Children and adults with disabilities and/or special health care needs need dental treatment the same as everyone else. They not only require routine dental care, but often need additional attention. Their treatments may be affected by their physical, emotional, developmental, cognitive, or sensory disabilities.
Georgia Medicaid provides comprehensive dental services for children under the age of 21, but the services for adults are significantly different.
For children under 21, dentistry is a mandatory service, provided as a part of Early and Periodic Screening Diagnosis and Treatment (EPSDT). The services include regular check ups as part of preventive care. Check ups should be done at intervals that are the reasonable standard of dental practice, and also when there is a need, such as when the child is in pain or has an infection. The services cannot be limited to emergency care only, but must include restoration of teeth and maintenance of dental health.
For adults, Georgia Medicaid covers only emergency dental care. Dental care is not mandatory and there are no minimum requirements for adult dental coverage.
Trying to find a dental provider that accepts Medicaid can be a challenge. Less than 1 in 3 dentists in Georgia accept Medicaid.
Although Medicaid will only cover limited dental procedures in Georgia, adults with developmental disabilities may be able to receive dental care funding through the NOW/COMP waiver or family support funding. Contact your support coordinator or your DBHDD Regional Field Office for more information.