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Dental Coverage

Child having teeth examined by Dentist

When you’re a Delaware First Health member, great dental benefits are part of your plan! With dental coverage for both children and adults, your whole family can keep their smiles healthy.

Benefits for Members Under the Age of 21

Dental services are now available for members under the age of 21 through Delaware First Health. No copay.

Benefits for Members Ages 21 and Over

Dental services for members ages 21 and older include $1,000 of coverage per calendar year for routine and basic dental services. Each visit has a $3 copay.

Note: Delaware First Health will also provide removal of bony impacted wisdom teeth under the medical benefit.

 

COVERED DENTAL SERVICES* INCLUDE:

  • Preventative care:
    • Exams and X-rays
    • Cleanings
    • Fluoride treatments
  • Restorative care, such as fillings
  • Crowns and root canals (members under age 21 only)
  • Orthodontic work (such as braces): Covered when medically necessary
  • Periodontics services such as scaling and root planing (removal of plaque from the teeth)Denture repair (for members ages 21 and over, denture repairs only)
  • Oral and maxillofacial surgery (any procedure related to the teeth, mouth, face, and jaw)
  • Dental repair (for members ages 21 and over)

*Members 21 and over get $1,000 of dental care coverage per calendar year.

Earn Dollar Rewards with My Health Pays®: Members ages 21 and older are eligible for a $20 reward for going to their annual dentist visit.

Emergency Adult Dental Benefit: Once members ages 21 and over have used their $1,000 standard benefit, they may get up to $1,500 of additional coverage per calendar year for dental work that meets the extended benefit criteria. Call Member Services at 1-877-236-1341 (TTY: 711) for more information.

FIND A DENTIST

It’s important to find a dentist you can rely on to help you and your family’s dental health. Having a regular dentist that you can go to means they will know your health history, you can easily make appointments, and you can avoid the emergency room (ER) when you have a dental issue.

To find a dentist near you, go to our website and use our “Find a Provider” tool. Or call Member Services at 1-877-236-1341 (TTY: 711), Monday to Friday, from 8 a.m. to 7 p.m.

PRACTICE DENTAL VISIT

As a value-added benefit, Delaware First Health offers practice dental visits for adult members with special health care needs. This benefit is also available to all pediatric members. The practice visit is a chance for members to meet with their new dental team, share what they like and their concerns, and learn what happens at a dental visit before any exams or treatments take place.

NEED A RIDE TO YOUR APPOINTMENT?

Delaware Medicaid and Medical Assistance provides non-emergency medical transportation (NEMT) services. To schedule a ride, call 1-866-412-3778 (TTY: 711). Please call at least three days (72 hours) ahead of your scheduled visit.

QUESTIONS?
For more information about your dental benefits, call Member Services at 1-877-236-1341 (TTY: 711). We’re here to help Monday to Friday, from 8 a.m. to 7 p.m.