PSA: Your MassHealth covers dental as well

Submitted by DesiOtaku t3_10m45y5 in massachusetts

(I'm posting this because lately a lot of my patients didn't know this and thought they had to pay out of pocket. )

If you have MassHealth you also have some kind of dental benefits as well. The real question is what kind:

MassHealth Child: For people under 21; Covers basic exams, x-rays, cleanings, fillings, crowns. It can cover braces but the teeth have to be misaligned enough in order to qualify.

MassHealth Childrens Medical Security Plan: Same as MassHealth Child; but has a limit of $750 per year for services

MassHealth Adult (Regular): For people over 21. Covers basic exams, x-rays, cleanings, fillings, crowns.

MassHealth Adult (Limited): For people over 21. Only covers limited/emergency exams and extractions. A few public health clinics are able to use this for cleanings but you need to find out ahead of time if your local one does.

You can find out which one you have via the MassHealth website (assuming you have a username/password) or you can ask your local dentist that accepts MassHealth.

Do note I am not a MassHealth expert; I just happen to accept it myself. I would recommend checking out the MassHealth website to find a local dentist that accepts MassHealth and give them a call to see if they are still accepting new patients for MassHealth.

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Waggmans t1_j60tfwl wrote

If you're an adult it doesn't cover much. I recently switched to OneCare (Commonwealth Care Alliance) and they have much better dental coverage including root canals.

I'm hoping since I was in the middle of implants they'll cover at least some of it- I can't afford to finish.

The main issue with CCA dentists/oral surgeons is they're difficult to find and are usually booked months in advance.

Any suggestions?

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DesiOtaku OP t1_j60v0bb wrote

You probably had Adult Limited before which has little coverage.

CCA does have some decent coverage but you may have to be willing to wait a little or be willing to drive further out to find a provider that can see you sooner.

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Waggmans t1_j61u1qf wrote

I had the the basic coverage, if you needed something like a root canal you were SOL. I was never offered crowns because of course since there was no root canal coverage you were more likely to have an extraction (which I did).

I started a couple implants right before the pandemic, realized I couldn’t afford it, so now I’m at the point where I need tons of dental work and a big part of it isn’t covered.

Hard to get a job with no teeth.

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Maronita2020 t1_j62qgv0 wrote

IF you have to pay for it yourself you might consider looking into Delta Dental Discount plan. You pay a small one time membership fee, and then you pay a small amount every month to have it. You get up to 50% off any dental work at contracted providers. They do have a lot of providers. When I joined membership fee was $20.00 and then I pay just under $8 a month.

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VibrantSunsets t1_j62qmr4 wrote

Do you work with a case manager at CCA? They may be able to help find a dentist/oral surgeon. Back when Fallon had a one care I worked in partnership with them and the case managers at Fallon were great at helping their clients find providers and worked directly with the providers to help schedule appointments. My understanding was that the other one cares also did this. Fallons One Care died quite a few years back so things obviously may have changed, or I could be repeating something you already know, but so many of my clients were unaware of all the benefits we/Fallon offered through their onecare until the team reached out so felt it was worth mentioning.

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Waggmans t1_j62wiqc wrote

I don’t have a lot of faith in CCA. I just signed up and needed an escort (a service which they supposedly provide) for an inpatient medical procedure where I’d be sedated. I asked a month in advance, said they’d get back to me- didn’t. I called back, spoke to my care Mgr and then her boss, neither of which could get the escort for me. I have yet to have had the procedure.

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Maronita2020 t1_j64dszb wrote

People who have Mass Health get medical transportation! You don't have to belong to CCA to get that benefit.

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Waggmans t1_j64f9r6 wrote

Escort. I can get a PT1 but can’t be sedated without one.

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Maronita2020 t1_j64fkgq wrote

Yes but a PT1 can be approved for you and an escort. You can then ask a friend, neighbor, family member, etc to be your escort.

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Waggmans t1_j64o4bk wrote

I live alone. Not everyone friends willing to take a full day off work for multiple in-patient medical procedures where sedation is required.

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Maronita2020 t1_j65f2xj wrote

Maybe you could ask CCA about if they would pay for Guardian Healthcare in Jamaica Plain to provide a "Guardian Medical Companion." They often go with people who need to have someone be responsible for them for the day (getting them there and taking them home.)

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Waggmans t1_j661wph wrote

They are well aware- they just say all the providers are short staffed and there's no one available, which doesn't help me.

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Maronita2020 t1_j66yvur wrote

Does the city/town you live in have a reddit group that you could ask for a volunteer willing to go with you?

Are you signed up for your look nextdoor group www.nextdoor.com I have noticed many generous people step forward to help people in situations like this at least around where I am.

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Waggmans t1_j68414v wrote

I’ve asked multiple times on the town Facebook page. It’s one thing when the appointment is right up the street, another when it’s a 45min drive. I am on a fixed income and can’t really afford to pay people to escort me. I need at least to be escorted at least 6x to various appointments.

As I said, I know I’m not the only one with this problem, but that doesn’t particularly help me.

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Clownsinmypantz t1_j61vjzl wrote

To an extent, won't cover a night guard for me but hey they'll get more business in the future when my teeth get more fucked up from grinding them.

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cheribom t1_j62irnv wrote

After I chewed through my expensive dentist-made mouthguard, I bought the drugstore ones but they are expensive for how bad they are. Then I found these and they work great. Last pretty long and way more comfy than the kind with plastic plates in them. (I fit them to the bottom even though it’s supposed to fo on the top teeth).

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Maronita2020 t1_j62q8cb wrote

Mass Health approved for me to get a mouth guard (to wear at night) even before they realized I also have Medicare. I had no out-of-pocket costs. Maybe and this is just a maybe you are requesting a night guard rather than a mouth guard. If you need to find a dentist that will do it for you and your in the Boston area let me know via private message.

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Clownsinmypantz t1_j63zgta wrote

Its for the one at night, they said I could have gotten it for free if I was under 21 but now have to pay 400+ dollars because masshealth wont cover it. 2 Different dentists told me and if I couldnt just buy an OTC one.

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Maronita2020 t1_j64cuxd wrote

I'm much older than 21 and they covered it for me. I had no out of pocket costs. If you are near Boston you can private message and I can share the info with you.

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Clownsinmypantz t1_j65ark9 wrote

Unfortunately I'm not near boston but thank you, I'll keep looking around

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Snufflarious t1_j64pbqf wrote

I graduated to Medicare and the coverage even with Medicare Advantage plan is not nearly as good

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