Dental benefits and coverage*

Our plans offer coverage on preventive dental services for the whole family. You may pay copayments for the services below; you also may be responsible for a deductible for certain services.

What's covered?

Service or procedure
Preventive dental exam, once every six months. Includes:
  • An explorer and mouth mirror exam
  • Fluoride treatment
  • Pulp vitality tests
  • Diagnostic casts
  • Periapical and bitewing X-ray (one to four films)
Minor restorative dental care, such as metal or composite fillings.
Emergency medical care to relieve pain and/or stop bleeding as a result of traumatic and/or accidental injury to teeth. You don't need authorization for emergency care needed as the result of dental trauma. Go to the closest provider.

What isn't covered?

Service or procedure
More than one preventive office visit in each six-month period
Dental services for cosmetic reasons (e.g., teeth whitening )
Inpatient dental care (except for inpatient hospital services when you have a nondental medical condition that requires you to be an inpatient when you receive dental services)
Dental treatments and appliances for the treatment of temporomandibular joint (TMJ) disorder or other conditions.
Orthodontics
Removal of nonimpacted wisdom teeth
Medications and products for noncovered dental conditions

Discounted services

Some dental services are available at discounted rates. These discounted services are not considered to be plan benefits. The discounted fees vary depending on the procedure; a complete list is provided in “Addendum: Discounted Dental Services-Fees.” Discounted services include:

Service or procedure
Major restorative crowns and inlays
Endodontics and root canal therapy
Sealants, space maintainers and panoramic films
Periodontics, gingivectomy/gingivoplasty
Prosthetics and removable or fixed dentures

Dental discounts not available for FCHP MassHealth members.

For details on your specific benefits, coverage, and copayments:

  • Refer to your Member Handbook or Schedule of Benefits, or Dental Addenda described above,
    or
  • Call our customer service department at:
    1-800-868-5200 (TDD/TTY: 877-608-7677), Monday through Friday, 8 a.m. to 6 p.m.

* Benefits and coverage may vary by product, plan design and employer.  For specific details regarding your FCHP plan, benefits and features, please check with your employer or contact a member of our customer service team at 1-800-868-5200 (TDD/TTY: 1-877-608-7677), Monday through Friday, 8 a.m. to 6 p.m. Eastern time.  MassHealth members can call the MassHealth Customer Service Center at: 1-800-841-2900 (TDD/TTY: 1-800-497-4648) Monday through Friday, 8 a.m. to 5 p.m.