Information about your plans dental services was retrieved from the Medicaid member handbooks: DentaQuest, LIBERTY, and MCNA Dental on June 23rd, 2023.
You may need a referral from your doctor, dentist, or approval from your dental plan before you go to an appointment or use a service. Services must be medically necessary in order for your plan to pay for them. You may have a $3.00 copayment per day for a non-emergency dental visit in a federally qualified health center. If there are changes in covered services or other changes that will affect you, the plan will notify you in writing at least 30 days before the effective date of the change. However, it is strongly recommended that you call ahead to member services to confirm the services before your appointment.
Service | Description | Frequency/specific limitation | Prior Authorization |
---|---|---|---|
Dental Exams
| A review of your tooth, teeth, or mouth by a dentist
| – Complete exams are covered 1 time every 3 years – Check-up exams are covered 2 times every year – Emergency exams are covered as medically necessary | DentaQuest: No MCNA Dental: No LIBERTY: No |
Dental Screenings
| A review of your mouth by a dental hygienist
| – Covered 2 times every year – May be done in a school or Head Start | DentaQuest: No MCNA Dental: No LIBERTY: No |
Dental X-rays
| Internal pictures of teeth with different views
| All types of dental x-rays are covered
| DentaQuest: No MCNA Dental: No LIBERTY: No |
Teeth Cleanings
| Basic cleanings that may include brushing, flossing, scrubbing, and polishing teeth
| – Covered 2 times every year – May be done in a school or Head Start program | DentaQuest: No MCNA Dental: No LIBERTY: No |
Fluoride
| A medicine put on teeth to make them stronger
| Fluoride is covered: – 4 times every year for children that are 0-5 years old – 2 times every year for children that are 6-20 years old May be done in a school or Head Start program | DentaQuest: No MCNA Dental: No LIBERTY: No |
Sealants
| Thin, plastic coatings painted into the grooves of adult chewing surface teeth to help prevent cavities
| – We cover sealants 1 time every 3 years for each adult chewing (back) tooth – May be done in a school or Head Start program | DentaQuest: No MCNA Dental: No LIBERTY: No |
Oral Health Instructions
| Education on how to brush, floss, and keep your teeth healthy
| – We cover oral health instructions 2 times every year – May be done in a school or Head Start program | DentaQuest: No MCNA Dental: No LIBERTY: No |
Space Maintainers
| A way to keep space in the mouth when a tooth is taken out or missing
| Covered as medically necessary
| DentaQuest: No MCNA Dental: No LIBERTY: No |
Fillings and Crowns
| A dental service to fix or repair teeth
| Covered as medically necessary
| DentaQuest: No MCNA Dental: No LIBERTY: No |
Root Canals
| A dental service to fix the inside part of a tooth (nerve)
| Covered as medically necessary
| DentaQuest: No MCNA Dental: No LIBERTY: No |
Periodontics
| Deep cleanings that may involve both your teeth and gums | Covered as medically necessary
| DentaQuest: No MCNA Dental: No LIBERTY: No |
Prosthodontics
| Dentures or other types of objects to replace teeth | – 1 upper, 1 lower, or 1 set of full dentures – 1 upper, 1 lower, or 1 set of partial dentures – 1 flipper to replace front teeth – 1 improvement for denture fit and comfort (reline) for each denture | DentaQuest: No MCNA Dental: Ask for approval before you go to an appointment for these services LIBERTY: Ask for approval before you go to an appointment for these services |
Orthodontics
| Braces or other ways to correct teeth location
| Covered as medically necessary
| DentaQuest: No MCNA Dental: Ask for approval before you go to an appointment for these services LIBERTY: Ask for approval before you go to an appointment for these services |
Extractions
| Tooth removal
| Covered as medically necessary
| DentaQuest: No MCNA Dental: Ask for approval before you go to an appointment for these services LIBERTY: Ask for approval before you go to an appointment for these services |
Sedation
| A way to provide dental services where a patient is asleep or partially asleep
| Covered as medically necessary
| DentaQuest: No MCNA Dental: No LIBERTY: No |
Ambulatory Surgical Center or Hospital-based Dental Services | Dental services that cannot be done in a dentist office. These are services that need to be provided with different equipment and possibly different providers | Covered as medically necessary for any dental services needed | DentaQuest: No MCNA Dental: Ask for approval before you go to an appointment for these services LIBERTY: Ask for approval before you go to an appointment for these services |
To qualify for Florida Medicaid, individuals have to be within certain income limits. These limits are based on the federal poverty level (FPL) and vary depending on age and household size.
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The Florida Dental Access Guide is a project of the The Florida Oral Health Alliance.
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