Dental Benefits

Your child’s UnitedHealthcare Dental Texas Medicaid or CHIP plan covers a wide range of dental treatments and services. These services include medically necessary preventive and diagnostic care, and treatment for dental and gum disease. Some dental services may require “prior authorization” or approval before getting the service.

What Are My Child’s Dental Benefits?

Medicaid dental benefits for your child include the following services:

• Exam, cleaning and fluoride treatment every six (6) months.
• X-rays every six (6) months.
• Fillings, extractions, crowns, root canals and other medically necessary treatments.

How do I get these services for my child?

Schedule a checkup appointment for your child with your child’s main dentist. The main dentist will provide these services and determine if additional services may be needed.

What services are not covered under Medicaid?

• Cosmetic procedures (i.e. tooth whitening).
• Procedures considered experimental or investigational.
• Services that are determined to not be medically necessary.
• Services that could be covered under another insurance or health plan.

What services are not covered under CHIP?

• Cosmetic procedures (i.e. tooth whitening).
• General anesthesia or intravenous/conscious sedation.
• Orthodontia.
• Procedures considered experimental or investigational.
• Services that are determined to not be medically necessary.
• Services that could be covered under another insurance carrier or health plan.

What Does Medically Necessary Mean?

That’s the standard for deciding whether Medicaid will cover a dental service for your child. For dental services or products provided, the test is whether a prudent dentist would provide the service or product to a patient to diagnose, prevent, or treat dental pain, infection, disease, dysfunction, or disfiguration in accordance with generally accepted procedures of the professional dental community.