Does Medicaid Cover Dentures?

Book your next appointment
Does Medicaid Cover Dentures

Does Medicaid Cover Dentures

Yes. According to the New York State Department of Health Dental Policy and Procedure Code Manual, the Medicaid program covers the cost of full or partial dentures required to alleviate a member’s serious medical issue or one that affects their employability.

Understanding Medicaid Coverage

Medicaid is a healthcare program for pregnant women, children, low-income people, disabled individuals, and older adults. You are eligible for coverage through the program until you turn 65.

Every state administers a Medicaid program and determines member eligibility and coverage guidelines based on federal regulations.

The federal government requires each state to cover various medical services, including:

  • Hospital stays
  • Nursing home care
  • Doctor visits
  • Home health care

Dental coverage is optional in every state. In New York, the Medicaid program covers the cost of numerous dental procedures, including dentures and implants.

Requirements to Qualify for Medicaid

New York residents are eligible for Medicaid if they have income and resources below the state limits. In 2023, someone who earns under $1,677 monthly and has resources under $30,180 can qualify for Medicaid coverage. The requirements for couples include a monthly income under $2,268 and resources less than $40,820.

You’re automatically eligible for Medicaid if you qualify for the State Supplement Program. That is a portion of Supplemental Security Income payments in the state.

How to Apply for Medicaid Coverage

If you’re not already a member of the Medicaid program, you can apply by completing an application that outlines your income and other relevant information. You must file your application with the Department of Social Services in the county where you reside.

New York City residents must file with the New York City Human Resources Administration. If you’re over 65, you must include a Supplement A form to outline your resources.

The income and resources you must report when you file your application include:

  • Earned income – Your earned income is income from regular employment, operating a small business, freelance work, or renting space in your residence to boarders and lodgers.
  • Unearned income – Unearned income includes interest, pensions, insurance payouts, dividends, government benefits, and other payments unrelated to your job.
  • Resources – Resources refer to cash, assets, and real property you can convert into cash quickly, including life insurance policies, mutual fund shares, bank accounts, stocks, promissory notes, and bonds.

Dental Care Medicaid Coverage in New York

Does Medicaid Cover Dentures

Medicaid covers full and partial dentures if they are necessary to alleviate your serious health problem or one that interferes with your ability to seek or maintain employment. You must obtain prior approval to receive coverage for dentures through Medicaid.

You can’t replace complete or partial dentures, whether stolen, unserviceable, broken, or lost, within eight years of the initial service. However, coverage will apply if the Department or its agent determines the service is medically necessary.

When you make a prior approval request before eight years have passed, the request must include a physician and dentist letter explaining the circumstances that make the denture replacement necessary. The letter must also explain the denture’s role in improving employability and alleviating the patient’s serious medical condition. The documentation must explain the preventative measures implemented to reduce the necessity for additional replacements.

Medicaid also covers the cost of dental implants if they are medically necessary. You must receive a prior approval request and acquire supporting documentation from your dentist and physician. 

A physician’s letter must accompany the request outlining how the implants will relieve your health issue. Your dentist must also provide a letter explaining why alternative treatments won’t correct your dental problem and why you require the implants.

New York residents can receive other medically necessary dental procedures through their Medicaid program without prior approval, such as:

  • Preventative care, including cleanings and polishing
  • Emergency care, such as treating infections or pain
  • Extracting a nonrestorable or infected tooth that doesn’t require a prosthetic
  • Periapical, occlusal, bitewing, and extraoral X-rays
  • Root canal for one cuspid or incisor tooth
  • Oral exams and treatment plans
  • Repairs and fillings with plastic materials, silicate cement, silver, or stainless steel

Make an Appointment to Get Fitted for Your Dentures Today

Restorative dentistry is often necessary to restore a patient’s smile and boost their confidence. At Babylon Dental Care, we understand the frustration of talking or chewing with damaged or missing teeth. It can create multiple issues, including the risk of infection, a less youthful appearance, and a variety of dental problems.

Let us give you the smile you always wanted. Call the Babylon dental professionals of Babylon Dental Care at (631) 983-6665 for an appointment in West Babylon to discuss how we can meet your denture needs.

Related posts

What You Need To Know About Dental Implants

Are Dentures Right For Me?

Are Dental Crowns Painful?

Share This Article :

Related Posts

Are Dentures Right for Me?

November 1, 2022

Leave A Reply



“Amazing experience getting my teeth cleaned at Babylon Dental Care. Melody is fantastic and provided a top-notch painless service. Highly recommend.”

Ron S


“Absolutely incredible team. From the very moment you walk in you're greeted with kindness and people who want to help you. When I was asked how everything was I literally told them I was speechless. Having had terrible experiences as a kid with dentistry I wasn't sure if the nice things I've heard and read would live up to my expectation. I'm so glad they met them, and even went above and beyond what I had imagined. They offered me several options (a comfort menu) for things I could ask for to help make the time go by easier and with less anxiety.. all for free! If you have been holding off due to how long it's been and how anxious you might be then take this as your sign to look into coming here. I really truly am so glad I overcame my fear and made my appointment, they are just *that* good”

Brian K


“Really love this office, they are so kind and non judge mental, I have dealt with so many judge mental dental offices and I have felt totally at ease here. Truly grateful to find them. Dr David is so gentle and for the first time ever I don’t have an anxiety attack coming in to the dentist. The ladies in the front are a pleasure as well, Beth is a breathe of fresh air.”

Angela P


“I had my teeth cleaned by Melody and she did an incredible job. She is gentle, and caring. My teeth look and feel amazing! I normally hate going to the dentist but now look forward to my cleanings with Melody and this location! Everyone is this office is so kind and sweet from the moment you walk in.”

Gillian W


“This was my first time at this Dental office. I went in for a cleaning and dental exam. The office is Clean and modern. I felt comfortable and welcomed right from the start. My hygienist 'Melody' was great! I feel that she was very thorough, talked me through everything she was doing and made recommendations for improving my routine at home. My dental exam with Dr. Diamond was just as pleasant. I liked that she also took her time and I didn't feel rushed. All-in-all it was a good experience. The entire team at the clinic displayed a high level of professionalism and made me feel comfortable throughout my visit.”

Brenda S


“Love this office and all staff! From the front desk, to the hygienist, the dentists and the lovely ladies that check you out, it’s a top notch experience. I trust them 100%!”

Marian P


“Dr. David and the entire staff at Babylon Dental Care are amazing! Every single person who works there is so kind compassionate. I’m a very nervous patient and Dr. David and his assistant Amber made me feel so at ease. I highly recommend Babylon Dental Care especially if you’re an anxious patient!”

Elisabeth D


“From the moment I walked in it was a great experience. The facility is modern and clean. I was treated extremely well. And I really don't like going to the dentist but I'm actually looking forward to my next visit. Everyone I met was great! Thank you for making me feel comfortable.”

Tom M


“Everyone in the Patchogue office are wonderful! Kind, caring, and attentive. I have always hated dentists but I am never anxious to come there. I can honestly say I have NEVER felt this at ease. Thank you all for making this a wonderful experience for me. I won’t ever hesitate to go to the dentist again!”

Susan G


“First visit and everyone was so nice and made the transition to a new dentist seamless! Corinn did a great cleaning and explained everything as she was doing it!”

Kayleigh P


“I would highly recommend Babylon Dental Care. The Drs and Staff are all very friendly and professional. They take the extra time to explain the procedures which are truly done gently and with care. I saw Dr. Knakal and Dr. Diamond. The lobby is comfortable and the dental work areas are immaculate. Also, I have never had to wait very long before being seen!”

Regina B


“First time here, never felt so comfortable at the dentist. Super clean and friendly staff. Corrin and Dr. Brown are absolutely wonderful! Very thorough and knowledgeable.”

Cara P


“This is quite possibly the most impressive Dental office I’ve ever seen. All the staff goes above and beyond to make you feel welcome. The office is so gorgeous through out. I loved my hygienist, she was very knowledgeable and very thorough and informative about being proactive with your hygiene habits. Dr Hsu was amazing. I highly recommend him. Very professional and explains everything he’s doing and that you’re comfortable during the visit. I’m really glad I found this office and my new Dentist.”

Angel W


“I have been using Babylon Dental Care for almost 10 years. Dr. Brown, Jen, Melody and Michelle are incredible. They are always concerned with the patients well being and health making it a different experience. They treat you like family, not a patient. I use them for dentistry and their silent night therapy. Thank you for taking care of my family. Great job team!”

Chuck M


“I've been coming here for about a year and a half. I have always had Francesca and she's great. She's always professional, friendly and honest with me. They have a pretty good system with the walkie-talkies too which makes the process more or less pretty smooth. I also really appreciate that they are transparent up front with cost, not many places are like that in my experiences.”

Scott A


“Professional and courteous staff, every time I come here I’m more than satisfied. Dr Wrann & Dr Knakal are exceptionally good. I would highly recommend Babylon Dental!”

Nick S


“Very professional staff and the hygienist Melody is amazing. The dentist are very thorough and they explained every little bit of details of your procedure. They make you feel so relaxed and welcoming. I would recommend Babylon Dental Care to anyone.”

Verona B


“I recently moved approximately 300 miles away, I continue to make the trip back to Babylon Dental Care. My hygienist Paige could not be kinder, friendlier or professional. I have been having issues with bone loss in my jaws and now it's time for implants. Dr. Knakal has been outstanding. I know I am in the best hands. Everyone I have dealt with at BDC from the receptionists to the checkout personnel are awesome! I will be continuing to make the trip for all my dental care.”

Pete R


“Babylon Dental Care is an amazing practice! I had an issue with my teeth and they took me immediately. Their friendly and compassionate staff walked me through each step and in a matter of a week I had that tooth extracted and my flipper ready for every day use! You can’t even tell I have it in! The office is spotless and they even have Netflix! How cool is that! You’re welcomed as soon as you walk in and they made me feel so comfortable. Dr. Golo and Dr. Knakal took such good care of me and I would recommend them to anyone! The office is so convenient and literally across the street from my home so it doesn’t get better than that! Thank you Babylon Dental!”

Joseph S


“I've never had such an amazing experience at a dentist. They are so kind, so caring, so friendly, and really make you feel appreciated and not just like a patient number. I am blown away by the care I received here, and will be recommending them to everyone I know!”

Jessica C


“I cannot adequately express my appreciation for this practice. Best dental practice ever! Everyone is so kind, caring and respectful. I don't dread going to the dentist anymore. I've had a lot of work done and am extremely pleased. They are very gentle and strive to keep you pain free. Very professional from reception on up. I highly recommend Babylon Dental. Would give them 10 stars if I could!”

Debra B


“Had the zoom whitening treatment and all I can say is wow!!”

Beth L


“At Babylon Dental Care, “care” is given from arrival to check out. I was anxious; it had been a few years since my last filling. From the moment I walked into the exam room, Karen comforted me. She explained the process, answered my questions and talked with me to keep me calm. Dr. Wrann was excellent! I did not have any pain before, during or after the procedure. So happy! Thank you to a truly great team!”

Kristina F


“I went there during covid as my dentist was shut down by the pandemic. They really do everything they can to make you feel good about your experience. Melanie who cleans my teeth as well is wonderful and does a great job everything by the time I leave I don't want to go. Excellent place for dental work. They go above and beyond.”

Connor L