Dental care for persons with special needs is financed through a variety of mechanisms including:

• private insurances
• fee-for-service
• Medicaid (MCD)
• Medicare (MCR)
• Children’s Health Insurance Program (CHIP)

Medicare Dental Coverage

Medicare will pay for dental services only under very specific circumstances. This includes being part of a covered procedure such as reconstruction of the jaw following accidental injury; extractions done in preparation for radiation treatment for neoplastic diseases; oral examinations, preceding kidney transplantation or heart valve replacement.

Medicaid/Title XIX

• Medicaid is a collaborative effort between federal and state programs for medical assistance to low-income children and pregnant women, persons over age 65, and the disabled. Each state establishes eligibility requirements and coverage limitations. Most state Medicaid programs purchase at least some medical care services through contracts with managed care plans.

• States are required to provide dental benefits to children covered by Medicaid and the Children's Health Insurance Program (CHIP), but states choose whether to provide dental benefits for adults.

• Most states provide emergency dental services for adults but less than half of the states provide comprehensive dental care. This policy also affects persons with disabilities who turn 21 and are no longer eligible for dental services. Some states have alternative provisions such as Medicaid waiver programs for such individuals. However, these programs often have a long wait lists for services.

• Dental services for children must minimally include:
• Relief of pain and infections
• Restoration of teeth
• Maintenance of dental health

Children's Health Insurance Program (CHIP)

CHIP is a Medicaid expansion program required to provide the Early and Periodic Screening, Diagnostic, and Treatment benefits (EPSDT).