Paul Sanchez
Florida offers a range of dental insurance plans for Medicaid recipients, ensuring access to dental care for eligible low-income individuals and families. As of 2016, the Florida Legislature directed the Agency for Health Care Administration to enroll most Medicaid recipients into dental plans. These plans provide coverage for a variety of dental services, including preventive care, emergency treatments, and orthodontic services for children. Florida Medicaid recipients can choose from several options, including DentaQuest, Humana Healthy Horizons, and Advantage Dental+, each offering its own set of benefits and restrictions. Additionally, the Statewide Medicaid Managed Care program in Florida comprises three parts: Managed Medical Assistance, Long-Term Care, and Dental, providing a comprehensive range of medical and dental services to those in need.
| Characteristics | Values |
|---|---|
| Dental Insurance Providers | DentaQuest, Humana Healthy Horizons, Tricare |
| Dental Services Covered | Cleanings, fillings, extractions, dentures, orthodontic treatment, routine cleanings, oral surgery |
| Additional Services Covered | Transportation to doctor visits, hospital care, prescribed drugs, mental health care |
| Eligibility Requirements | Income at or below 138% of the federal poverty level, US citizenship or national, or satisfactory immigration status, Florida residency |
| Enrollment Process | Enroll through Florida's enrollment broker by calling 877-711-3662 (TTY: 711) |
| Dental Plan Selection | Recipients can pick from two dental plans; they will receive a dental ID card separate from their health plan member ID card |
| Dental Plan Lookup | Call Medicaid Choice Counseling at 1-877-711-3662 or visit www.FLSMMC.com |
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What You'll Learn
- Medicaid recipients in Florida can choose from two dental plans
- Medicaid eligibility is based on income, citizenship, and residency status
- Medicaid dental plans cover a range of services for children and adults
- DentaQuest is a dental plan with a Florida Medicaid contract
- Humana Healthy Horizons is a Medicaid product of Humana Medical Plan, Inc
Medicaid recipients in Florida can choose from two dental plans
In 2016, the Florida Legislature directed the Agency for Health Care Administration (Agency) to enrol most Medicaid recipients into dental plans. These plans help children and adults find a dentist and a dental home.
Managed Medical Assistance (MMA)
This plan provides Medicaid-covered medical services like doctor visits, hospital care, prescribed drugs, mental health care, and transportation to these services. Most people on Medicaid will receive their care from a plan that covers MMA services.
Long-Term Care (LTC)
The LTC plan provides Medicaid LTC services such as care in a nursing facility, assisted living facility, or at-home care. To get LTC, one must be at least 18 years old and meet nursing home-level care requirements (or meet hospital-level care requirements if you have cystic fibrosis).
Dental Plan Options
There are several dental plan options for Medicaid recipients in Florida, including:
- DentaQuest: This plan offers comprehensive coverage on preventive and diagnostic services like check-ups, cleanings, and x-rays.
- Humana Healthy Horizons: This is a Medicaid product of Humana Medical Plan, Inc.
- Advantage Dental+: This plan covers a range of services, including routine cleanings, fillings, extractions, and dentures.
Medicaid dental coverage in Florida includes a range of services, such as cleanings, fillings, extractions, and dentures. It also covers dental services for children, including orthodontic treatment.
To find out which dental plan you have, you can call Medicaid Choice Counseling toll-free at 1-877-711-3662 or visit the website at www.FLSMMC.com.
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Medicaid eligibility is based on income, citizenship, and residency status
In 2016, the Florida Legislature directed the Agency for Health Care Administration to enrol most Medicaid recipients into dental plans. These dental plans are provided by private companies such as DentaQuest, Humana, and Choice Counseling.
Medicaid is a government-sponsored health insurance program that provides dental coverage for eligible low-income families and individuals. Eligibility for Medicaid is based on income, citizenship, and residency status. To qualify for Medicaid coverage in Florida, you must meet the following requirements:
Income
Your income must be at or below 138% of the federal poverty level (FPL). The FPL changes each year, so it is important to check the current income guidelines.
Citizenship and Residency
You must be a U.S. citizen, U.S. national, or have satisfactory immigration status. You must also be a resident of the state of Florida.
Medicaid dental coverage in Florida includes a range of services such as cleanings, fillings, extractions, and dentures. All dental services are provided through a dental plan, and most Medicaid recipients are enrolled in the Statewide Medicaid Managed Care program. This program has three parts: Managed Medical Assistance, Long-Term Care, and Dental. People on Medicaid will get services using one or more of these plan types.
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Medicaid dental plans cover a range of services for children and adults
In 2016, the Florida Legislature directed the Agency for Health Care Administration to enroll most Medicaid recipients into dental plans. All Medicaid recipients must enrol in a dental plan, and they will receive a dental plan based on their county location.
Medicaid dental plans in Florida cover a range of services for children and adults. For example, DentaQuest, a Dental Plan with a Florida Medicaid contract, covers preventive and diagnostic services like checkups, cleanings, and x-rays. Medicaid dental coverage also includes a range of services such as cleanings, fillings, extractions, and dentures. Additionally, Medicaid covers dental services for children, including orthodontic treatment. It is important for children to see a dentist regularly, as problems with teeth and gums can be avoided by regular visits. Children should begin seeing a dentist by age 1, even if they do not have teeth yet.
Florida Medicaid dental plans will help children and adults find a dentist and a dental home. They can also help to choose or change dentists, find out if a service is covered, get referrals, and find a provider. Some services may require permission from a dental plan before the dentist performs the service. This is called a prior authorization, and services must be medically necessary for dental plans to pay for them.
Florida's Statewide Medicaid Managed Care program has three parts: Managed Medical Assistance, Long-Term Care, and Dental. Managed Medical Assistance provides Medicaid-covered medical services like doctor visits, hospital care, prescribed drugs, mental health care, and transportation to these services. Long-Term Care provides services like care in a nursing facility, assisted living facility, or at-home care. To get Long-Term Care, one must be at least 18 years old and meet the nursing home level of care.
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DentaQuest is a dental plan with a Florida Medicaid contract
In 2016, the Florida Legislature directed the Agency for Health Care Administration (Agency) to enrol most Medicaid recipients into dental plans. As a result, all people on Medicaid must enrol in a dental plan.
DentaQuest's coverage includes preventive and diagnostic services such as check-ups, cleanings, and x-rays. It also covers dental services for children, including orthodontic treatment.
Florida Medicaid also offers Humana Healthy Horizons, a Medicaid product of Humana Medical Plan, Inc. However, it is important to note that Humana does not provide Medicaid dental coverage in Florida. Instead, Medicaid recipients in Florida can pick from two dental plans, after which they will receive a dental ID card.
Additionally, the Florida Department of Children and Families provides information about Medicaid eligibility and dental coverage, while the Florida Dental Association offers resources for individuals seeking dental care in the state. TriCare, a health insurance program for military personnel and their families, is also available and includes dental coverage for eligible service members, retirees, and their families.
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Humana Healthy Horizons is a Medicaid product of Humana Medical Plan, Inc
In 2016, the Florida Legislature directed the Agency for Health Care Administration to enrol most Medicaid recipients into dental plans. These plans are separated into phases based on the recipient's county location. All dental services are provided through a dental plan, and Florida Medicaid dental plans will help children and adults find a dentist and a dental home.
Florida Medicaid wants to ensure that children have healthy teeth and offers a range of services to help them achieve this at no cost. Some services may require permission from a dental plan before the dentist performs the service. This is called a prior authorization. Services must be medically necessary for dental plans to pay for them.
Florida Medicaid offers three main types of plans: Managed Medical Assistance, Long-Term Care, and Dental. Managed Medical Assistance provides Medicaid-covered medical services like doctor visits, hospital care, prescribed drugs, mental health care, and transportation to these services. Long-Term Care provides Medicaid LTC services like care in a nursing facility, assisted living facility, or at-home care. Individuals must be at least 18 years old and meet nursing home-level care requirements to qualify for Long-Term Care (except for those with Cystic Fibrosis, who only need to meet hospital-level care requirements). The Dental plan provides all Medicaid dental services for children and adults.
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