Delaware Medicaid Dental Coverage

Updated August 2026

Children enrolled in Delaware Medicaid and the Delaware Healthy Children Program receive comprehensive dental care under the federal EPSDT mandate. EPSDT requires coverage of all medically necessary dental services for enrolled children, regardless of state plan limitations. Delaware's MCOs include pediatric dental in their benefit packages.

Up to $1,000/yr + $1,500/yr emergency

Adult dental coverage

Full EPSDT

Children's dental coverage (under 21)

3 MCOs

AmeriHealth Caritas, Delaware First Health & Highmark Health Options

Delaware has a dedicated Adult Dental Services page at DMMA

Delaware DMMA maintains a specific Adult Dental Services page at dhss.delaware.gov/dmma/home/medicaid/adult-dental-services/ confirming that adult dental services are covered. Medicaid-enrolled adults age 21+ are eligible for up to $1,000 of dental care per year, plus an additional $1,500 that may be available for qualifying emergency or supplemental care when medically necessary. The Diamond State Health Plan MCOs — AmeriHealth Caritas, Delaware First Health, and Highmark Health Options — administer dental for enrolled members. Verify your specific dental benefits by calling the member services number on your MCO card.

Dental coverage for children under 21

Oral exams and cleanings (twice per year)
Dental X-rays
Fluoride treatments and preventive sealants
Fillings and restorations
Tooth extractions
Root canal treatment
Space maintainers
Orthodontic treatment when medically necessary
Emergency dental care

Adult Delaware Medicaid dental benefits

Delaware provides adult dental benefits through the Diamond State Health Plan. DMMA maintains a dedicated Adult Dental Services page — confirming that adult dental is part of Delaware's Medicaid benefit package. This is more than many states offer; a significant number of states provide only emergency dental care or none at all to adult Medicaid enrollees.

Preventive exams and cleanings (one cleaning every 6 months)
Dental X-rays
Fillings and restorations
Tooth extractions
Root canal treatment (subject to plan benefit schedule)
Sedation when medically necessary (prior authorization required)
Emergency dental services

Per DMMA, Medicaid-enrolled adults age 21 and older are eligible for up to $1,000 of dental care per year, with one cleaning covered every six months. An additional $1,500 may be available per year for qualifying emergency or supplemental care when medically necessary — for a combined benefit of up to $2,500 per year in qualifying cases. Sedation, including IV sedation, is covered based on medical need and requires prior authorization. Wisdom tooth removal is covered under the Medicaid medical benefit rather than the dental benefit.

Adult dental benefits in Delaware are delivered through the MCOs — AmeriHealth Caritas, Delaware First Health, and Highmark Health Options. Coverage includes preventive exams, cleanings, X-rays, fillings, extractions, and other restorative services. Prior authorization may be required for more extensive procedures. Contact your MCO for the specific dental benefit schedule that applies to your plan, or DMMA Provider Services at 1-800-999-3371 (Option 0, then Option 4) for general questions.

How to find a Delaware Medicaid dentist

Dental providers are in your MCO's network. For AmeriHealth Caritas Delaware, use the provider directory at amerihealthcaritasde.com. For Delaware First Health, use the "Find a Provider" tool at delawarefirsthealth.com or call member services at 1-877-236-1341 (TTY 711). For Highmark Health Options, use the provider directory at highmarkhealthoptions.com or call member services.

The Delaware Aging and Disability Resource Center (delawareadrc.com) can help eligible individuals find dental care. For children, the Insure Kids Now dentist locator at insurekidsnow.gov/find-a-dentist identifies dentists who accept Delaware Medicaid and CHIP near you.

Delaware's FQHCs provide dental services for Medicaid members and offer sliding-scale fees for uninsured patients.