South Dakota Medicaid Dental Coverage

Updated August 2026

Children enrolled in South Dakota Medicaid receive comprehensive dental benefits under the federal EPSDT mandate (42 U.S.C. § 1396d(r)). South Dakota administers EPSDT dental on a fee-for-service basis — children can see any South Dakota Medicaid-enrolled dentist. South Dakota does not use a managed care dental plan for children.

Fee-for-service

Dental delivery model

$2,000/year

Adult annual dental benefit cap

1-888-828-0059

DSS member line

Adult South Dakota Medicaid dental coverage is capped at $2,000 per year

South Dakota Medicaid provides comprehensive dental to children through the EPSDT mandate. Adult dental coverage includes preventive, restorative, and some prosthodontic services, but is capped at $2,000 per state fiscal year (July 1 – June 30); recipients pay for services beyond that limit. Emergency services, preventive services, and dentures/partials are exempt from the cap. Delta Dental of South Dakota administers dental claims — call 877-841-1478 to verify covered services or check your remaining benefit.

Dental coverage for children under 21

Oral exams and cleanings
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 South Dakota Medicaid dental coverage (age 21 and older)

South Dakota's adult Medicaid dental benefit covers a broader range of services than many people expect — including preventive, restorative, and some prosthodontic care — but total spending is capped at $2,000 per state fiscal year (July 1 – June 30). Recipients are responsible for paying for covered services once they exceed the $2,000 limit. Medically necessary emergency services, preventive services, and dentures/partials are exempt from the cap and do not count against it.

Two oral exams per year
Two cleanings per year
Two fluoride treatments per year
Dental sealants for permanent molars
X-rays
Fillings
Tooth extractions
Crowns
Root canals — front teeth only
Partial and full dentures — no more than once every 5 years (exempt from the $2,000 annual cap)

South Dakota administers adult dental on a fee-for-service basis — there is no capitated MCO dental plan. Delta Dental of South Dakota processes claims and can tell you whether the $2,000 yearly limit has been or will be reached for a planned procedure. Ask your dentist to seek pre-approval from Delta Dental of South Dakota before scheduling dental work so you know what portion, if any, you may be responsible for.

South Dakota's Federally Qualified Health Centers provide dental services to Medicaid members and offer sliding-scale fees for uninsured patients. FQHCs are reimbursed at cost for Medicaid-covered services, which means they typically accept Medicaid patients more readily than private dental offices. Use the HRSA Health Center Finder at findahealthcenter.hrsa.gov to locate an FQHC dental clinic near you.

How to find a South Dakota Medicaid dentist

South Dakota Medicaid operates on fee-for-service — there is no managed care dental network directory. To find a participating dentist, visit insurekidsnow.gov, call DSS at 1-888-828-0059, or ask your current dentist directly whether they accept South Dakota Medicaid. Not all dentists participate. Delta Dental of South Dakota, which processes dental claims for the program, can also be reached at 877-841-1478 (8 a.m.–5 p.m. CST, weekdays) or sdmedicaid@deltadentalsd.com for coverage questions.

Dental provider participation in Medicaid can be limited in rural areas — a particular challenge in South Dakota's geographically large, sparsely populated counties. If you cannot find a local participating dentist, contact your nearest Indian Health Service facility if you are an enrolled tribal member — IHS facilities provide dental services to eligible Native American and Alaska Native populations.

South Dakota has nine federally-recognized tribes, and IHS and tribal dental programs are a significant source of dental care for eligible American Indian Medicaid enrollees in the state.