Dental care is a covered service for eligible Medicaid members who are pregnant, disabled, blind, age 65 or older, eligible for Medicaid for specific adults and. Contact a DHS county office near you to apply for Medicaid Dental coverage. Find a DHS County office near you. If you want to know what services are covered, call your provider or check your plan on your provider's website.
The Centers for Medicare Medicaid Services & does not define in more detail what specific dental services should be provided; however, EPSDT requires that all services covered by the Medicaid program be provided to EPSDT beneficiaries if they are determined to be medically necessary. If a condition is discovered that requires treatment during an evaluation, the state must provide the services necessary to treat that condition, regardless of whether those services are included in the state Medicaid plan or not. Medicaid covers dental services for all enrolled children as part of a comprehensive set of benefits, called the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) benefit. NJ Family Care includes expanding CHIP, Medicaid and Medicaid populations and covers doctor visits, prescriptions, vision care, dental care, mental health and substance use services and even hospitalization.
Under federal law (COBRA) and state law, a person who chooses to continue coverage may be required to pay the full premium plus a 2% administrative fee. If you're happy with your plan, you don't have to change and your coverage will continue with the same dental provider and benefits as you did last year. However, please note that the Families First Coronavirus Response Act sets requirements to provide no-cost coronavirus diagnostic testing to consumers under certain plans not regulated by the Department. The reference dental package must be substantially the same as (the most popular dependent dental plan for federal employees), (the most popular plan selected for dependents in the state's employee dental plan) or (dental coverage) offered through the state's most popular commercial insurer.
All eligible residents can enroll now through Get Covered New Jersey, the state's official health insurance marketplace, and coverage will begin on the first day of the month after your plan is selected. States are required to provide dental benefits to children covered by Medicaid and the Children's Health Insurance Program (CHIP), but states decide whether to offer dental benefits to adults.
