Below is the Access to Oral Health Care section of the Maryland Oral Health Plan, 2026-2030. Click here to download the full Maryland Oral Health Plan
Access to Oral Health Care
All Maryland residents need access to affordable, comprehensive oral health care to prevent and treat oral disease. This requires access to commercial insurance, Medicaid, Medicare or the Maryland Children’s Health Program (MCHP), or paying directly for the care yourself. The goals outline strategies to further expand access to oral health care through changes to policy, strengthening the dental professional workforce and fostering coordination between oral health professionals and other health professionals.
Goal One: Increase the number of Marylanders with dental coverage.
The insurance market is segmented. Each market has its own unique set of requirements for dental coverage, which
is why we recommend a varied strategy approach to expanding coverage.
Strategy One: Continue implementation of comprehensive adult dental coverage in Medicaid.
Strategy Two: Modify the Maryland Health Benefit Exchange plan rules and regulations to include adult oral health care as an essential health benefit (EHB).
>Action A: Conduct an in-depth analysis of commercial dental coverage in Maryland. Maryland policy-makers need to understand trends in commercial dental coverage, how Maryland compares to other states, and opportunities to increase access to commercial dental coverage. The analysis should be segmented into state-regulated commercial plans and commercial plans exempt from state regulation.
>Action B: Establish adult dental coverage as a requirement for qualified health plans under the Maryland Health Benefit Exchange. This strategy is an extension of Maryland’s efforts to reach low-income adults with Medicaid dental coverage. The Maryland Health Benefit Exchange could work with stakeholders and establish adult dental coverage requirements through Plan Management Standards.
>Action C: Modify Maryland’s EHB to include adult dental as a standard for the state-regulated commercial market. Dental coverage would be more affordable under the Maryland Health Benefit Exchange. Consumers would be able to use advance premium tax credits to purchase adult dental coverage.
Strategy Three: Expand dental coverage opportunities for immigrants regardless of legal residency status through Medicaid and the Maryland Health Benefit Exchange. Maryland can build upon other state initiatives, including the Healthy Babies Equity Act and the Qualified Residents Act. With federal efforts to rescind these opportunities, Maryland should explore how to preserve our current program options and think creatively on how the state can meet the dental needs of immigrant communities.
Strategy Four: Establish dental coverage under Medicare. Recently, Centers for Medicare & Medicaid Services finalized a rule to provide Medicare dental coverage under limited circumstances related to certain medical illnesses. While the impact of this rule is limited, it is still an important step in improving access to oral health care for Medicare enrollees. While Medicare is a federal program, Marylanders should advocate for the expansion of Medicare to include dental coverage with our Congressional delegation and support national coalition work on this important issue.
Strategy Five: Develop an outreach and engagement initiative to increase enrollment in dental plans through the Maryland Health Benefit Exchange.
Goal Two: Improve access to oral health care by enhancing covered services when financially feasible.
In Maryland, Medicaid provides coverage of critical oral health care for both adults and children. Medicaid has worked with the advocacy and provider community to shape the dental coverage package to meet the needs of Marylanders. In the commercial market, plans have flexibility to structure their dental coverage. Plans generally cover certain preventive services with no or low costsharing, while providing coverage for more expensive restorative services with higher cost-sharing requirements. In the Medicare Advantage market, plans have the flexibility to structure their dental coverage. Most plans offer coverage of a wide range of preventive and restorative services but may impose annual expenditure caps and cost-sharing requirements.
Strategy One: Expand the dental coverage package of services for adults in the Maryland Healthy Smiles Dental Program to include full and partial dentures.
>Action A: Prepare a comprehensive assessment of the impact of dentures on the health of consumers. Leverage partnerships in the state and beyond to demonstrate the impact that this expanded coverage could have on the health of Marylanders.
>Action B: Develop an incremental plan to establish coverage of dentures in Medicaid. The stakeholder community should assess options for incremental progress and then work with the Maryland Department of Health and the Maryland General Assembly to move forward. The plan will need to be phased in, as the State is currently facing severe fiscal constraints.
Strategy Two: Annually review parameters of the Maryland Healthy Smiles Dental Program and compare services covered to other states. The Maryland Department of Health has been working collaboratively with the stakeholder community on establishing and refining program parameters including preauthorization requirements and frequency limits on procedures. This collaborative relationship has strengthened the Maryland Healthy Smiles Program for children and adults.
Goal Three: Increase the number of dental providers that participate in Medicaid.
Dental coverage is only part of the equation in advancing access to dental services. There must also be a sufficient number of dental providers in a diverse range of geographic areas, that participate with Medicaid and commercial plans. See “Maryland’s Oral Health Workforce” section for more details.
Strategy Two: Continue to conduct a regular review of Maryland Medicaid dental reimbursement rates and report on how state reimbursement rates compare to other states. Develop and implement a plan for regular rate increases in Medicaid and targeted rate increases to grow enrollment of dentist specialists. Rate increases may not be feasible in the near term, given the State’s fiscal situation.
>Action A: Identify opportunities for sustainable funding for uncompensated oral health care. Federally qualified health centers and other types of community health centers have reported that uncompensated care rates are impacting their capacity.
>Action B: Expand capacity of community health centers through loan repayment programs. The Maryland Dent-Care Loan Assistance Repayment Program is an essential tool in the recruitment and retention of dental providers in DHPS areas.
>Action C: Support the use of teledentistry in community health centers. Community health centers can have multiple sites, but establishing a dental clinic at each site can be challenging.
Strategy Three: Expand the number of school-based providers offering preventive oral health care (e.g., oral screenings), including the utilization of dental hygienists and school nurses.
>Action A: Actively support the work of the Maryland Collaborative to Improve Children’s Oral Health Through School-Based Programs, which was established by House Bill 1143 in the 2025 legislative session.
Goal Four: Increase dental provider participation in private insurance.
Barriers, including credentialing requirements, make it difficult for dental providers to participate in insurance plans.
Strategy One: Evaluate network adequacy standards for state-regulated dental plans.
Strategy Two: Assess the consistency of provider participation in Maryland Medicaid and health plans offered in the Maryland Health Benefit Exchange. Consistent provider networks are important to ensure continuity of care for individuals who switch between coverage type.
Strategy Three: Streamline credentialing requirements of dental insurance plans to reduce barriers for dental providers to participate in insurance plans.
