Medicaid Information

The ARC accepts many forms of Dental Medicaid including Smiles for Children, Famis, Famis Plus, Optima, Virginia Premier for both adults and children. The ARC also participates with the newly expanded Medicaid programs under Medallian 4.0 including Smiles for Children, Virginia Premier, Magellan, Aetna, and Optima.

Services Covered by Medicaid for Children (21 and younger):

  • Preventative dentistry (examinations, teeth cleaning, fluoride application, sealants, x-rays, oral hygiene and nutritional counseling)
  • Restorative dentistry (fillings)
  • Endodontics (root canals, pulpotomies, crowns)
  • Extractions (limited surgical)

Services Covered by Smiles for Children for Adults (21 +)

  • Examinations
  • X-rays
  • Extractions (limited)

Patients enrolled in expanded Medicaid plans may be eligible for additional services. Once the comprehensive examination is completed our office staff will be happy to review your benefits with you. For services not covered under your insurance plan (simple restorative and hygiene), patients enrolled in Medicaid who reside in Staunton, Waynesboro or Augusta County will be assigned a co-pay based on your income. Extensive procedures such as root canals, crowns and bridges do not fall under your assigned co-pay. If these services are indicated our office will provide you with a treatment cost estimate.

Patients enrolled in Medicaid who reside outside of the ARC service area and need services that are not covered by their insurance plans will be assigned to the Medicaid rate fee schedule. Our office staff will provide you with a treatment cost estimate for services indicated.

Medicaid for pregnant women:

When you are enrolled in Medicaid for pregnancy, you get comprehensive health care benefits (INCLUDING DENTAL) during your pregnancy and for two months following the birth. Medicaid may provide up to three months retroactive coverage. Dental services are administered through the Smiles for Children program. For more information, please call Smiles for Children at 1-888-912-3456.

If you have any questions regarding your Medicaid dental insurance coverage please feel free to call our office at 540-221-6635.