Dental Benefits

With Tufts Health One Care (Medicare-Medicaid Plan), you get access to quality dental care through DentaQuest.

You must go to a DentaQuest-participating (link opens outside of Tufts Health Plan's website) dental services professional for all covered dental services.

Through DentaQuest, we cover the following dental services: 

  • Preventive, restorative and basic services to prevent and control dental disease and maintain oral health, including: 
    • Two cleanings per benefit year
    • One complete series of X-rays every two years
  • Emergency dental care visits, including: 
    • Oral surgery performed in an office
  • Orthodontic and prosthetic services

You may need to get prior authorization Prior Authorization: Prior authorization, also called “prior permission,” is the approval needed before you can get a specific service or drug or use an out-of-network provider. Tufts Health One Care may not cover the service or drug if you don’t get approval. Some network medical services are covered only if your doctor or other network provider gets prior authorization from our plan. Covered services that need prior authorization are marked in the Benefits Chart in Chapter 4 of the Member Handbook. Some drugs are covered only if you get prior authorization from us. Covered drugs that need prior authorization are marked in the List of Covered Drugs.  for some of these services to be covered.

For more information on your dental benefits, please call DentaQuest at 1-888-278-7310 (TTY: 1-800-466-7566).


Disclaimers

Tufts Health One Care is a health plan that contracts with both Medicare and MassHealth (Medicaid) to provide benefits of both programs to enrollees.

This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the Member Handbook (2024).

Si habla español, tiene disponible los servicios de asistencia de idioma gratis. Llame al 1-855-393-3154 (TTY: 711), siete días de la semana, de 8 a.m. a 8 p.m. La llamada es gratuita.

You can get this document for free in other formats, such as large print, formats that work with screen reader technology, braille, or audio. Call 1-855-393-3154 (TTY:711), seven days a week, from 8 a.m. to 8 p.m. The call is free.

The Formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary.

Benefits may change on January 1 of each year.

 

H7419_4520_CMS Approved
Page modified on: 3/16/2022 5:35 PM