MassHealth Dental Benefit Cut-Backs Affect Seniors

by Matthew Karr, Esq. on May 30, 2011

MassHealth (Medicaid in Massachusetts) provides a wide range of health and medical services to seniors. However, recently the MassHealth Dental Program has severely cut back on what it will cover for adults age 21 and over. Seniors seeking long-term care benefits through MassHealth should be aware of these cut-backs and seek alternatives to ensure they receive proper care.

The MassHealth Dental Program provides dental benefits for MassHealth members including diagnostic and preventive services (such as checkups, cleanings, and x-rays), extractions, and emergency treatment. However, as of July 1, 2010, adults age 21 and older, except DDS clients, are not covered for fillings, root canals, crowns, periodontal services (deep scaling), or dentures. This change could significantly affect the amount of services available to seniors, who often require one or more of these treatments.

Adult MassHealth members may be able to get these dental services covered at community and hospital-based health centers through the Massachusetts Health Safety Net, which covers restorative dental services such as fillings, crowns, and dentures if they are provided at community or hospital-based health centers. Otherwise, private dental insurance premiums may be deductible from the senior’s monthly private pay amount being paid to MassHealth for long term care services.

If you are already receiving MassHealth, you do not have to apply separately for dental benefits. To get dental services, you should call a MassHealth dental provider to set up an appointment. For a list of health centers with Health Safety Net dental programs, see the Massachusetts Community Health Center Dental Program Directory on the Department of Public Health web site.

MassHealth will pay for your dental services only if you go to a dental provider who accepts MassHealth. MassHealth dental providers include private practice dentists, orthodontists, and oral surgeons; dental clinics; community health center dental services; and dental schools.

If you already have a dentist, you should check to see if your dentist accepts MassHealth. If your dentist does not accept MassHealth, you must switch to a MassHealth dentist to get dental benefits.

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