The following tables list the dental services that are covered by Florida Medicaid’s dental plans.
Important Things to Remember:
DentaQuest
1-888-468-5509
TTY 1-800-466-7566
Member Handbook
MCNA Denta
1-855-699-6262
TTY 1-800-955-8771
Member Handbook
LIBERTY
1-833-276-0850
TTY 1-877-855-8039
Member Handbook
Service | Description | Frequency/specific limitation | Prior Authorization |
---|---|---|---|
Dental Exams
| A review of your tooth, teeth, or mouth by a dentist
| – Complete exams for dentures are covered 1 time every 3 years – Emergency exams are covered as medically necessary | DentaQuest: No MCNA Dental: No LIBERTY: No |
Dental X-rays
| Internal pictures of teeth with different views
| Only some types of dental x-rays are covered: – 1 full mouth set of x-rays every 3 years – 1 view of the whole mouth (panoramic) x-ray every 3 years – Other single tooth x-rays as needed | 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 improvement for denture fit and comfort (reline) for each denture every year | 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 |
Each plan features “Expanded benefits” that are extra goods or services that should be provided to you, free of charge.
Important Things to Remember:
Service | Description | Frequency / limitation Adults (ages 21+) | Frequency / limitation Additional Services for Pregnant Adults (ages 21+) | 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 | Additional dental exams 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
| Additional dental screenings are covered as medically necessary | 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
| Additional dental x-rays are covered as medically necessary
| 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
| Additional dental cleanings are covered as medically necessary
| DentaQuest: No MCNA Dental: No LIBERTY: No |
Fluoride
| A medicine put on teeth to make them stronger
| Covered 2 times every year | Additional fluoride is covered as medically necessary | 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
| DentaQuest: No MCNA Dental: No LIBERTY: No | |
Oral Health Instructions
| Education on how to brush, floss, and keep your teeth healthy
| Covered 2 times every year | Additional oral health instructions are covered as medically necessary | DentaQuest: No MCNA Dental: No LIBERTY: No |
Fillings
| A dental service to fix or repair teeth
| Some fillings services are covered for front and back (chewing) teeth 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
| Additional general services are covered as medically necessary
| DentaQuest: No MCNA Dental: No LIBERTY: No |
Extractions
| Tooth removal
| Covered as medically necessary
| DentaQuest: No MCNA Dental: No LIBERTY: No | |
General Services
| Dental consultations to visits a dentist for an opinion and dental pain treatment
| Covered as medically necessary
| Additional general services are covered as medically necessary
| DentaQuest: No MCNA Dental: No LIBERTY: No |
Diabetic Testing | Dental office diabetes testing
| Covered 1 time every year
| DentaQuest: No MCNA Dental: No LIBERTY: No | |
Dental Office Visits for Persons with Disabilities
| A visit to the dental office to get comfortable with the office and the dentist before dental work is done.
| Covered for persons with intellectual disabilities 1 times for every new dental office or dentists
| DentaQuest: No MCNA Dental: No LIBERTY: No |
The toolkit is a project of the The Florida Oral Health Alliance.
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