Delaware Medicaid dental coverage
Last verified: June 2026
Dental benefits vary by state and change with budget cycles
Delaware has a dedicated adult dental benefit page at DMMA
Dental coverage for children under 21
Children enrolled in Delaware Medicaid and the Delaware Healthy Children Program receive comprehensive dental care under the federal EPSDT mandate. EPSDT requires coverage of all medically necessary dental services for enrolled children, regardless of state plan limitations. Delaware's MCOs include pediatric dental in their benefit packages.
- Oral exams and cleanings (twice per year)
- 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
Source: Delaware Medicaid covered benefits; EPSDT mandate under 42 U.S.C. § 1396d(r). Use the Insure Kids Now dentist locator at insurekidsnow.gov to find a Delaware Medicaid dentist who sees children.
Adult Delaware Medicaid dental benefits
Delaware provides adult dental benefits through the Diamond State Health Plan. DMMA maintains a dedicated adult dental benefits page (dhss.delaware.gov/dmma/adult_dental_benefits.html) — confirming that adult dental is part of Delaware's Medicaid benefit package. This is more than many states offer; a significant number of states provide only emergency dental care or none at all to adult Medicaid enrollees.
Adult dental benefits in Delaware are delivered through the MCOs. Coverage includes preventive exams, cleanings, X-rays, fillings, extractions, and other restorative services. Prior authorization may be required for more extensive procedures. Contact your MCO — Highmark Health Options or Molina Healthcare — for the specific dental benefit schedule that applies to your plan.
- Preventive exams and cleanings
- Dental X-rays
- Fillings and restorations
- Tooth extractions
- Root canal treatment (subject to plan benefit schedule)
- Emergency dental services
Source: DMMA adult dental benefits information (dhss.delaware.gov/dmma/adult_dental_benefits.html). Specific services and prior authorization requirements vary by MCO.
How to find a Delaware Medicaid dentist
Dental providers are in your MCO's network. Contact your plan directly:
Highmark Health Options
Use the provider directory at highmarkhealthoptions.com or call member services to find participating dentists in Delaware.
Molina Healthcare of Delaware
Use the online provider directory at molinahealthcare.com or call the member services number on your Molina ID card.
The Delaware Aging and Disability Resource Center (delawareadrc.com) can help eligible individuals find dental care. For children, the Insure Kids Now dentist locator at insurekidsnow.gov/find-a-dentist identifies dentists who accept Delaware Medicaid and CHIP near you.
Delaware's FQHCs provide dental services for Medicaid members and offer sliding-scale fees for uninsured patients. Use the HRSA Health Center Finder at findahealthcenter.hrsa.gov to find a community health center dental clinic in Delaware.
Dental coverage in Medicaid: what to know
Medicaid dental coverage is not uniform across states. Federal law requires comprehensive dental care for children under 21 through Early and Periodic Screening, Diagnostic, and Treatment (EPSDT). Adult dental is optional — states can offer emergency-only coverage, limited coverage, or a full dental benefit. Several states have reduced or eliminated adult dental during budget cuts, then restored it later.
The practical result: two people in different states with identical income and family circumstances can have very different dental coverage. Children's dental is the one reliable floor; adult coverage depends entirely on what Delaware has chosen to fund.
Children's dental coverage (under 21)
Under the EPSDT mandate — codified in 42 U.S.C. § 1396d(r) — Medicaid must cover all medically necessary dental services for enrollees under 21 in every state. This is one of the few areas where the federal floor for Medicaid is genuinely comprehensive: states cannot restrict children's dental coverage the way they can adult coverage.
EPSDT dental includes preventive care (cleanings, fluoride treatments, sealants), diagnostic X-rays, restorative work (fillings, crowns), extractions, orthodontia when medically necessary, and emergency dental care. The "medically necessary" standard is broad for children — if a dentist certifies that a service is needed for the child's health, Medicaid must cover it.
Children covered by Delaware Medicaid or CHIP are entitled to this full EPSDT dental benefit regardless of what Delaware provides to adults.
Adult dental coverage (age 21 and older)
Adult Medicaid dental falls into three general tiers across states, though the specifics vary considerably:
Emergency only
Covers tooth extractions and treatment for acute dental pain or infection. No preventive cleanings, fillings, or restorative work covered.
Limited coverage
Covers emergency services plus some preventive care and basic restorative work (fillings). Typically excludes orthodontia, implants, and more complex procedures.
Comprehensive coverage
Covers the full range of dental services — preventive, diagnostic, restorative, and sometimes orthodontic — comparable to commercial dental insurance. Available in fewer than half of states.
Check the current Delaware Medicaid benefit package to confirm which tier Delaware currently provides and whether a dental benefit cap applies.
Adult dental benefits can change without notice