Medicaid State Breakdown | Medicaid Dental Utilization Rates

 Determining the exact percentage of Medicaid's overall healthcare spending allocated to dental services is challenging due to variations in state policies and reporting practices. Medicaid is a joint federal and state program, and each state has discretion over the scope of dental benefits, particularly for adults. While comprehensive data on the national allocation to dental services is limited, some insights can be drawn from available information:

• Medicaid Reimbursement Rates: The American Dental Association (ADA) reports that Medicaid fee-for-service (FFS) reimbursement rates for dental procedures vary significantly by state. For example, in 2022, these rates ranged from as low as 30% to as high as 80% of typical dentist charges, depending on the state and specific procedure.

• Utilization Rates: The Kaiser Family Foundation (KFF) found that the percentage of Medicaid-enrolled adults receiving at least one dental service annually varies widely among states, from under 5% in some states to over 30% in others.  

Medicaid adult dental care utilization rates vary significantly across the United States, reflecting differences in coverage policies, reimbursement rates, and access to care. According to data from the American Dental Association's Health Policy Institute, as reported by Becker's Dental, the national average for adult Medicaid dental care utilization is 18%.

States with the Highest Utilization Rates:

1. New Jersey: 32%
2. Massachusetts: 30%
3. Connecticut: 29%
4. Minnesota: 29%
5. Montana: 29%
6. Vermont: 27%
7. Alaska: 24%
8. District of Columbia: 24%
9. Iowa: 25%
10. Colorado: 25%

States with the Lowest Utilization Rates:

• Alabama: 0%
• Mississippi: 0%
• Tennessee: 1%
• Florida: 2%
• Texas: 4%
• Arizona: 5%
• New Hampshire: 6%
• Hawaii: 7%
• Arkansas: 7%
• Georgia: 8%

These disparities highlight the impact of state-specific Medicaid policies on dental care access. States with more comprehensive adult dental benefits and higher reimbursement rates tend to have higher utilization rates. Conversely, states with limited or no adult dental coverage under Medicaid often see lower utilization, underscoring the importance of policy decisions in shaping healthcare access.