New York Medicaid Dental Coverage

Updated August 2026

New York Medicaid covers dental care for adults enrolled in fee-for-service Medicaid and most managed care plans. The benefit is not limited to emergencies. NY DOH sets the covered services list, and dental plans within MLTC managed care may vary, but the core benefit includes the services below.

Included (not emergency-only)

Adult dental coverage

Full EPSDT

Children's dental coverage (under 21)

HealthPlex, Liberty Dental, DentaQuest

Managed care dental plans

What New York Medicaid covers for adult dental

Some services require prior authorization from NY Medicaid before treatment begins. Your dentist's office handles the authorization process. Ask before any procedure that seems elective — skipping prior auth when required can leave you with an unexpected bill.

Routine exams and cleanings (prophylaxis) — typically once per year
Dental X-rays — bitewing and full-mouth series, subject to frequency limits
Fillings — amalgam and composite restorations for decayed teeth
Extractions — including surgical extractions of impacted wisdom teeth
Root canal treatment — anterior and posterior teeth
Partial and complete dentures — including repairs and relines
Dental implants — in certain circumstances
Oral surgery services — biopsies, incision and drainage for dental infections
Periodontal (gum disease) treatment — scaling and root planing
Teledentistry visits, where appropriate — useful for members in rural areas without easy access to an in-person dentist

Recent changes to New York Medicaid dental benefits

As of January 31, 2024, New York Medicaid expanded coverage for crowns and root canals in certain circumstances, making it easier to keep natural teeth. Replacement dentures and implants no longer require a letter from your physician before they can be approved.

Beginning January 1, 2025, silver diamine fluoride (SDF) treatment for cavities was expanded to cover members of all ages. SDF is a liquid medication brushed onto the tooth surface that treats decay without drilling, and is often used for young children, members with special needs, or members with dental anxiety.

Members with intellectual and developmental disabilities (I/DD) may have access to additional dental services and supports — contact the New York State Office for People With Developmental Disabilities (OPWDD) for details.

Children under 21: federal EPSDT guarantees broader dental coverage

Federal law requires all state Medicaid programs to cover Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services for children under 21. EPSDT is a broad mandatory benefit — if a dental service is medically necessary for a child, Medicaid must cover it regardless of whether the service appears in the state's adult benefit package.

In practice, this means children on New York Medicaid have broader dental access than adults: orthodontics are covered when medically necessary, as are pediatric dental procedures under sedation when clinically indicated. Routine preventive visits are also covered, and children should establish dental care early — Medicaid recommends a first dental visit by age 1.

Dental coverage in managed care and MLTC plans

Most New York Medicaid enrollees receive dental benefits through their managed care plan, not directly through fee-for-service Medicaid. Plans contracting with NY DOH may carve dental out to a dental plan — HealthPlex, Liberty Dental, and DentaQuest are among the plans operating in New York's Medicaid managed care dental network.

If you are in an MLTC plan for long-term care services, check your plan's Evidence of Coverage document for dental specifics. MLTC plans may offer dental as a supplemental benefit beyond the standard Medicaid dental package, particularly for dual eligibles who also have Medicare.

Call the member services number on your Medicaid card to confirm your dental plan and find in-network dentists in your area.

How to find a dentist who takes New York Medicaid

Dentist participation in Medicaid varies considerably by region. Urban areas — especially New York City — have more participating providers. Rural upstate counties can have limited Medicaid dental access.

Search the NY Medicaid provider directory at health.ny.gov — filter by dental specialty and your county
Call your managed care plan's member services line and ask for an in-network dentist near you
Federally Qualified Health Centers (FQHCs) accept Medicaid and offer sliding-scale dental regardless of income
In NYC, NYC Health + Hospitals dental clinics accept Medicaid patients

If you cannot find a participating dentist in your county, contact your local DSS or HRA and ask about transportation assistance or referrals to dental providers. NY Medicaid covers non-emergency medical transportation (NEMT) to dental appointments in some circumstances.