South Dakota Medical Assistance (SDMA) covers a range of dental services for adults and children that include preventive (exams, X-rays, cleanings) and restorative (fillings, root canals for certain teeth, crowns and anesthesia) services. Some limits apply, particularly for adults, and adults are limited to a total of $1,000 per State fiscal year (July 1 to June 30) for non-emergency dental services. SDMA covers dentures and partial dentures in some specific, medically necessary circumstances; however, all dentures and partial dentures require prior authorization, as do the more extensive services.
For children 20 years old and younger, SDMA covers orthodontic treatment when specific criteria have been met. Recipients must be younger than age 21 at the time service begins, and in most situations have "medical need," which is defined as an orthodontic condition that severely limits the ability to eat, chew food, and speak, and must follow the prescribed treatment plan. All orthodontia must be approved before treatment begins. SDMA covers the cost of examination and scoring to determine whether the recipient meets the medical need for orthodontia.
For assistance finding a dental provider or for assistance with more questions about dental or orthodontic services, please contact Delta Dental of South Dakota at 1-800-627-3961.