Ohio Medicaid Dental Coverage

Updated August 2026

Ohio Medicaid enrollees get dental coverage through their managed care plan. Each managed care organization (MCO) — including AmeriHealth Caritas, CareSource, Humana Healthy Horizons, Molina, Anthem, and UnitedHealthcare Community Plan — administers dental benefits using the DentaQuest provider network, but each MCO has its own member services number. Check the back of your Ohio Medicaid ID card, or call your MCO's member services line, to confirm your dental benefits and find a participating dentist.

DentaQuest

Dental network used by Ohio Medicaid plans

Your MCO

Who to call for dental benefits

Under 21

Full EPSDT dental coverage

How Ohio Medicaid administers dental benefits

Children covered by Ohio Medicaid receive dental services through the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit, a federal mandate under 42 U.S.C. § 1396d(r). EPSDT requires Ohio to cover all medically necessary dental services for anyone under 21, regardless of whether the state covers those services for adults. In practice, this means children have broader coverage than adults in any gray areas.

Annual limits on adult dental coverage can change with Ohio's biennial state budget. Before scheduling a procedure, confirm your remaining benefit by calling the member services number for your specific MCO.

Dental services covered for Ohio Medicaid adults

Ohio Medicaid's adult dental benefit covers a range of routine, restorative, and prosthetic services. The list below reflects covered service categories per ODM's dental fee schedule; individual service coverage may be subject to frequency limitations.

  • Oral exams and dental X-rays — including full-mouth series and bitewing X-rays
  • Prophylaxis (routine cleanings) — typically covered twice per year
  • Fillings — amalgam and composite (tooth-colored) on both front and back teeth
  • Extractions — routine and surgical
  • Root canals — anterior (front teeth) and posterior (back teeth, including molars)
  • Crowns — with prior authorization required
  • Partial dentures and full dentures — with prior authorization
  • Denture repairs and relines
  • Periodontal treatment for gum disease — scaling and root planing with documentation of medical necessity

Prior authorization: what requires approval first

Several dental procedures require prior authorization from DentaQuest before the work is performed. If a provider skips this step, the claim may be denied even if the service would otherwise be covered.

Crowns require DentaQuest to review clinical notes and X-rays to confirm a crown is the appropriate treatment; providers must submit documentation showing the tooth cannot be restored with a filling. Full and partial dentures require pre-authorization before impressions are taken, and frequency limitations apply — dentures aren't typically replaced more than once every five years without specific clinical justification. Periodontal procedures beyond routine prophylaxis, such as scaling and root planing, typically require documentation of clinical findings such as pocket depth measurements.

Ask your dentist to submit the prior authorization request before scheduling the procedure. The process generally takes a few business days but can take longer for complex cases.

How to find an Ohio Medicaid dentist

Search DentaQuest's provider directory at dentaquest.com, or call your MCO's member services line — for example, AmeriHealth Caritas Ohio at 1-833-764-7700, Humana Healthy Horizons at 877-856-5702, or UnitedHealthcare Community Plan at 877-542-9239 — and ask for help finding a participating dentist near you. When calling a dental office, confirm they currently accept Ohio Medicaid — networks change, and a provider listed in the directory may have recently stopped accepting new Medicaid patients.

Federally Qualified Health Centers (FQHCs) throughout Ohio provide dental services on a sliding-fee scale and accept Ohio Medicaid. FQHCs often have same-week appointments available when private dental offices have longer waits. Find an FQHC near you through the HRSA Health Center Finder at findahealthcenter.hrsa.gov.

Ohio Medicaid

  • AmeriHealth Caritas Ohio member services: 1-833-764-7700
  • Humana Healthy Horizons member services: 877-856-5702
  • UnitedHealthcare Community Plan member services: 877-542-9239
  • DentaQuest provider directory: dentaquest.com
  • HRSA Health Center Finder: findahealthcenter.hrsa.gov
Visit the official Ohio Medicaid website

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