WAG 20-14-00
Dental services are provided to all clients under age 21, with limited services available to adults.
HFS covered dental services include treatment and restorative dental care. Participants in All Kids are eligible to receive clinical oral examinations, routine prophylaxis (cleanings), and topical fluoride treatment every six months. Other dental services, such as dentures and braces, may be covered on a case-by-case basis if deemed medically necessary.
Dental Services for Adults (Persons Age 21 and Over)
Clients can receive a complete set of dentures once every 5 years.
Full dentures may be provided based on consideration of a variety of factors including the client's condition and ability to adjust to dentures. Dentures are not provided if the reason is solely cosmetic.
HFS pays for full mouth X-rays once every 3 years.
The following dental services are not covered for adults:
- routine office visits;
- preventive services;
- cleaning;
- fluoride treatment;
- cosmetic dental services;
- orthodontia;
- periodontal services; and
- partial dentures.
The Department of Human Services (DHS), through Work and Training supportive services, pays for some dental services not covered by HFS (see PM 21-05-11).
DentaQuest's Office Reference Manual for Dentists lists specific services covered by HFS.
Dental Services for Persons Under Age 21
HFS pays for full mouth X-rays only once every 3 years.
Orthodontics is provided only for clients who score 42 points or more on the Salzmann Index, which assigns points for crowded, missing and rotated teeth, as well as spacing.
Clients under age 21 can receive a partial or complete set of dentures once every 5 years.
Dentures may be provided based on consideration of a variety of factors including the client's condition and ability to adjust to dentures. Dentures are not provided if the reason is solely cosmetic.
The Department of Human Services (DHS), through Work and Training supportive services, pays for some dental services not covered by HFS.
DentaQuest's Office Reference Manual for Dentists lists specific services covered by HFS.
