Most Dentists Do Not Accept Medicaid

Dentists Accepting Medicaid In this survey, two-thirds of dentist respondents revealed that they do not accept Medicaid payments.

Though one in three dentists does take Medicaid, many were unimpressed. “Too much red tape, broken appointments and unappreciative patients,” complained one doctor. “Not worth my time or my staff’s time.”

General dentists are three times as likely to accept Medicaid as are specialists. In addition, the majority of rural dentists do accept Medicaid, whereas most of their urban and suburban colleagues do not.

What else do dentists have to say about Medicaid? Here’s a sampling:

  • “Medicaid is a loss leader. If they ever reimburse for what the procedures/time/materials are worth, I might change my mind.” (Arkansas dentist)
  • “With all the dentists being prosecuted and some thrown in jail lately for what appear to be honest coding mistakes, I’d quit dentistry before I’d take Medicaid patients. It’s just too risky.” (Texas dentist)
  • “I can’t in good conscience refuse to treat a patient because of who pays the bill, especially if an existing patient falls on hard times.” (New York dentist)
  • “I accepted Medicaid for 18 years, but no longer serve this population. They are the most unreliable and ungrateful group of patients.” (Kansas dentist)
  • “I lose money on each Medicaid patient I see, but it’s a matter of charitable community service.” (California dentist)
  • “States promise but do not deliver adequate funding for socially-needed projects. Waste and mismanagement undercut the truly necessary oral health initiatives.” (Connecticut dentist)
  • “With the economy sliding downward, rapidly, I’m glad I’ve got the extra source in a small town.” (Arkansas dentist)

Read more: Dentists Say Medicaid Isn’t Worth It


About Julie Frey

+Julie Frey is the Editor of TheWealthyDentist.com blog. She has dedicated her career to Internet marketing and communications, working side-by-side with dental marketing guru Jim Du Molin since 2006. She has a degree in Linguistics from Stanford University, has a passion for language and writing, and lives in San Francisco.

  • http://www.orgsites.com/ny/nyscof nyscof

    Unlike fluoridation of the water where freedom of choice is thrown out of the window by dentists who claim to care about poor people, dentists give themselves the freedom to choose or reject poor people on Medicaid.

    This may be fair to some. But what isn’t fair is when organized dentistry, acting on the behalf of individual due-paying dentists, fight vigorously with political might, money and effective lobbying to thwart any other viable group from filling the void.

    Dental therapists could easily work in the entire US. The first ones are working effectively in rural Alaska where people would otherwise be pulling out their own teeth.

    The ADA and its affiliates do all they can to keep people in dental pain, keep dentist income high while people in America are dying from untreated tooth decay. The ADA fights against hygienists going solo, denturists fitting false teeth without a dentist getting a cut as well as dental therapists who have worked for decades in developed countries as effectively as dentists but more cheaply and in areas and mouths where dentists refuse to go.

  • Pavanjit Chhabra

    It seems the Medicaid system is purposely designed to make it difficult to get reimbursed for treatment. Thus discouraging Dentists from accepting and that results in less people using Medicaid and saving money for the State. I have just started my practice and I do accept it. I dont have much of a choice at this time. But already I have hundreds if not thousands of dollars of treatment not paid by Medicaid for one stupid reason or another.

  • a,tom

    I am not a dentist, but I do believe in what all of you have to say. It is hard to run a business if you can’t get paid from the state and federal assistance programs.
    I am a Medicaid recipient due to a debilitating injury that has left me poor and unable to work which make me feel very ashamed of my self. When I need to use my assistance for food and medicines I feel bad, and not that I need dental work I am not going to get it because I don’t want to put any one out of the moneys they deserve for the works they would perform on me. While reading some of your responses I started to cry because I now feel like I am not worth the trouble of having my teeth and the pain worked on. I am so ashamed that I will not ask for help, and I do know or have a friend who is a licensed dentist in Hawaii because I would not be able to pay him, instead I will just try to manage the pain until the end comes and no more pain.
    I hope one day the government will get their act together and change the way the system works and that more of the participating dentist are paid what they are worth. There is nothing you can do about the people that you treat you can only hope that they are kind and appreciative of the work that is performed on them for free through the Medicaid program. Although we should understand that most people on Medicaid have some kind of mental illness or defect and that is why they are so rude or demanding on the dentist and their staff, if these people didn’t have issues or problems they wouldn’t be on Medicaid.
    With that I would like to thank you for all the good works you do for the kids, you are the unsung heroes of our societies.

  • suzie

    My husband and I have worked the last 20 years and now we find ourselves unemployed and unable to find jobs that will allow even a modest, middle class lifestyle. I have resorted to applying for state health and dental care for my children. The problem is that we do not qualify for the “good” (MIchild) program (we don’t make enough) and only qualify for the Medicaid Healthy Kids program (for the truly indigent, poor, and mentally ill). It shames me that we have sunk this low and cannot even present decent health care coverage when going to our dentist and doctors. We have been paying the 500.00 a month through COBRA for good insurance, and now even that is impossible to manage. It sickens me that health care has so much red tape and it’s only going to get worse once the government gets their hands into the health care industry even further with the ‘coverage for all’ option. Do any of us have any illusions that it will be run any differently than Medicaid or Medicare? Nope. No hope at all.

  • WIC Nutritionist

    As a Public Health Nutritionist for WIC in FL, I see so much tooth decay in children under 5. In my area (N. FL) Medicaid recipients must travel 30 minutes to over 2-3 hours to much larger cities and even HOPSITALS to get dental services. And this is ONLY if the child has severe decay or other oral problems. Preventative: Yeah right: 30-60 minute drive IF they are lucky. We nutritionsists work hard to tell clients to delay giving juice to infants: (Yes we have 5+ month olds drinking the equivalent of an OJ carton of formula and Juice a day), DO NOT give it in a bottle or let them walk around with a juice cup in their mouths, and limit juice to toddlers to only 8 ounces (diluted with water) a day if that.

    I saw a beautiful 3 year old girl a few months ago-Until she opened her mouth: her 4 front teeth were rotted down to small white little pegs, and now she has to eat soft food. She avoids meat too-which is a nutrition risk. She eats the same texture food as my 72 year old grandmother.

    I say all this to say is that I don’t fault dentists for not taking Medicaid or not seeing kids less than 5. In this whole system You Dentists AND the kids are the biggest Losers in this whole deal. Kudos to the dentists who struggle to make ends meet with with the Medicaid patients who are ungreatful, and the lack of adequate pay. its so sad you lose before you win. But I also feel bad for those people on hard times (Some working folk are 1 paycheck away from homelessness or loss of benefits) who need a little help in between jobs/situations too.

    Dentists: Fight harder to get more help and say on who you can treat and how you can be paid. You are not totally helpless!

  • WIC Nutritionist

    @suzie:

    500.00/month for your COBRA! Oh my gosh! We need to be protesting outside those insurance companies for milking you so! When did healthcare coverage get so expensive? It seems like Healthcare coverage is only for the employed and well to do.

    Thats why my husband of 2.5 years and I are delaying having a baby. We bring in 60K between the both of us, have 3 degrees and student loans to the yingyang. We are lucky to be on with the state for healthcare. But I can’t help thinking: What if we were unemployed? We’d be back to what we were before: unemployed and on a wing and a prayer with hoping we don’t suffer a bad accident. We are only lucky cause we have jobs. It makes no sense people between jobs have to HOPE they don’t get sick.
    I am glad this administration is trying to do SOMETHING. Growing up we had nothing: My parents couldn’t even afford the (my mom’s job)company insurance (dad worked for very small company-no insurance)…. But they DID work hard. We were totally blessed we were healthy kids. I didn’t get a cavity until I was about 23. A friendly dentist did a few cleanings for me and let me pay under the table as I was a struggling grad student at the time. Many people are not so lucky. I am glad this adminstration too is outraged that people like suzie is having to spend so much on her COBRA and is TRYING to do SOMETHING. Nothing is perfect. But at least if I lose my job I MAY get a little coverage and not have to hope a dentist will let me pay under the table-or worse yet, when I did get a little money, the last dentist we saw scammed us so hard and overcharged us (per his assistant who is now my client and admitted this to me in tears) we delayed getting married. Didn’t matter that he was charging our very rich pastor less $$. Oh yes: He is a member of my church!

  • YaRight

    It is not that we dentists do not get paid at all. It is that we get paid a fraction of what we can charge other customers with regular insurance or cash paying customers.
    Medicaid keeps or astronomical prices in check. For instance. We may charge a cash/insured customer $400.00 for a tooth extraction, but if they have medicaid we can only charge $100.00 because medicaid knows that this is the cost of the procedure and equipment and supplies and wages ect. So why would we want a customer that we can not make as much money off of? We don’t.

  • Kara

    To ya right…if all that only costs 100.00 then why are you charging us 400.00 a little rip off to us it seems

  • Doc Z

    First off, unless you are an Oral Surgeon a simple tooth extraction D7250 is not $400, but much closer to the $100 to $200 range. Depending on location etc. Any dentist charging $400+ for a simple extraction is a bit overpriced. Or just come to Buffalo and I will glady take the tooth outh for my normal fee of $125.
    I do take medicaid and they only reinburse $45 for a simple extraction. It is almost not worth my time. If they are one of my patients I will take on the case and remove the tooth. If they are coming from another dentist I will not treat them. Why? Simply put the medicaid population are most likely to sue over anything that may go wrong. Same reason I don’t take out lower wisdom teeth. Not that I am not capable, but the Oral surgeon carries a much larger malpractice insurance than General Dentists do. They are most apt to handle the legal problems when the inferior alveolar nerve gets damaged during a wisdom tooth removal. Is it malpractice? No, but the justice system is more a sympathy system if you get my drift.
    Not to mention that I am not going to do the dirty work for other dentists. Do your own extractions, don’t pass them off to others, and cherry pick the procedures.
    So far I have stopped doing dentures and partials for medicaid patients. I simply cannot afford to lose money for other people’s problems. The lab bills are now larger than medicaid’s reinbursement.
    Medicaid needs to increase their reinbursement rate or dentists are going to drop them like a bad habit. I am already debating on dropping medicaid because the reinbursement rate is just not worth it.
    As for having hygenists or therapists doing dentistry, it is just dumb. The difference in schooling is vastly different. Ever see a denture made by a denturist? They are horrible. Not to mention a dentist can exam and actually identify cancer. Hygenists for the most part are 2 years of training out of high school. You really want them to be taking care of your dental needs. There are some Hygenists out there that are really good and could be dentists if they chose. Yet if they want to do the dentists job, get the training and be a dentist.
    The same goes for physicians. Everyone wants cheap service, and they think having less trained individuals is the way to get that. Then they are the first one’s to sue for a misdiagnosis. Oh but the nurse didn’t check for…
    Exactly, you get what you pay for. Physicans and Dentists pretty much kill themselves in schooling to get their training. If the reinbursement is not there at the end of the rainbow, then you are not going to have Physicians and Dentists embarking on that path.

  • barbara mastro

    I am a mother of 3 and have always put my kids first..well when times get tough and you cant find work or pay to take care of yourself you have no choice but to look for help. I applied for medicaid becaue my 3 front teeth where badly cracked from falling. I went to a medicaid dentist and he was to remove only those 3 teeth..after 9 needles to my upper mouth and gums I walked out of that office with a mouth full of blood, blurry vision and I was very dizzy. I went to the hospital because I was in soo much pain and thats when I discovered the dentist removed all of my upper teeth. Now its 3 months later and I cant afford full dentures and I dont trust medicaid dentist. So it is a door that swings both ways..I always keep my appointments..I am always very greatfull, and if I didnt need help I would not abuse the system like most do.

  • Theresa

    It drives me crazy that i cant find a dentist that will help me!!! I feel like killing myself because of my teeth. They are sooo gready!!!

  • Toni

    This is for Dr.Z
    Just so you know Dental Hygiene is a 4 year degree.
    If you hired any with a 2 year degree – that is wrong!!
    Yes Medicaid/Medicare should pay more.
    More dentists should accept it.
    The patients should learn how to behave and have their children behave as well.

  • Toni

    I don’t mean those with an associate degree either. That still requires 2 years of prerequisite courses. I mean 2 years straight out of high school.

  • jax

    I just read this and i’m wondering how much of it is BS. theoretically, i could comment a million times using fake email addresses and names I created.

    Dicks like jesus.

  • http://www.thevisibledentist.com/ The Visible Dentist

    Julie, Jim:

    Guys do yourselves a BIG favor; install Akismet on your blog to protect against spam posts. I really recommend it; it’s free and you’ll wonder how you ever got along without it.

    John Barremore
    Houston, TX

  • http://www.thewealthydentist.com Jim Du Molin

    Thanks for the tip, John, but we already have Akismet protecting us against spam, and it catches dozens of fake messages each week.

    Though some of these comments may seem silly or petty, the comments shopwn here are NOT actually spam. We let people say pretty much whatever they want (within reason) on our blog.

    The actual spam is so much spammier! But pnline meds, see naked celebrities, and all that ridiculousness.

  • http://www.thevisibledentist.com/ The Visible Dentist

    Jim that’s good to hear, however, as you may already know, allowing outbound, off-topic links, even though they’re “no followed” in your blog’s code, can result in your site’s relevance and industry association being diminished, that is, in the eyes of the search engines.

    John Barremore
    Houston, TX

  • Amanda Baynes

    Im a 23 year old girl in St Petersburg Florida and its really sad that the goverment/ungrateful people have messed it up for people like me. Im in unbareable pain everyday and cant afford to get any teeth fixed. Its really sad becasue i took great care of my teeth and was famous for a beautiful smile and now i cover my mouth to smile due to no enamel production. Its the worst feeling in the entire world I just want to laugh with my friends without being subconcious. I kind of feel bad for all the people walking around with only shards of teeth now i thought it was gross and how could anyone let that happen to them selves. Well here i am a young girl has pain everyday and just wants a decent smile but no one takes any Medicaid! I wish more people wanted to help than worry about loosing a few dollars when you have no teeth pain (witch is worst than anything else) and if i would have became a dentist i sure would use Medicaid and watch coding super careful if thats at all true.

  • http://www.insightsfordentists.com Dental Marketing Options

    It’s easy to stand above oneself and say, “Oh no, I’m not making money therefore what I’m not doing is not worth it” but some of these testimonies on here prove that there are people outside of ourselves who need help and we have to stop being detached and feel their pain. Perhaps some people abuse their medicaid, but there are others who really need it, just because one person lies does not mean we lose faith in all humanity; just because one person is ungrateful with medicaid and their service, it does not mean there are many others who would be too.

  • http://www.torontodentist-smileblog.com Toronto Dentist in Etobicoke

    There’s always been a huge segment of the population that have been walking dental disasters. The numbers are rising as more slip down into poverty.

    No easy answers.

  • Amy

    To Amanda…
    I know exactly how you feel. I have lost any ability to eat most things. I have to eat only things that are VERY soft and then it still hurts. I recently moved to Arkansas and finally got on Medicaid because I am a single mother and cannot find a job because of the way my mouth looks. It is sad that Medicaid doesn’t reimburse like they should but, what are we supposed to do? Suffer? I will never be able to smile or even be happy because I look so awful. I don’t even like to talk anymore.
    Some people want to win the lottery or get a big sum of money to do lavish things….I just want to be able to smile and not have my son ask me what is wrong with my teeth…

  • Melissa

    I was abused by a dentist when I was younger. No not sexual or something like that. But I had 3 extractions with NO novocaine. I had fillings with no novocaine. I was told I was being a baby. To the point that I was TERRIFIED to go to the dentist. We have fallen on rough times and we are on Medicaid to keep our family afloat.

    My teeth have been in piss poor shape because of my fear of the dentist. Yet I decided that my kids needed to go to the dentist so they didnt end up like me. I sucked it up. And managed to make it into the dentist. Granted I had been in pain for 3 years from a broken tooth that I knew had to be extracted. The dentist I went to was VERY understanding about my fears. They took wonderful care of me even tho I was blubbering in the waiting room, in the chair and heck I am getting the shakes just remembering. Well I got the extraction but the dentist didnt do the root canals and crowns I needed. So gave me a referral.

    Worked up my courage to call the number. ‘Oh I am sorry we don’t take Medicaid referrals.’ Shaking I put down the phone. Called another number on my list. Same deal. One dentist actually made me an appointment, had me drive an hour to see him (mind you I needed to find childcare) sat in his office for almost 90 minutes, shaking I sat in the chair and was told ‘Oh I am sorry we don’t do Medicaid RCT referrals. After that incident I have all but given up.

    This morning one of the teeth that I needed to be crowned broke a little more. So now I am back in pain. I cannot find anyone who will help me. All I want is compassion.

  • dsmom

    you should be ashamed of yourselves thinking your better than the poor man, who use to maybe have been your neighbor!

  • dsmom

    I thought you all became doctors and dentists to help people that need the help. No matter what their standings are or how much money they don’t have. I am talking to the dentists who don’t accept medicade

  • dsmom

    WWJD

  • Newton dentist

    I do accept MassHealth for kids. I think kids are basically innocent of their condition, and find that they do tend to show up, since not many practices locally accept MassHealth.

  • Snilsen

    I was a hard-working teacher until I came down with a severe case of rheumatoid arthritis. My doctors wouldn’t and won’t sign a note for me to go back to work. Frankly, my good days are so sporadic, I’m not even sure I could keep a job if I had one.
    As a result, I am on Social Security Disability and Medicaid. I have no choice.
    There was a dentist in town who did accept Medicaid, but he had since retired. Now there is no dental care for anyone where I live who is on Medicaid. None.
    In addition, even the ONE time I went to the aforementioned dentist, I was not spoken to by the dentist, my questions were ignored, and the only person who DID say anything was the receptionist. She is one of, if not THE most rude person I have ever encountered in my life. Among other snotty comments she made, she shouted across the waiting room as I was leaving, “You Medicaid people can’t come back here for another six months!” (I hadn’t asked to come back–I guess she just felt like twisting the knife a little harder.)
    I didn’t miss my appointment. I was grateful for the service, even though I was treated like dirt. I have not had dental care for years now because I cannot afford it. (Now before you start judging and saying I must have money because I have a computer—I am writing this on my sister’s computer.)
    Anyway, thanks a lot to the entire dental “profession” for treating me like a second-class citizen and taking the failure of the Medicaid system out on me.
    I rest on the knowlege that God has something special in store for you all.

  • Snilsen

    I was a hard-working teacher until I came down with a severe case of rheumatoid arthritis. My doctors wouldn’t and won’t sign a note for me to go back to work. Frankly, my good days are so sporadic, I’m not even sure I could keep a job if I had one.
    As a result, I am on Social Security Disability and Medicaid. I have no choice.
    There was a dentist in town who did accept Medicaid, but he had since retired. Now there is no dental care for anyone where I live who is on Medicaid. None.
    In addition, even the ONE time I went to the aforementioned dentist, I was not spoken to by the dentist, my questions were ignored, and the only person who DID say anything was the receptionist. She is one of, if not THE most rude person I have ever encountered in my life. Among other snotty comments she made, she shouted across the waiting room as I was leaving, “You Medicaid people can’t come back here for another six months!” (I hadn’t asked to come back–I guess she just felt like twisting the knife a little harder.)
    I didn’t miss my appointment. I was grateful for the service, even though I was treated like dirt. I have not had dental care for years now because I cannot afford it. (Now before you start judging and saying I must have money because I have a computer—I am writing this on my sister’s computer.)
    Anyway, thanks a lot to the entire dental “profession” for treating me like a second-class citizen and taking the failure of the Medicaid system out on me.
    I rest on the knowlege that God has something special in store for you all.

  • Snilsen

    I was a hard-working teacher until I came down with a severe case of rheumatoid arthritis. My doctors wouldn’t and won’t sign a note for me to go back to work. Frankly, my good days are so sporadic, I’m not even sure I could keep a job if I had one.
    As a result, I am on Social Security Disability and Medicaid. I have no choice.
    There was a dentist in town who did accept Medicaid, but he had since retired. Now there is no dental care for anyone where I live who is on Medicaid. None.
    In addition, even the ONE time I went to the aforementioned dentist, I was not spoken to by the dentist, my questions were ignored, and the only person who DID say anything was the receptionist. She is one of, if not THE most rude person I have ever encountered in my life. Among other snotty comments she made, she shouted across the waiting room as I was leaving, “You Medicaid people can’t come back here for another six months!” (I hadn’t asked to come back–I guess she just felt like twisting the knife a little harder.)
    I didn’t miss my appointment. I was grateful for the service, even though I was treated like dirt. I have not had dental care for years now because I cannot afford it. (Now before you start judging and saying I must have money because I have a computer—I am writing this on my sister’s computer.)
    Anyway, thanks a lot to the entire dental “profession” for treating me like a second-class citizen and taking the failure of the Medicaid system out on me.
    I rest on the knowlege that God has something special in store for you all.

  • Joolzz

    My daughter is covered under my private insurance, medicaid is secondary.  Now that she is graduating from high school, I can no longer keep her on my policy.  I have started looking for a dentist who takes Medicaid.  There are only two where we live.  This is so frustrating, for years we have been seeing the same dentist, driving an hour each way.  They won’t help me out, and I can’t find anyone!  My daughter has CHARGE Syndrome, we are not “welfare” clientele.  This just seems so unfair!!! 

  • Dorothy Boyd

    Lost my job 2 years ago…always had good insurance. Now I need work done on my teeth and cant afford to pay. Im on medicaid and social security..Pretty sad that no dentist will help

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