Virginia Medicaid dental coverage
Last verified: June 2026
Dental benefits vary by state and change with budget cycles
Virginia Medicaid covers dental for children under 21 as a mandatory service
Dental coverage for children and teens (under 21)
Under the federal EPSDT mandate, Virginia Medicaid must cover any dental service that is medically necessary for a child under 21, even if that service is not listed as a standard adult benefit. DMAS contracts with managed care plans under Cardinal Care to deliver dental services to most enrolled children.
- Oral exams and cleanings (two per year)
- Dental X-rays
- Fluoride treatments and sealants
- Fillings (amalgam and composite)
- Extractions
- Root canal treatment (anterior teeth)
- Orthodontics (when medically necessary — not cosmetic)
- Emergency dental services
- Nitrous oxide and sedation when medically necessary
Source: DMAS Medicaid and CHIP dental benefit information; Cardinal Care member handbook guidance.
Adult dental coverage (age 21 and older)
Adult dental coverage under Virginia Medicaid is an optional state benefit. DMAS covers a limited set of dental services for adults — primarily emergency and preventive care. Comprehensive restorative work is more restricted for adults than for children.
Services typically covered for adults include emergency extractions, oral examinations, dental X-rays, and simple restorations in some cases. Cosmetic procedures, dentures (for most adult categories), and orthodontic treatment are generally not covered.
Verify your specific adult dental benefits through Cardinal Care
How to find a Medicaid dental provider in Virginia
Cardinal Care health plans each maintain their own dental provider networks. To find an in-network dentist, use your plan's member portal or call the Cardinal Care Enrollment Broker at 1-800-643-2273, who can direct you to your health plan's dental contact.
Federally Qualified Health Centers (FQHCs) across Virginia also accept Medicaid for dental services and use sliding-scale fees for uninsured patients. The HRSA Health Center Finder at findahealthcenter.hrsa.gov can locate an FQHC near you.
Children are entitled to at minimum two dental exams per year under EPSDT. If your child's dentist is not accepting new Medicaid patients, contact DMAS at 1-800-552-8627 for provider location assistance.
School-based dental screenings and FAMIS members
Children enrolled in FAMIS Plus (Virginia's CHIP-funded Medicaid children's program) receive the same dental benefits as other Cardinal Care Medicaid enrollees. FAMIS dental benefits include the full EPSDT preventive and restorative package described above.
Virginia also offers school-based dental screenings through the DMAS EPSDT program. If your child receives a referral for follow-up dental care through a school screening, that referral should be honored by any Cardinal Care in-network dental provider.
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 Virginia 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 Virginia Medicaid or CHIP are entitled to this full EPSDT dental benefit regardless of what Virginia 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 Virginia Medicaid benefit package to confirm which tier Virginia currently provides and whether a dental benefit cap applies.
Adult dental benefits can change without notice