Does ARHome Cover Dental? $500 Limit, Costs, and Providers

ARHome’s private health plans do not cover routine adult dental care, but if you’re enrolled in ARHome you still get dental benefits through a separate Arkansas Medicaid fee-for-service dental program, which pays up to $500 per state fiscal year for covered services. So the short answer to “does ARHome cover dental” is: not through your Blue Cross or Ambetter plan, but yes through Medicaid’s standalone dental benefit.

What Your ARHome Health Plan Covers for Dental

ARHome uses federal Medicaid dollars to buy Qualified Health Plans from Blue Cross Blue Shield or Ambetter for adults aged 19 to 64.¹ Those plans follow the Arkansas Essential Health Benefits benchmark, which lists routine adult dental, basic dental care, orthodontia, and major dental care as “Not Covered” for the 2025–2027 plan years.² The ARHome cost-sharing comparison tables say the same, with one narrow exception: accidental dental care within 72 hours of an injury.³

One Ambetter Summary of Benefits and Coverage document lists adult dental care with a $1,000 annual limit, so plan-level details can vary.⁴ It’s worth calling the member services number on your QHP card to confirm what your specific plan includes. Either way, every Medicaid-eligible adult in Arkansas has access to the separate dental program described next.

The Arkansas Medicaid Adult Dental Benefit

Dental coverage for ARHome adults runs through a statewide fee-for-service program administered directly by the Department of Human Services. As of November 1, 2024, DHS ended its managed care contracts with Delta Dental and MCNA and moved dental back to fee-for-service.⁵ If you still have an old Delta Dental or MCNA card, set it aside; your regular Medicaid ID card is what the dentist needs.⁶

What the $500 Annual Limit Covers

Adult Medicaid enrollees get up to $500 in dental benefits per state fiscal year, which runs July 1 through June 30. Unused dollars do not roll over.⁶ Services that count against the $500 include oral evaluations, X-rays, one cleaning per fiscal year, one fluoride treatment per fiscal year, crowns, sealants, and tobacco cessation counseling.⁷

What Doesn’t Count Against the $500

The Medicaid dental provider manual places simple and surgical extractions, complete dentures, and partial dentures outside the $500 calculation.⁷ A DHS beneficiary document adds that fillings and the lab fees for making dentures also sit outside the cap, though the dentist’s fee for fitting dentures does count against it. Dentures are covered once per lifetime.⁸

What Isn’t Covered at All

Pulpotomies and space maintainers are explicitly excluded for adults.⁷

Who Gets More Than the $500

Two groups of ARHome enrollees have access to broader dental coverage.

If you’re 19 or 20, you qualify for Early and Periodic Screening, Diagnosis, and Treatment (EPSDT). Those EPSDT dental and vision benefits come through the fee-for-service system as a wrap-around to your QHP. The ARHome waiver is clear that this applies only to 19- and 20-year-olds, not to the full adult enrollment.⁹¹⁰

Under Arkansas Act 1025 of 2025, the annual dental limit for adults with special needs is set to rise from $500 to $1,000 per state fiscal year effective September 1, 2025, pending approval from the Centers for Medicare and Medicaid Services. The same law raises reimbursement rates for oral surgery, pediatric dental care, and dental services for adults with special needs, and DHS has said federal regulators may require those rate increases to apply to all adult beneficiaries.¹¹

How To Find a Dentist and Use the Benefit

Every dentist who was in the old Delta Dental or MCNA networks is enrolled in Medicaid fee-for-service, but call ahead to confirm the office still takes Medicaid patients.⁶ Three ways to find one:

Search the Arkansas Medicaid provider portal by location, distance, and provider type (choose “Dental”).¹²
Call the ConnectCare help line at 1-800-275-1131 (TDD 1-800-285-1131) for help locating a provider or checking eligibility.⁶
Contact the Arkansas Foundation for Medical Care at 1-877-650-2362 or dentalpr@afmc.org for program-specific dental questions.¹³

Most dental procedures require prior authorization, which your dentist submits through the Acentra portal.¹¹ If you use up the $500 and still need care, you may be responsible for the rest. The Dental Lifeline Network runs a volunteer program providing free dental services to eligible Arkansans who need more help.⁶

What You’ll Pay

ARHome copayments for most covered services run $4.70, with $9.40 for non-preferred drugs and non-emergency ER visits, and total cost sharing is capped at 5% of household income per quarter. Enrollees below 20% FPL, pregnant women, 19- and 20-year-olds, and medically frail individuals are exempt from copayments entirely. The ARHome cost-sharing documents don’t spell out separate dental copays, so ask the dental office what you’ll owe at the visit.¹⁴ DHS also notes that some benefit limits vary by the specific Medicaid program you’re enrolled in, so the ConnectCare help line is the right call for coverage questions on a particular service.⁶

1
Arkansas Department of Human Services. ARHOME Healthcare Program
2
Centers for Medicare & Medicaid Services. Arkansas EHB Benchmark Plan Summary PY2025-2027
3
Arkansas Department of Human Services. ARHOME Cost Sharing Comparison Tables
4
Centene Corporation. Ambetter Summary of Benefits and Coverage
5
Arkansas Department of Human Services. DHS To End Medicaid Managed Care Dental Program, Return to Fee-for-Service
6
Arkansas Department of Human Services. Dental Beneficiaries
7
Arkansas Department of Human Services. Dental Section I – Age 21 and Up
8
Arkansas State Library. Arkansas Medicaid Dental Services Beneficiary Information
9
Medicaid.gov. ARHOME Section 1115 Demonstration
10
Arkansas Department of Human Services. ARHOME Summary
11
Arkansas Department of Human Services. Dental Providers
12
Arkansas Medicaid. Search Providers
13
Arkansas Department of Human Services. Dental Services
14
Arkansas Department of Human Services. ARHOME Cost Sharing Information