Dental Services in Louisiana's Public Health Coverage Programs 

Louisiana Medicaid and the Louisiana Children's Health Insurance Program (LaCHIP) are sponsored by the federal government and administered by states that is intended to provide health care and health-related services to low-income individuals. In Louisiana, Medicaid is administered through the Department of Health and Hospitals (DHH). For more information on each of the programs, including information on services covered, visit the DHH Web site. You can also click here to find a provider in your area or call 1-877-455-9955. Another DHH link connecting patients to providers can be found by clicking here.

The state of Louisiana does have the following programs related to Medicaid dental services:

•  The Early Periodic Screening, Diagnosis, and Treatment (EPSDT) Program is the child health component of Medicaid.  The EPSDT Dental Program provides coverage of certain diagnostic; preventive; restorative; endodontic; periodontic;  removable prosthodontic; maxillofacial prosthetic; oral and maxillofacial surgery; orthodontic; and adjunctive general services.  Specific policy guidelines apply.

•  Adult Denture Program - Medicaid recipients 21 years of age and older. Dentures, denture relines, and denture repairs are covered under this program, as well as examination and x-rays in conjunction with the construction of a Medicaid-authorized denture.

•  Expanded Dental Services for Pregnant Women (EDSPW) - Exam; Radiographs (x-rays); Prophylaxis (cleaning); certain restorative services when the location of the cavity to be restored is in an area that impacts the gum tissue and affects the periodontal health of the woman; certain periodontal services; and certain oral and maxillofacial surgery services. The individual must be:  1) Medicaid eligible for full benefits*; 2) age 21 through 59;  3) pregnant and have an original BHSF Form 9-M completed by the medical professional providing pregnancy care.  Eligibility for the EDSPW Program ends at the conclusion of the pregnancy.  The recipient must be pregnant on each date of service to be eligible for EDSPW Program services.

 

There are many different types of eligibility groups within the state's Medicaid program, including, but not limited to:

•  LaCHIP - LaCHIP is no-cost health insurance, including dental, for children. LaCHIP stands for "Louisiana Children's Health Insurance Program." If your child is younger than 19 and does not have health insurance, he or she could get LaCHIP to pay for seeing a doctor or dentist. LaCHIP covers care at a hospital, prescription drugs and shots, too! The only way to know if your child can have LaCHIP is to apply. (LaCHIP is an expansion of Medicaid and those certified in LaCHIP are considered EPSDT eligible; therefore eligible for the dental services covered in the EPSDT Dental Program (certain program policies apply).

• LaMOMS - The LaMOMS program is an expansion of Medicaid coverage for pregnant women with an income up to 200 percent of the Federal Poverty Level.  Through this program, pregnant women of working families, either married or single, have access to no-cost health care coverage. Medicaid will pay for pregnancy-related services, delivery and care up to 60 days after the pregnancy ends including doctor visits, lab work/tests, prescription medicines and hospital care.

For more information on other programs, visit the DHH Medicaid Program's Website.