If you live in Massachusetts and are one of the four Americans without dental insurance, you don’t have to deprive yourself from dental care anymore. The state offers its own version of the popular Medicaid program under the name MassHealth.
MassHealth standard eligibility requirements sometimes change with updated guidelines and state laws. If you want to know how to apply for MassHealth insurance coverage and all the great benefits the plan offers, you’ve come to the right place! Dr. Dental accepts MassHealth dental insurance, and we’ve helped many patients with their MassHealth dental coverage.
What You Should Know About MassHealth
Like its counterpart, Massachusetts’ own health insurance program is designed to help low- to medium-income residents and even offers a program for HIV positive patients. The initiative also manages the Insurance Partnership for small businesses, the Children’s Medical Security Plan, Special Kids/Special Care Pilot Program, and Healthy Start.
Now if you want to apply for the MassHealth coverage, you need to be one of the following:
- Children and their parents/caretakers
- Adults working for small businesses
- Unemployed adults
- Pregnant mothers
- Elderly people
- Disabled individuals
- Patients who require long-term care
- Breast or cervical cancer sufferers
- HIV positive patients
- Clients of the Department of Mental Health
Even if you have health insurance, you can apply for MassHealth coverage since the Executive Office of Health and Human Services (EOHHS) assesses eligibility based on family income.
Dental Care Under MassHealth
The MassHealth Dental Program provides members of the program with numerous benefits without co-payments or coinsurance expenses. For children (under 21 years) and clients of the Department of Developmental Services (DDS), preventative and diagnostic cover is covered. Basic and major restorative services and specific Masshealth dental services are also offered.
As for adults, diagnostics and preventative dental services, extractions, emergency dental treatments, and all types of fillings for all teeth are covered. However, if you need additional services that are medically necessary, you may have to acquire prior authorization. In addition, certain services like cosmetic dentistry, dental implants and habit-breaking appliances will not be covered for both adults and children.
The MassHealth Dental Program
To be eligible for the MassHealth Dental Program, you need to be covered by one of the following programs first:
- Family Assistance Direct Coverage
- Family Assistance Premium
All of these cover the categories of people mentioned earlier. However, you also need to abide by financial criteria, which differ from one category to another. Generally, Massachusetts residents under 65 with incomes under or exactly 138% (133% + 5% income disregard) of the Federal Poverty Guidelines On the other hand, HIV positive individuals with 134% – 200% FPG are eligible. You can find out more through the EOHHS website or from a Massachusetts insurance provider.
You still may have questions about MassHealth dental coverage and the process. How do I apply for Masshealth online? Where can I apply for Masshealth? How is MassHealth standard eligibility determined? What about root canals and other complex procedures? These questions are still valid and your eligibility and coverage level depends on income, the number of family members and other factors. We created a comprehensive MassHealth dental guide for more information – click here to learn more.
If you have additional questions about how to apply for dental medicaid, what does Masshealth cover, does Masshealth cover braces, or other concerns, please don’t hesitate to call us at 877-776-9833.
With the federal government’s support and MassHealth’s assistance, you can now get affordable dental care. Our Dr. Dental clinics across the state welcome MassHealth members, including:
- New Bedford Dentist
- Haverhill (Water St.) Dentist
- Haverhill (Lincoln Ave.) Dentist
- East Boston (Maverick Square) Dentist
- Chelsea (Bellingham Square) Dentist
- Dentist in Lowell (Bridge St.) Dentist
- Quincy Dentist
- Springfield Dentist
- Revere Dentist
- Plymouth Dentist
- Methuen Dentist
- Lowell (Church St.) Dentist
- Jamaica Plain Dentist
- East Boston (Meridian St.) Dentist
- Chelsea (Broadway) Dentist
- Danvers Dentist
- Cambridge Dentist
- Allston Dentist
Looking to learn more about MassHealth dental insurance benefits, coverage & plans, please visit http://www.mass.gov/eohhs/consumer/insurance/