For children under the age of 19, the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit, which is part of Medicaid, covers dental fillings. These fillings are considered medically necessary and are included in standard preventive and restorative services.
The Kids Dental Office of Phoenix accepts Medicaid payment through AHCCCS, including for children’s dental fillings. To schedule an appointment for your child, call us at (602) 903-4894 or use our contact form.
How Does Medicaid Dental Coverage Pay for Dental Fillings?
As an Arizona resident, if you qualify for Medicaid dental coverage, then AHCCCS is the state agency through which Medicaid coverage will cover your child’s costs. Through AHCCCS, you will have access to an insurance company that will cover services such as dental fillings.
All AHCCCS beneficiaries under the age of 21 are assigned to a Dental Home by their insurance health plan. A Dental Home is a dental office, like the Kids Dental Office of Phoenix. You can choose your own Dental Home if it accepts Medicaid payment through AHCCCS. You can also change your current dental home under the same condition.
Under EPSDT, your child’s primary care doctor (PCP) will do an oral health screening as part of a routine physical examination. This screening will determine his or her dental needs. A PCP referral to a dentist is based on the needs identified during the screening, which includes urgent and routine services.
You do not need a referral from your PCP to visit your Dental Home.
Examples of dental health services covered by AHCCCS include:
- Teeth cleanings
- Necessary x-rays
- Dental exams
- Dental sealants and fluoride treatments
- Dental fillings
- Tooth extractions
- Root canals
- Crowns
- Bridges
- Dental emergency visits
There is no copay for Medicaid dental services coverage.
Arizona KidsCare
If your household does not qualify for Medicaid coverage, a possible alternative is Arizona’s KidsCare program. This is another federal-state partnership under Medicaid, with the federal program in this instance being the Children’s Health Insurance Program (CHIP).
Compared to Medicaid coverage, KidsCare CHIP coverage has a couple of restrictions:
- KidsCare covers children under 18 years of age, whereas Medicaid covers children through the age of 19.
- KidsCare has a small copay requirement for the provided services. The amount you will pay varies depending on your income, ranging from as low as $3 per visit up to $35.
Does Your Child Need Dental Fillings Under Medicaid?
Not all dentists accept Medicaid, but if you are covered by Medicaid dental benefits in Arizona, then the Kids Dental Office of Phoenix can provide dental fillings as your child’s Dental Home.
If you would like to schedule an appointment for a filling for your child, please call us at (602) 903-4894 or use our online contact form.