies by state. Whether you will have dental coverage under Medicaid depends on if your state has decided to provide that coverage or not.
Georgia Medicaid Dental Coverage
As mentioned, dental benefits are not covered nationally in Medicaid and are optional in-state programs.
This means that states may choose to include (or not include) dental benefits for adults in their Medicaid programs, and also decide what level of coverage they will provide.
States are however required to provide dental benefits to children covered by Medicaid and the Children’s Health Insurance Program (CHIP).
Does Georgia Medicaid cover dental for adults?
Georgia Medicaid dental coverage for Adults is only limited to emergencies.
How to Find a Dentist that Takes Medicaid
Finding a dentist who takes Medicaid can be difficult. Only about one in three Georgia dentists accept payment from the Georgia Medicaid program.
The state of Georgia has about 4,700 dentists, but only about 1,600 take Medicaid.
In addition, of those who take Medicaid, many are not taking new Medicaid patients. Therefore, to find a Dentist that takes Medicaid takes some effort.
To find a dentist near you that accepts Medicaid and CHIP, click on the link below:
Find a Dentist
Georgia Medicaid Fee Schedule
The Georgia Medicaid Fee Schedule is administered through the Georgia Medicaid Management Information System (GAMMIS).
There, you will find the fee schedules and rates listed by codes for particular providers or facility types.
To view and download the fee schedule, click here.
5 Things Every GA Medicaid Recipient Should Know
Depending on your Medicaid category, you may have to make a small co-payment when you receive your medical care.
However, you cannot be denied service because you are not able to pay the co-payment. Your provider may still bill you for the co-payment amount.
Need a Ride?
Georgia Medicaid has agreements with several companies to arrange nonemergency transportation to and from medical appointments. Each company covers different regions of the state.
Call the company for your area for help with transportation.
Here are the numbers to call:
North Georgia: 1-866-388-9844
Central Georgia: 1-888-991-6701
East Georgia: 1-888-224-7988
Southwest Georgia: 1-886-443-0761
Services Not Covered by GA Medicaid
There are some services that are not covered under Georgia Medicaid.
- Services that are not medically necessary
- Private duty nursing
- Medical services and care given by a reponsible relative or member of your household
- Cosmetic surgery
- Experimental items and chiropractic services
You Can Appeal Medicaid Decision
You have the right to a fair hearing if you disagree with a decision regarding your Medicaid eligibility or if you feel that Medicaid has not served your medical needs properly.
To request a hearing, contact your county DFCS office within 10 days of the date on the notice about eligibility or services.
Report Status Changes Promptly
As a Georgia Medicaid recipient, you are responsible for reporting changes in your circumstances.
If your income, resources, living arrangements, family size or other circumstances change, they could affect your eligibility.
It is your responsibility to let your DFCS caseworker know, or if you receive SSI, the Social Security Administration know about these changes within 10 days of the change.
Questions about Georgia Medicaid?
Thank you for taking the time to read this article. In addition, we encourage you to post any questions you have about Georgia Medicaid in the comments section below.
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