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Learn about MassHealth dental benefits

Dental care is one of many benefits available to people who are enrolled in MassHealth.

Dental care includes comprehensive services, including dental checkups, preventive services, cleanings, fluoride treatments, and dental sealants, as well as pain relief, treatment of infections, fillings, crowns, and root canal treatment. It is important to see a dentist twice a year to maintain good dental health. In general, you are eligible for dental benefits if you are enrolled in one of the following coverage types.

  • MassHealth Standard
  • MassHealth CommonHealth
  • MassHealth Family Assistance, or
  • MassHealth CarePlus

If you’re enrolled in One Care, Senior Care Options (SCO), or the Program of All-inclusive Care for the Elderly (PACE), contact your One Care plan, SCO, or PACE organization directly for assistance with dental services.

Table of Contents

Dental services covered by MassHealth

This chart shows the dental services that are covered for people who are enrolled in MassHealth Standard, MassHealth CommonHealth, MassHealth Family Assistance, or MassHealth CarePlus. Dental services covered by MassHealth must be deemed medically necessary by your provider.

ServiceIs it covered for children? (members younger than 21)Is it covered for adults? (members 21 and older)Is PA needed?
Anesthesia (general, nitrous, intravenous, and non-intravenous)YesYesNo
BracesYesNoYes, for children
Cavity arresting medicament (silver diamine fluoride)YesYesNo
CleaningsYesYesNo
Crowns/capsYesYesNo
Deep cleaningYesYesYes, for adults
Dentures/partial dentures/platesYesYesNo
Immediate (temporary) denturesYesNoNo
Extractions (tooth-removal)YesYesNo
FillingsYesYesNo
FluorideYesYesNo
Oral examsYesYesNo
Oral surgeryYesYesNo
Root canal treatments (not on third molars)YesYesNo
SealantsYesNoNo
Space maintainersYesNoNo
Some periodontal (gum) servicesYesYesNo
X-raysYesYesNo
Other medically necessary dental servicesYesNoYes

Understanding your benefits

MassHealth contracts with Benecare Dental Plans to manage the Dental Program. Benecare, referred to as Dental Customer Service, specializes in dental services for MassHealth members.

They can help you understand your dental benefits, find a MassHealth dental provider, and schedule an appointment.

How to contact the MassHealth Dental Customer Service Center

MassHealth Dental Customer Service Center
Phone:  Main  (844) 643-3685
TDD/TTY:  711
Online:  https://massdhp.org/

Finding a dentist

MassHealth will pay for covered dental services only if they are provided by dental providers in our provider network. To help you find a dentist, MassHealth has an online list of dentists who participate. We update the list regularly.

To use the list, go to the MassHealth Dental Program website (massdhp.org). Click on Find a Dentist and fill in the information requested, such as your ZIP code and your preferred distance. You can also search for a dental specialist. You’ll see a list of MassHealth dental providers and specialists in your area. Just review the list and call any of the providers listed to make an appointment.

Calling a Dental Service Representative

Alternatively, you can call the toll-free MassHealth Dental Customer Service Center line at (844) 643-3685 to find out if a dentist is in the directory or get help finding a dentist.

Prior authorization

Some services may require prior authorization (PA) from MassHealth before a dentist can provide them.

Depending on the type of dental service you need, your provider may need to send a PA request to Benecare or, for oral surgeries or other related medical services, directly to MassHealth or your MassHealth health plan. You can review the chart above to find out which services require PA.

If you or your provider have questions about prior authorizations, contact Benecare or your MassHealth health plan. The Frequently Asked Questions About Dental Services section below has more information.

Dental coverage for MassHealth Limited members

MassHealth Limited covers emergency dental services. These are for conditions that could put your health in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of any organ or part. For more information about dental services covered by MassHealth Limited, please contact the MassHealth Dental Customer Service Center.

Dental coverage through the Children’s Medical Security Plan

MassHealth members enrolled in the Children’s Medical Security Plan (CMSP) can receive coverage for dental care, up to $750 per year, including preventive and restorative services like routine cleanings, plaque or stain removal, topical fluoride treatments, sealants, and fillings. Coverage does not include cosmetic or orthodontic services (like braces).

For more information about dental services covered by the CMSP, contact the MassHealth Dental Customer Service Center.

Dental coverage through the Health Safety Net

The Health Safety Net (HSN) is available to uninsured and underinsured Massachusetts residents whose family income is under a certain percentage of the federal poverty level. HSN will only pay for certain dental care services, and you will need to receive them from a community health center, hospital-licensed health center, or hospital satellite clinic. The HSN website has more information.

To find a provider, call the MassHealth Dental Customer Service Center.

Frequently asked questions about dental services

Are dental implants and bone grafts covered by MassHealth?

Dental implants are not covered by MassHealth. Bone grafts may be covered as a medical service with prior authorization under your MassHealth health plan or by MassHealth directly. If you have questions about bone grafts, or other medical services, contact your MassHealth health plan.

If you do not have a MassHealth health plan, contact the MassHealth Customer Service Center at (800) 841-2900, TDD/TTY:711.

Is oral surgery covered by MassHealth?

If your dentist refers you to an oral surgeon for oral surgery or other related care, these services are typically covered by your MassHealth health plan or by MassHealth directly. If you or your provider has questions about which services are covered by which program or whom to bill for services, start by calling the MassHealth Dental Customer Service Center.

Can I receive transportation to a dental appointment?

If you are eligible for MassHealth Standard, MassHealth CommonHealth, or MassHealth CarePlus, you can get transportation to and from appointments for MassHealth-covered services. For more information about transportation services, visit our page on nonemergency medical transportation. 

Commonly used dental terms

Anesthesia: A type of medication that results in partial or complete elimination of pain (for instance, numbing a tooth). General anesthesia produces partial or complete unconsciousness.

Bridge: A prosthesis replacing one or several adjacent teeth (not covered by MassHealth).

Cavity: Also called tooth decay; caused by bacteria in the mouth and sugary foods resulting in destruction of tooth structure.

Cleaning: The removal of plaque and calculus (tartar) from teeth, generally above the gumline.

Crown: A prosthetic covering for a tooth.

Denture: A removable appliance (prosthesis) that replaces all of the missing teeth in the upper or lower jaw. Usually made of plastic or a combination of plastic and metal.

Enamel: The hard covering on the exposed part of a tooth.

Extraction: Removal of a tooth from its socket.

Molar: A back tooth with a broad surface used for grinding one's food.

Orthodontics: A specialty of dentistry concerned with correcting misalignment of teeth.

Periodontics: The study of supporting structures of teeth (for example, gums and bone) and diseases and conditions that affect them.

Root Canal: The hollow part of the root of a tooth containing the nerve and blood vessels.

Additional resources

MassHealth Dental Member Handbook at massdhp.org/your-resources

Contact

Phone

Self-service available 24 hrs/day in English and Spanish. Other services available Monday-Friday 8 a.m.–5 p.m. Interpreter services are available.

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