Finding Oral Health Professionals That Accept Medicaid and Children’s Health Insurance Program (CHIP)

Two boys and two girls with their arms over each others shoulder with the logo for Enroll 365 on the bottom. Medicaid is a state-run health insurance program for children from families with low incomes. Many, but not all, state Medicaid programs cover pregnant people, individuals with disabilities, and older adults. CHIP is also a state-run health insurance program. It is for children from families with incomes too high for them to qualify for Medicaid but too low for them to afford private insurance.

This Brush Up on Oral Health tip sheet describes Medicaid and CHIP and explains why the programs are important. It includes tips Head Start staff can use to help parents find a dental office or clinic that accepts Medicaid and CHIP.

The Importance of Medicaid and CHIP

Medicaid and CHIP pay for oral health care for children enrolled in these programs. Without these two programs, many children would not receive the oral health care that they need. Dental benefits typically include teeth cleanings, check-ups, X-rays, fluoride treatments, dental sealants, and fillings. Information on oral health coverage through Medicaid or CHIP in your state can be found on InsureKidsNow.gov.

Tips to Help Parents Find Dental Offices and Clinics That Accept Medicaid and CHIP

Below are strategies for Head Start staff to help parents find a dental office or clinic in their community that accepts children enrolled in Medicaid or CHIP. Show parents how to use the Find a Dentist search tool on the InsureKidsNow.gov website. The tool identifies dental offices and clinics that accept children enrolled in Medicaid or CHIP. For each office or clinic, the tool shows if new patients are being accepted and the languages spoken. The list is updated every three months to keep the information accurate.
Encourage parents to ask others to recommend a dental office or clinic. Have parents ask their pediatrician, family physician, pharmacist, and other parents to recommend a dental office or clinic. In many states, a dental insurance company or managed care organization may have a contract with the Medicaid program to pay for oral health care. If a child enrolled in Medicaid is covered by this kind of company or organization, encourage parents to call the company’s or organization’s member services department and ask for a referral to a dental office or clinic.
Partner with organizations in your state. A good place to start identifying potential partners to contact is your state’s Head Start Collaboration Office (HSCO). HSCOs help develop partnerships between Head Start agencies and other state organizations that provide services to benefit children and families enrolled in Head Start. Other potential partners include the state Office of Oral Health, dental association, Head Start association, and oral health coalition. These organizations can help programs create new and innovative ways to find and access dental offices and clinics that accept children enrolled in Medicaid or CHIP. For example, through a partnership agreement with the Pennsylvania Head Start Association, each of the state’s eight insurance companies that pay for Medicaid and CHIP services have established liaisons to work with Head Start staff and families on oral health-related issues. The liaisons conduct outreach to parents and oral health professionals, help families access care, and provide case-management services.
Develop a relationship with the Medicaid and CHIP dental contact in your state. These contacts can refer you to the Medicaid and CHIP dental contacts in your state to answer questions about coverage and identify dental offices and clinics that accept children enrolled in Medicaid or CHIP. Each state’s dental hygienist liaison can also help Head Start staff get in touch with their Medicaid or CHIP dental contact.