MassHealth Dental program resources

Date:

01/01/22

Author:

MassHealth

For general information on dental services in MassHealth, CMSP and the Health Safety Net, visit this MassHealth website https://www.mass.gov/info-details/learn-about-masshealth-dental-benefits

For legal advocates the starting point is in the MassHealth Dental Regulations, they are included along with other information in the Dental Provider Manual posted here: https://www.mass.gov/lists/dental-manual-for-masshealth-providers

For more detailed information on dental services including dentists participating in MassHealth, contact information for Dentaquest, the company that makes dental prior authorization decisions for MassHealth, video tutorials, and other information on the MassHealth Dental Program, visit https://www.masshealth-dental.net/Home

For people enrolled in a OneCare or SCO plan, the plan authorizes and pays for dental services not Dentaquest. Look at the websites for the specific One Care or SCO plan for more detailed information on dental and other benefits. As of 2022 there are 6 SCO plans and 3 One Care Plans.

To obtain a copy of a case file to review in advance of a fair hearing, call the Dentaquest Customer Service number for information on how to make that request, 800-207-0519. If that is unsuccessful, please let us at MLRI know by emailing vpulos@mlri.org

The Member Handbook and Dentaquest Release Forms in English and Spanish are posted along with other Member Documents under the document tab for Patients on the massheatlh-dental.net (Dentaquest) website. The most detailed information on covered services is found under the document tab on the home page or under the Dentist tab and is called the "MassHealth Office Reference Manual." Links are supplied below --but check the website to confirm you are using the most recent version of the documents below.

Go to Website

https://www.masshealth-dental.net/Home