Does MetroPlusHealth cover dental care?

Yes, MetroPlusHealth offers a variety of plans for individuals and families that include dental and vision:

1. Marketplace Plans

Marketplace plans include a wide variety of comprehensive health plans for individuals and families with great benefits and services, including dental care, and at very competitive prices.

To choose a Primary Care Dentist (PCD) or if you need help finding a dentist in your area, contact DentaQuest.

2. Essential Plan

The Essential Plan covers emergency, preventative, and routine dental care, including:

• • Dental examinations, visits and consultations once within a six (6) month consecutive period (when primary teeth erupt)
  • X-rays, full mouth x-rays or panoramic x-rays at 36-month intervals, bitewing x-rays at six (6) to 12-month intervals, and other x-rays if medically necessary (once primary teeth erupt)
  • Procedures for simple extractions and other routine dental surgery not requiring hospitalization, including preoperative care and postoperative care
  • In-office conscious sedation
  • Amalgam, composite restorations and stainless steel crowns

3. Medicaid members can access dental care using their MetroPlusHealth ID card. Medicaid benefits include dental check-ups, cleanings, X-rays, fillings, and follow-up care. Medicaid members do not need a referral from a PCP to see a dentist.
4. To choose a Primary Care Dentist (PCD) or if you need help finding a dentist in your area, contact DentaQuest.  Child Health Plus cover routine, preventive and emergency dental services through DentaQuest. You do not need a referral from your PCP to see a dentist. To choose a Primary Care Dentist (PCD) or if you need help finding a dentist in your area, contact DentaQuest.

5. Medicare Products
   To be eligible for our MetroPlus Advantage Plan (HMO D-SNP), you must have Medicare Part A, be enrolled in Medicare Part B, be eligible for Medicaid or Medicare cost-sharing assistance under Medicaid, and live in New York City.

6. Please be aware that emergency dental services are not restricted. In the event of a dental emergency, members may obtain care from any emergency provider.

To be eligible for our MetroPlus Platinum Plan (HMO), you must have Medicare Part A, be enrolled in Medicare Part B, and live in New York City.

Our MetroPlus UltraCare (HMO D-SNP) is a Medicaid Advantage Plus plan designed for people who are dual eligible for Medicare and full Medicaid and need long-term care services such as home care and personal care.

To choose a Primary Care Dentist (PCD) or if you need help finding a dentist in your area, contact DentaQuest.