Illinois Medicaid dental coverage
Last verified: June 2026
Illinois offers comprehensive adult dental — one of the most generous Medicaid dental benefits in the country
What Illinois Medicaid dental covers for adults
Per HFS, the Illinois Medicaid dental program covers a full range of dental services for children and restorative dental services for adults over 21. DentaQuest has served as the dental fiscal agent for HFS since March 1999, administering the program on a fee-for-service basis.
Adult dental services covered under Illinois Medicaid include:
- Oral examinations and X-rays
- Preventive cleanings (prophylaxis)
- Fillings (amalgam and composite, subject to coverage rules)
- Extractions — including surgical extractions
- Dentures — complete and partial dentures
- Emergency dental services for pain relief
Some services require prior authorization from DentaQuest before treatment. Dentures and certain surgical procedures typically fall into this category. Your dentist's office handles the authorization request — you do not submit it directly.
Children get full dental coverage under EPSDT
Children enrolled in All Kids (the Illinois CHIP/Medicaid program for children) receive dental coverage under the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) mandate. EPSDT requires all medically necessary services to be covered for enrollees under 21, which means children's dental is broader than adult dental. It includes:
- Routine checkups and cleanings at recommended intervals
- Fluoride treatments and dental sealants
- Fillings, crowns, and restorations as medically necessary
- Extractions
- Orthodontia when medically necessary
- Emergency dental care
How to find a dentist who accepts Illinois Medicaid
DentaQuest manages the Illinois Medicaid dental provider network. The fastest way to find a participating dentist near you is to use DentaQuest's provider search at dentaquest.com/en/find-a-dentist. Filter by "Illinois Medicaid" or "All Kids/HFS" to see in-network providers.
You can also call DentaQuest directly at 1-888-286-2447 (TTY: 1-800-466-7566) for help locating a dentist in your area. The call is free, and staff can confirm whether a specific provider is currently accepting new Medicaid patients.
If you are enrolled in a HealthChoice Illinois managed care plan, dental is a separate benefit administered by DentaQuest — not through your health plan. Your medical card and your dental coverage are handled by different entities.
Prior authorization and what Illinois Medicaid dental does not cover
Not all dental procedures are covered without prior approval. DentaQuest reviews requests for dentures, certain surgical procedures, and some restorative work before authorizing payment. The dentist's office submits the prior authorization request and typically receives a response within a few business days.
Illinois Medicaid dental does not cover cosmetic procedures. Teeth whitening, veneers, and purely cosmetic reshaping are excluded. Implants are generally not covered for adult Medicaid enrollees. Orthodontic treatment is covered for children when it meets the EPSDT medical necessity standard but is not routinely covered for adults.
If a procedure is denied, you have the right to appeal. Ask DentaQuest for the reason for denial in writing and request a review. Your dentist can also submit additional clinical documentation supporting medical necessity.
What Illinois Medicaid dental covers
| Service | Adults (19+) | Children (under 21) |
|---|---|---|
| Exams and x-rays | Covered | Covered (EPSDT) |
| Cleanings (prophylaxis) | Covered (2×/year) | Covered |
| Fillings (amalgam and composite) | Covered | Covered |
| Extractions | Covered | Covered |
| Root canals | Covered (prior auth) | Covered (EPSDT) |
| Crowns | Covered (prior auth) | Covered (EPSDT) |
| Full dentures | Covered (prior auth) | Covered (EPSDT) |
| Partial dentures | Covered (prior auth) | Covered (EPSDT) |
| Orthodontics | Limited (medical necessity) | Covered if medically necessary (EPSDT) |
Prior authorization (prior auth) is required for major services. Contact DentaQuest at 1-800-581-2583 to find a dentist or get prior auth status.
- Find a DentaQuest network dentist at dentaquest.com or call 1-800-581-2583
- Tell the dental office you have Illinois Medicaid and your HFS ID number
- For major services (crowns, root canals, dentures): your dentist must obtain prior authorization from DentaQuest before treatment
- Emergency dental is available even without a prior auth — call DentaQuest for guidance on emergency care
- Children under 21 are covered for all medically necessary dental under EPSDT — more extensive than the adult benefit
Can't find a DentaQuest dentist? FQHCs and CHCs often accept Illinois Medicaid dental