What Does MassHealth Dental Cover?
MassHealth is a health insurance plan for Massachusetts residents that includes dental benefits. Dental benefits from MassHealth are available to both adults and children who have an active MassHealth plan. Here at Pemberton Dental Associates we take MassHealth patients and help them improve their oral health with high-quality dental services. One of the most common questions patients ask is about what their insurance covers. First and foremost, we always recommend checking with your specific plan. You can use MassHealth’s website to learn more about dental services. That said, we wanted to provide some basic information about MassHealth’s dental coverage for enrolled members.
Why Are Dental Visits So Important For Adults
A regular dental appointment has two sides to it. First and foremost there is a professional cleaning. During a cleaning, your dental team will remove plaque and tartar that you cannot remove at home. Even if you brush your teeth twice a day every day and floss, there is no replacing a professional dental cleaning. During a cleaning plaque and tartar are removed, moreover a dentist can provide preventative dental care that helps protect your teeth from cavities. Second, your dentist will provide an exam which may include X-rays, where they will look for any early signs of dental issues. The earlier a problem is discovered the easier it is to correct. For example, before a cavity forms a dentist might recommend fluoride toothpaste to help strengthen the affected teeth. A cavity can easily be solved with a filling, but if it is ignored the decay will spread deeper into the tooth eventually leading to infection and tooth loss.
What Is Preventative Care?
Like many dental insurance plans, MassHealth provides coverage for preventative care. Preventative care is a catchall term for any dental treatment that helps prevent problems in the future. Simply put, it is recommended that kids, teens, and adults see the dentist twice per year for checkups. All of the services that are handled in the checkup are usually covered. Oral exams, fluoride, cleanings, X-rays, and similar treatments that help dentists check for problems and protect your teeth from decay are often covered. That said, it is important to understand prior authorization. Some specific treatments require prior authorization, which means the insurance company has to be aware that the treatment is happening before it happens. For example, deep cleanings require prior authorization for adults.
Does Masshealth Cover Dental Fillings?
Yes, MassHealth covers a variety of treatments that can address dental issues. This includes fillings, dental crowns, tooth removal, and root canals. Regarding root canals, MassHealth covers root canals except on third molars (wisdom teeth). MassHealth also provides coverage for medically necessary procedures. Simply put, if a dentist recommends a treatment to address dental problems, it will likely be covered. That said, the category “other medically necessary dental services” does require prior authorization. The team at MassHealth will likely need to discuss the treatment in advance with your MassHealth Dentist.
What Else Does MassHealth Cover?
MassHealth covers other treatments like dentures and braces for patients under the age of 21. That said it is important to check with your plan beforehand and make sure the treatment you are looking into is covered and to handle prior authorization if it is necessary.
MassHealth Dental Office In Lawrence Massachusetts
Pemberton Dental Associates is located in Lawrence Massachusetts and provides dental treatments for adults. Our office accepts MassHealth and would be happy to answer any questions you have about dental treatments, coverage, or appointments. Please give us a call to discuss setting up an appointment with our team.