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Dental benefits summary for Plan Type I

We have arranged with DentaQuest (formerly Doral Dental USA), a dental services benefits manager, to administer covered dental benefits for our Commonwealth Care Plan Type I members only. Through DentaQuest, we cover the same adult dental services that the MassHealth Dental Program covers for adults. You must go to a
DentaQuest-participating dental services professional for all covered dental services.

We cover the following dental services:

  • Diagnostic and preventive services, which include:
    • Two cleanings and exams every benefit year
    • A complete series of X-rays or a panoramic X-ray every three years
    • Periapical X-rays, up to a complete series, with no limitation
    • Four bitewings per year
  • Extractions
  • Emergency care visits
  • Some oral surgery (like biopsies and soft-tissue surgery)

Please note: You will need to get prior authorization before we cover some of these services. We do not cover all dental services (like restorative, orthodontic, and prosthetic services). For more information on your dental benefits, please call DentaQuest at 800-209-6280 (TTY: 800-466-7566), Monday through Friday, from 8 a.m. to
6 p.m.

Note: Tufts Health Forward is ending. Enroll in a new plan by January 23, 2015 to ensure you stay covered. Learn more about your health plan options.

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