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Does the Medicaid Cover Teeth Whitening?

Approximately 50% of Americans with private insurance possess dental coverage. However, it’s vital to note that such insurance seldom covers cosmetic procedures, including teeth whitening. Notwithstanding, select dental plans may proffer a teeth whitening stipend that partly funds the procedure.

Does Medicaid Cover Teeth Whitening?

Medicaid does not typically cover teeth whitening. Beneficiaries seeking teeth whitening should expect to pay out-of-pocket for this procedure.

Medicaid and Dentistry Dental Insurance Coverage

Medicaid is a state and federally-funded program designed to provide medical coverage for low-income individuals and families. Its primary goal is to ensure that beneficiaries have access to essential healthcare services. When it comes to dental care, Medicaid’s coverage primarily focuses on procedures and treatments deemed medically necessary.

Cosmetic dentistry focuses on procedures primarily intended to enhance the patient’s dental aesthetics. It includes:

  • Whitening treatments
  • Veneers
  • Bonding
  • Straightening solutions like Invisalign

Despite their popularity, these procedures often fall outside insurance coverage, necessitating patients to shoulder the full cost.

Teeth Whitening and Medicaid

Teeth whitening is predominantly viewed as a cosmetic procedure. Since it’s primarily intended to enhance dental aesthetics and isn’t deemed medically necessary, Medicaid does not typically cover teeth whitening. Beneficiaries seeking teeth whitening should expect to pay out-of-pocket for this procedure.

However, there are exceptions in specific cases or states. While Medicaid’s broad rules exclude cosmetic procedures, each state has the discretion to tailor its Medicaid program slightly differently. Thus, it’s always a good idea for beneficiaries to check with their specific state’s Medicaid program to confirm what dental services are covered and to what extent.

Other Dental Insurance Plans with Teeth Whitening Coverage

CompanyPlan NameReimbursement PercentageTeeth WhiteningWaiting Period
AmeritasPrimeStar BoostUp to 50% (varies by network and duration)50% in-network after one year.1 year
Delta DentalDelta Dental Patient DirectVariesDiscounted Fees _

Teeth Whitening Costs with and without Insurance

Without insurance, teeth whitening can vary from under $50 with over-the-counter kits to a steep $650 on average for in-office procedures. Although most dental insurances don’t cover teeth whitening, a few, like Humana, offer an allowance – up to $100 annually for in-office treatments in specific plans.

Cosmetic Procedures and Dental Insurance

Primarily, dental insurance does not foot bills for cosmetic procedures like teeth whitening and veneers since they’re aimed at enhancing dental aesthetics and are not deemed medically crucial. Therefore, patients usually bear the full cost of such treatments.

Frequently Asked Questions

1. Does Medicaid cover cosmetic dental procedures like teeth whitening?

No, Medicaid does not typically cover teeth whitening as it is predominantly viewed as a cosmetic procedure. Its primary focus is on procedures and treatments deemed medically necessary. However, each state has the discretion to tailor its Medicaid program slightly differently, so beneficiaries should check with their specific state’s Medicaid program for exact coverage details.

 2. How much does teeth whitening cost without insurance?

Without insurance, teeth whitening costs can vary. Over-the-counter kits can be under $50, while in-office procedures can average around $650. Some dental insurances, like Humana, offer an allowance for teeth whitening, providing up to $100 annually for in-office treatments in specific plans.

3. Do most dental insurance plans cover cosmetic procedures?

Primarily, dental insurance does not cover cosmetic procedures such as teeth whitening and veneers. These treatments are aimed at enhancing dental aesthetics and are not considered medically crucial. As a result, patients usually bear the full cost of such treatments. However, a few plans might offer allowances for these procedures, but they are generally out-of-pocket expenses for patients.

Final Words

The majority of dental insurance packages revolve around three principal tiers: preventative, basic, and major procedures. Cosmetic enhancements, such as teeth whitening, are generally not within their purview. A few plans may proffer allowances for such treatments, but most times, these procedures are out-of-pocket expenses for patients.

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