South Carolina Expands Medicaid Dental Coverage for Adults — Here’s What Changed in 2025
COLUMBIA, S.C. — As of July 1, 2025, thousands of low-income South Carolina adults gained access to critical dental care thanks to a major expansion of Healthy Connections Medicaid. The change offers up to $1,000 in dental benefits per year for enrollees age 21 and older — a first for the state, which previously only covered children or emergency oral surgeries.
The update brings South Carolina in line with a growing number of states addressing the long-overlooked dental needs of adults enrolled in Medicaid.
What’s Included Under the New Benefit
The expanded dental services now include:
- Routine cleanings, exams, and X-rays
- Tooth extractions, fillings, and limited root canals
- Surgical services and anesthesia, if medically necessary
- Pre-op dental care for organ transplant or cancer treatment patients
According to DentaQuest, these benefits apply annually and reset every July. Services must be provided by Medicaid-approved providers and must be deemed medically necessary.
An overview by the Center for Health Care Strategies shows how states that expand dental benefits often see a decline in ER dental visits — one of Medicaid’s most expensive fallback options.
Who Qualifies for Coverage
This new benefit applies to all adults 21 and older enrolled in full Healthy Connections Medicaid. That includes recipients who are part of Managed Care Organizations (MCOs) like Humana, Molina, or Absolute Total Care.
Those with limited Medicaid coverage, such as pregnancy-only or family planning coverage, are not eligible for the dental expansion. South Carolina’s SCDHHS provider manual outlines which enrollment categories are covered.
Participants must also ensure their provider is enrolled in the Healthy Connections Medicaid Dental Program.
Why This Expansion Matters
South Carolina’s move comes as studies increasingly link poor dental health with larger systemic issues — including heart disease, diabetes complications, and avoidable emergency room visits.
A 2025 report from Axios noted that adults without dental access are significantly more likely to seek emergency care for preventable tooth pain — costing the healthcare system far more than routine visits.
Previously, South Carolina only covered emergency extractions or infections. With preventive and restorative care now available, public health officials expect to see a drop in crisis care and a boost in long-term oral health.
How Patients Can Access Benefits
To use these benefits, Medicaid recipients should:
- Verify enrollment in full Medicaid (not a limited plan).
- Use the DentaQuest provider search tool to locate nearby dentists: DentaQuest SC Lookup
- Be aware that services are capped at $1,000 annually, so scheduling early in the fiscal year is encouraged.
- Discuss medically necessary sedation or procedures with providers, as anesthesia is now covered in broader cases per SCDHHS policy updates.
Many counties, including Saluda, Edgefield, and Lexington, now have participating clinics that weren’t previously able to offer adult dental care.
What’s Still Not Covered
The $1,000 limit per year does not include:
- Cosmetic procedures like whitening
- Orthodontics
- Any service provided by a non-Medicaid-enrolled provider
For more information, refer to the Healthy Connections Medicaid Dental Coverage Guide.
Local Reactions Across South Carolina
Saluda-area residents expressed relief at the long-awaited change. “I’ve been putting off a cavity for years,” said one local resident. “Now I can finally get it filled without going into debt.”
Many rural counties previously lacked affordable dental care options. Now, with Medicaid’s broader scope, patients are scheduling visits for preventive care rather than waiting for a crisis.
Oral health advocates have praised the move, calling it “one of the most important Medicaid expansions in the state in the last five years,” citing comparisons to programs in North Carolina and Virginia, where similar changes led to measurable public health improvements.
What to Expect in the Future
While this expansion is currently funded by the state’s Medicaid budget, advocates warn that federal Medicaid reform proposals could threaten adult dental programs in the coming years.
However, South Carolina has committed to maintaining the $1,000 coverage cap and reviewing utilization data before considering changes. Updates to the dental manual will be posted periodically on the SCDHHS website.
Share Your Experience
Have you been able to use the new dental benefit in your area? Were you able to find a provider? Share your story in the comments at SaludaStandard-Sentinel.com — we want to hear how this new law is working for real South Carolinians.
