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October 1, 2013 - September 30, 2014
The Department of Public Welfare (DPW) is committed to providing recipients with access to quality dental services. This dental section is designed to give recipients helpful information about getting dental services in the Medical Assistance (MA) program, which is also referred to as Medicaid. Listed below are answers to common questions about eligibility, enrollment, MA dental providers, appointments, dental care and emergency services.
The dental services you may get are based on your eligibility category, age and need. Medical Assistance covers all medically necessary dental services for enrolled children. This includes teeth cleaning, x-rays, cavity fillings, crowns and other services. Adults enrolled in MA are eligible at a minimum for surgical procedures and emergency services related to treatment for symptoms and pain. Some adults may be eligible for other dental services. To find out if you are covered for dental care, call your county assistance office or, if you are in the HealthChoices/Managed Care program, call your managed care organization (MCO).
You must apply for Medical Assistance to see if you are eligible. Your eligibility for MA depends on your income, assets and other factors. There are a few ways you can apply for MA.
ACCESS Plus Program
You can see any dentist that is enrolled with the Department of Public Welfare and will accept your MA Access card. If you need help finding a dentist that accepts Medical Assistance, you can call (800) 543-7633 for assistance.
MA Fee-for-Service Program
You can see any dentist that is enrolled with Medical Assistance and will accept your MA Access card. If you need help finding a dentist that accepts Medical Assistance, please contact the Medical Assistance Call Center (Monday-Friday: 8 a.m-5 p.m.) at 1-866-542-3015.
HealthChoices/Managed Care program
You can visit any dentist that signs up with your MCO. For help finding a dentist, call your MCO’s member services department or ask to speak to a special needs representative in your MCO’s Special Needs Unit.
Scheduling an Appointment
If you need to see your dentist, call your dentist’s office. When you call the office, tell the receptionist that you would like to make an appointment.
What should I do after I schedule an appointment?
Be sure to write down the date, time and place of the appointment. If needed, ask the receptionist how to get to the office using public transportation. Contact your local County Assistance Office to ask about the Medical Assistance Transportation Program (MATP). MATP provides transportation to and from medical or dental appointments. If you have children, remember to try to get someone to watch your children during the visit. This will make the visit easier for you and the dentist. If you find out that you will not be able to go to your appointment, call and tell the dentist’s office right away.
How often should I go to the dentist?
Recipients eligible for primary dental care should see the dentist twice a year. Visit the Web sites listed below for more information about caring for your teeth and visiting the dentist:
What should I do if I have a dental emergency?
Call your dentist right away. The dentist will ask you questions about how much pain you are in and the problem you are having. Depending on the type of emergency, the dentist’s office will do its best to see you as soon as possible. If the dentist cannot see you right away, ask the dentist if anything can be done to help with the pain until you are treated.