Medicaid dental coverage for kids in New York
A practical, parent-friendly guide written for families in New York looking for affordable pediatric dental care. Every clinic referenced below is a federally-funded community health center listed in our New York directory.
Pediatric dental care in New York is one of the most thoroughly covered benefits in the entire Medicaid program. Federal EPSDT (Early and Periodic Screening, Diagnostic, and Treatment) law requires New York Medicaid / Child Health Plus to provide every child enrolled in Child Health Plus or full Medicaid with comprehensive dental services from the first tooth onward. That means twice-yearly cleanings, fluoride treatments, sealants on permanent molars, fillings, root canals on baby teeth, stainless-steel crowns, extractions, and even orthodontia when it is medically necessary — all at no out-of-pocket cost to your family.
Who is eligible for Child Health Plus in New York?
Children under age 19 in New York qualify for Child Health Plus if their family's gross income is at or below 405% of the federal poverty level. Using the 2024 federal poverty guidelines, that translates to:
| Family size | Annual income limit | Monthly income limit |
|---|---|---|
| 1 | $60,993 | $5,083 |
| 2 | $82,782 | $6,899 |
| 3 | $104,571 | $8,714 |
| 4 | $126,360 | $10,530 |
| 5 | $148,149 | $12,346 |
| 6 | $169,938 | $14,162 |
Limits assume one parent's reportable income; pregnant women and children with medical disabilities may qualify above these thresholds. Child Health Plus dental covers cleanings, fillings, root canals, crowns, and orthodontia.
What does New York Medicaid / Child Health Plus actually cover for kids?
Coverage is divided into three tiers — preventive, basic, and major — and unlike adult Medicaid dental, every tier is included for children with no annual dollar cap.
Preventive (covered 100%, no copay)
- Periodic oral exams every six months from age 1.
- Prophylaxis (cleanings) every six months.
- Fluoride varnish up to four times per year for high-risk children.
- Dental sealants on first and second permanent molars.
- Bitewing and panoramic x-rays at age-appropriate intervals.
- Patient education and oral-hygiene counseling.
Basic restorative (covered 100%)
- Amalgam and composite fillings.
- Stainless-steel crowns on baby teeth.
- Pulpotomies (baby root canals) and pulpectomies.
- Simple and surgical tooth extractions.
- Space maintainers when a baby tooth is lost prematurely.
Major services (prior authorization usually required)
- Permanent crowns and root canals on adult teeth.
- Orthodontia for severe malocclusion, cleft palate, or craniofacial conditions.
- Sedation dentistry (nitrous oxide, oral conscious sedation, or hospital general anesthesia) for very young children or those with special health-care needs.
- Periodontal scaling for adolescent gum disease.
How to enroll in Child Health Plus
Apply at New York Medicaid / Child Health Plus's online portal, by mail with a paper application, or in person at any community health center listed in our New York directory. Most CHCs employ a dedicated enrollment counselor who can complete the application with you in 30 minutes and submit it electronically. You will need:
- Proof of New York residency (utility bill, lease, school enrollment letter).
- Birth certificates or hospital records for each child.
- Social Security numbers for everyone applying.
- Recent pay stubs (last 30 days) or last year's tax return.
- Immigration documents if applicable — note that DACA recipients in New York may also qualify.
What if your application is denied or your child is between coverages?
You still have options. Federal law requires every community health center in New York — there are 864 of them across 199 cities — to charge on a sliding-fee scale tied to household income. Families at or below 100% FPL typically pay nothing; those between 100% and 200% FPL pay a small nominal fee, often $25 to $45 for a complete pediatric dental visit. Read our companion guide on sliding-fee pricing in New York for the full breakdown.