Medicaid would cover dental care for eligible foster youth under 26

Medicaid would cover dental and other youth health services through age 25. Patients must be in state foster care, or have been in state care at 18 or the state's chosen higher age. Former foster youth must also have had Medicaid during that care. States would explain dental services and why good oral health matters. Both rules would start in the first calendar quarter beginning on or after 80 days after enactment.

States would set minimum dentist payments, with federal money covering the required increase. Patients must be under 26 and either in state foster care or previously in care at 18 or their state's chosen higher age. Former foster youth must have had Medicaid during that care. Full federal funding would cover only the gap above January 1, 2026, rates in the 50 states and Washington, D.C. The payment floor and full federal funding would apply to services starting in the first calendar quarter beginning on or after 80 days after enactment.

States would calculate the Medicaid dentist payment floor using average negotiated private insurance rates. Patients must be under 26 and either in state foster care or previously in care at 18 or their state's chosen higher age. Former foster youth must have had Medicaid during that care. States could choose rates for the same dental service in their state or nationwide. Rates would include patients' share of costs. The calculation would exclude employer health plans that pay claims themselves. The average would cover the five years ending on the date of each dental service.

States would run programs to help former foster youth enroll in Medicaid and encourage dentists to participate. The programs would target former foster youth eligible for Medicaid and dentists practicing in the state. Youth outreach would follow federal best practices. States would coordinate youth outreach with the state foster-care agency and other appropriate or interested agencies. States would have to establish both programs within six months after enactment.