MassHealth (Medicaid in Massachusetts) offers a wide range of health services for seniors, but it’s crucial to be aware of recent changes to its dental program. These changes, particularly for adults aged 21 and over, have significantly reduced what is covered. Seniors seeking long-term care benefits through MassHealth should understand these cutbacks and explore alternative options to ensure they receive the proper care.
What the MassHealth Dental Program Covers
The MassHealth Dental Program provides essential dental benefits, including:
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Diagnostic and preventive services like checkups, cleanings, and X-rays
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Extractions
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Emergency treatment
However, since July 1, 2010, the program no longer covers certain services for adults age 21 and older (with the exception of DDS clients). These uncovered services include:
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Fillings
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Root canals
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Crowns
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Periodontal services (deep scaling)
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Dentures
This change is particularly impactful for seniors who often require these types of treatments.
Finding Alternative Dental Care
If you are a MassHealth member over the age of 21 and need services that are no longer covered, you may have other options:
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Massachusetts Health Safety Net: Community and hospital-based health centers may offer services like fillings, crowns, and dentures through the Massachusetts Health Safety Net.
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Private Dental Insurance: The premiums for private dental insurance may be deductible from the monthly amount you pay to MassHealth for long-term care services.
Accessing Your Benefits
If you are already a MassHealth member, you do not need to apply separately for dental benefits. To find a provider who accepts MassHealth, you can:
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Call your current dentist to see if they accept MassHealth. If not, you will need to switch to a MassHealth dental provider.
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Check the Massachusetts Community Health Center Dental Program Directory on the Department of Public Health website for a list of health centers with Health Safety Net dental programs.
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Look for other MassHealth dental providers, which include private practice dentists, orthodontists, oral surgeons, dental clinics, and dental schools.
