MassHealth Coverage

Pemberton Dental Associates are your local Cosmetic, Implant, and General Dentists located in Lawrence, MA.

DEntal Insurance at Pemberton Dental Associates

MassHealth Dentist in Lawrence MA

Pemberton Dental Associates in Lawrence Massachusetts accepts MassHealth patients. MassHealth-enrolled patients have coverage for their regular dental visits, restorative dental treatments, and medically necessary treatments (with prior authorization). If you have any questions about your coverage or would like to schedule an appointment with our team, please give us a call to get started with our office. 

MassHealth Coverage

What Does MassHealth Cover?

Like with any insurance provider, coverage can vary based on your plan; but in a general sense, MassHealth provides basic coverage for preventative care and treatments that help address dental issues. Your two recommended cleanings/exams each year are covered including fluoride treatments, sealants, and X-rays. Dental treatments like fillings, crowns, and dental bridges are covered as well. Additionally, other medically necessary treatments can be covered with prior authorization from MassHealth. 

How Does Prior Authorization Work

There are a handful of dental treatments that require prior authorization. For example, deep cleanings at your dental office require prior authorization if you have MassHealth. Prior authorization simply means that MassHealth has to approve coverage for the treatment before you receive the treatment; otherwise you may have to pay out of pocket if they do not approve it in advance. This is also the case for the category of coverage for “other medically necessary treatments”. Basically if a treatment is recommended by your dentist but it was not in the list of specific treatments that MassHealth covers you will need to get approval in advance. 

Does MassHealth Cover Orthodontics?

MassHealth Dental only provides orthodontic coverage for patients under the age of 21. Different dental treatments have different coverage based on the age of the enrolled member so it is important to check all of the treatments that MassHealth covers. If you have any questions about dental coverage, please give us a call or visit MassHealth’s website to learn more about coverage. 

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