Finding dental care for a child with a disability or complex medical needs can be challenging, even when your child has Medicaid. Before scheduling an appointment, it can help to ask a few questions to make sure a dental office is a good fit for your family.

Confirm the Basics: Call the dental office to make sure they accept Medicaid and are taking new pediatric patients. The office’s online listing may not be up to date.

Understand Coverage: Ask which services Medicaid covers, whether prior authorization is needed, and what costs you may be responsible for. Request a written treatment plan before care begins.

Assess Fit and Experience: Ask if the office has experience working with children who have special health care needs and whether they offer accommodations such as longer visits, sensory support, accessibility, and if they allow caregivers to stay in the room.

Discuss Specialized Care: If your child may need further support, ask about sedation options or referral to hospital-based services.

Know Your Options: If you can’t find a Medicaid dental provider, there may be other ways to get care, including dental schools or community health centers. If you decide to pay out of pocket, ask about discounts or financing options.

Act Quickly for Urgent Needs: For pain, swelling or infection, contact a provider right away. Some medications may be covered through Medicaid medical benefits while your child waits for dental care.

If you need someone to talk with you about coverage choices, contact ForwardHealth Member Services or the state Medicaid BadgerCare Plus Dental Ombudsman at (800)947-9627 (option 4).

You do not have to navigate these challenges alone.