MassHealth Dental: The Comprehensive Guide
MassHealth is one of the premier and most widely-used healthcare providers in the state of Massachusetts. In fact, it is one of the nation’s first statewide guaranteed healthcare coverage options. Thanks to a healthcare reform law passed in 2006, MassHealth established comprehensive healthcare (including dental care) for practically all residents of Massachusetts.
About MassHealth Dental
The Massachusetts Department of Health and Human Services established MassHealth a decade ago to provide healthcare for state residents. As part of the MassHealth insurance plan, dental care has been offered to Massachusetts citizens since July 1, 2006. Through a variety of public funding, MassHealth Dental today remains a popular option for individuals and families all throughout the state.
The MassHealth dental plan is administered by an organization called DentaQuest. They take care of claims, customer service, insurance plan options, coverage requirements and more.
How to Apply
MassHealth administrators designed their insurance coverage to include a relatively easy application process. However, like many other government-run insurance plans, the MassHealth dental coverage application phase requires plenty of patience and the ability to provide personal information.
Before you find dentists that accept MassHealth , you’ll have to apply for coverage. The Massachusetts Department of Health and Human Services (HHS) website has an “Apply for MassHealth” page, with everything you need to get started. If you have existing healthcare coverage and are only interested in dental insurance, you’ll still have to apply on the HHS website.
MassHealth uses the Massachusetts Health Connector portal to initiate all applications for healthcare insurance, including dental coverage. This page includes an application form, help for common questions, payment information and other useful links related to the entire MassHealth program.
In addition to the Health Connector option, anyone looking to qualify for MassHealth dental benefits can also visit the Massachusetts Application for Health and Dental Coverage and Help Paying Costs form.
Before applying for MassHealth dental care, it is recommended to gather the following personal data:
- Social Security Number
- Employer and income information, including W-2 and 1099 forms, tax returns and other related documents
- Current healthcare coverage policy numbers (including phone and fax numbers, if you can’t find your policy number)
- Dependent information (children, spouse, etc.)
- Residence address
- Phone number (cell phone, home phone, etc.)
This information and much more will be used to see if you qualify for MassHealth dental insurance.
To speak with a representative about applying for MassHealth dental insurance, you can also call DentaQuest at (800) 207-5019.
What Happens After I Apply?
Within a short period of time, you will receive a response from Mass Health administration. Generally, you’ll get one of three different answers:
- Your MassHealth insurance application is incomplete and more information is required.
- You are approved for MassHealth insurance.
- You are denied coverage; in this case, you’ll have to find another dental provider besides MassHealth insurance.
Even if you are denied coverage, follow up with a MassHealth representative to make sure. Application form errors, paperwork miscues and other errors may be some of the reasons for your unfavorable eligibility. Since MassHealth medical coverage is designed to cover almost all Massachusetts residents, it’s a good idea to check with a state healthcare consultant.
If your income levels fall within the MassHealth guidelines (see below) you can file an appeal for denial of coverage. Just because you receive an initial denial DOES NOT mean you are ineligible for coverage. Under the Massachusetts healthcare reform act, all residents are entitled to basic rights, including quality and affordable dental care.
Who is Eligible? Finding MassHealth Dental Insurance
MassHealth Dental enjoys one of the largest participant rolls in the state of Massachusetts. In fact, Massachusetts was one of the first states to implement (on the state level) the policies and coverage options that are commonly known as “Obamacare.” That’s right – years before federal healthcare coverage came into play, Massachusetts was already ahead of the curve. And that’s great news for state residents, because the administrative and medical care infrastructure is already in place to ensure optimum coverage.
In order to determine your eligibility, you’ll have to utilize the Massachusetts Virtual Gateway Self Service page, where you can enter your personal information.
According to the MassHealth dental benefits guide, anyone who is enrolled in the following plans is eligible for dental coverage:
- MassHealth Family Assistance
- MassHealth Standard
- MassHealth CommonHealth
- MassHealth Limited
Initial qualification depends mostly on income level. The latest MassHealth Income Standards are based on federal poverty guidelines. You can view this chart on the MassHealth’s legal services website. MassHealth dental coverage is available for a vast range of monthly income requirements. For example, a senior citizen earning just $1,001 per month is eligible to see MassHealth dental providers. On the upper limit of the MassHealth insurance guideline, a family of eight earning $10,394 per month is also eligible for dental coverage. MassHealth has always been a “universal” healthcare option, and their latest income guidelines are testament to this face.
MassHealth Dental Benefits: What Does the Plan Offer?
The MassHealth Online Dental Booklet provides a great overview of all the services and features you’ll enjoy on the plan.
The latest MassHealth dental benefits cover the following care categories:
- Oral exams (twice in 12 months) X rays
- Oral surgery
- Cleanings (2 times per year)
- Extractions Fluoride (2 times per year)
- Space maintainers
- Orthodontic care (pre-qualifying conditions must be met first)
- Root canals
Please note, this is a general list of services available to all MassHealth dental plan participants. For a detailed description of the differences between child and adult dental care, please consult the MassHealth Dental Benefit Booklet. This indispensable resource also includes information on filing appeals and complaints, finding a dentist, making appointments, emergency instructions, rights & responsibilities and more.
Where to Get Help with MassHealth Dental
To find dentists that take MassHealth, ask questions about MassHealth dental coverage or for additional information about MassHealth dental benefits, DentaQuest (the administrative wing of the MassHealth dental insurance program) has a resource page with phone numbers, website addresses, email contact points and more.
DentaQuest’s Member Services hours are from 8:00 AM EST until 6:00 PM EST. You can call their main phone number with questions and concerns at (800) 207-5019. If you need to fax information to MassHealth or DentaQuest, their number is (800) 207-4795.
For email inquiries, send a message to firstname.lastname@example.org.
For all written requests, use the following address:
MassHealth Dental Program
12121 N. Corporate Parkway
Mequon, WI 53092
Dr. Dental’s Massachusetts Offices – Your Source for MassHealth Dental Coverage
If you choose to sign up for MassHealth dental providers, and you’re eligible for coverage, the next step is finding a local Massachusetts dental office that accepts MassHealth insurance. Dr. Dental, a leading network of dental care providers throughout the state, gladly accepts MassHealth dental insurance at all of our Massachusetts office locations.
To find a Dr. Dental clinic in Massachusetts, please visit our Office Locations page. Our team will be happy to answer any questions you have about MassHealth dentists, coverage options, what services we offer in compliance with MassHealth standard dental coverage and much more.
Dentists that Accept MassHealth – Try Dr. Dental for Comprehensive MassHealth Dental Coverage
If you use the Massachusetts Health and Human Services website, their “Find a Dentist” portal includes every Dr. Dental office in the state. Dr. Dental accepts both private insurance (Aetna, Cigna, Metlife, etc.) and public-funded plans (like MassHealth) to ensure the best possible coverage for all of our patients. Dr. Dental’s 19 Massachusetts office locations accept MassHealth dental coverage. For a Dr. Dental clinic near you, please visit our Office Locations portal.
At Dr. Dental, our goal is to make your visit as comfortable as possible. We always enjoy meeting new patients, just as much as our repeat customers. We’re happy to accommodate your MassHealth dental plan. If you have any questions about our specific care and services, please call one of our convenient locations at (877) 776-9833. We look forward to serving you – stop by today!