Benefits For Children Birth-20 (Covered CT 19-20)
Your Dental Plan with the Connecticut Dental Health Partnership offers coverage for the following benefits:
Important to note:
- HUSKY Health and Covered CT cover certain MEDICALLY necessary dental services. For HUSKY Health, children are considered all individuals under the age of 21. For Covered CT, ages 19 and 20.
- Not all dental procedures are covered benefits, and certain covered dental services require prior authorization by your dentist.
- Covered services are provided at dental providers in the CTDHP network which is part of the HUSKY Health network. You may have to pay for services if the service is provided by a dentist that does not participate in the CTDHP network.
- Covered services are provided at no cost to you. You will have to pay for services if you choose to have a service that is not included in the HUSKY Health plan.
- If you wish to speak to a member services representative, please call the Connecticut Dental Health Partnership (CTDHP) toll free 1-855-CT DENTAL (1-855-283-3682). We are available Monday through Friday, from 8:00 a.m. to 5:00 p.m.
| Service | Description | Limitations | Is Authorization Required? |
|---|---|---|---|
| Oral Evaluations and Screenings | An oral evaluation is an examination of your teeth, gums, and mouth to see how healthy the mouth is and to check for any treatment needs. | Periodic Exam: Once every 6 months. | No |
| Problem Focused Exam: Four per calendar year. | No | ||
| Comprehensive Exam: Once every 3 years. | No | ||
| Comprehensive Periodontal Exam: Limited to one per lifetime. | No | ||
| Caries Risk Assessment: Two assessments per calendar year when performed by a Public Health Registered Dental Hygienist in a community public health setting, such as a school or location other than a dentist's office. | No | ||
| Orthodontic Screening Exam: Two per member per lifetime. | No | ||
| X-Rays (Radiographs) | A dental x-ray is a picture of the inside of the teeth and jaw to see things that can't be seen just by looking at the mouth. This helps to identify what treatment may be needed. | Bitewing X-ray: Once per calendar year. | No |
| Periapical X-ray: Four times per calendar year. | No | ||
| Complete Full Mouth Series: One full mouth series or one panoramic X-ray every 3 years for members age 9 and older. | Yes – For Certain Dental Provider Types | ||
| Panoramic X-ray: One panoramic or one full mouth series every 3 years for members aged 9 and older. | Yes – For Certain Dental Provider Types | ||
| Preventive Care | Services that help keep teeth and gums healthy and prevent dental problems before they start. | Cleanings: Once every 6 months. | No |
| Fluoride treatment: Once every 6 months. | No | ||
| Sealants: Placed on first molars and second molars once every 3 years per tooth. | No | ||
| Space Maintainer: The number allowed per lifetime depends on the device type (some are 4 per lifetime, other 2 per lifetime). | Yes – For Certain Dental Provider Types | ||
| Fillings | Fillings fix cavities by removing the damaged part of the tooth and fills the space with strong materials. | Fillings: Once every two years per tooth per surface. | No |
| Crowns | Crowns are a “cap” that covers a damaged tooth to protect the tooth and make it strong enough to chew. A crown can be used when a tooth is cracked, very weak, or has a large filling. | Crowns: Once every ten years. | Yes |
| Root Canal Therapy | Treatment for inside the tooth if the tooth is infected. | Root Canal: Once per tooth per lifetime limitation on teeth that can be successfully restored and has good prognosis. | Yes |
| Retreatment of Root Canal: One retreatment per tooth per lifetime. | Yes | ||
| Indirect Pulp Cap: Includes all bases and liners. | Yes | ||
| Apexification: One time per tooth for children under age 18. | Yes – For Certain Dental Provider Types | ||
| Apicoectomy: Covered only when medically necessary. | Yes | ||
| Pulpotomy: Covered only on primary teeth. | Yes – For Certain Dental Provider Types | ||
| Extractions | Removal of teeth including wisdom teeth and infected teeth that cannot be restored. | Simple Extraction: Covered for all teeth including primary and supernumerary or extra teeth. | Yes – For Certain Dental Provider Types |
| Surgical Extraction: Covered for all teeth including primary and supernumerary or extra teeth. | Yes – For Certain Dental Provider Types | ||
| Periodontal Therapy | Care for gums and bones that hold teeth in place when there is gum disease. | Scaling and Root Planing: No more than two quadrants per visit. | Yes |
| Periodontal Maintenance: Two times in a 12-month period. | Yes | ||
| Full Mouth Debridement: One time per lifetime, additional services can be requested for reasons of medical necessity. | Yes | ||
| Prosthetics | Dental prosthetics are artificial replacements of missing teeth to restore functional use of the mouth. | Removable Full and Partial Dentures: Once every 7 years. | Yes |
| Reline and Rebase of Dentures: Once every 2 years – allowed 6 months after initial placement of denture. | Yes | ||
| Fixed prosthetics (bridges, fixed partial dentures): May be covered in special circumstances and requires authorization. | Yes | ||
| Orthodontic Therapy | Appliances or tools to help move teeth into better position or alignment to enable functional use of the mouth. | Braces: Must qualify for services. HUSKY A, C, and D members braces are covered once per lifetime. HUSKY B is covered for children up to age 19, with no lifetime limits. | Yes |
| Interceptive Orthodontics (Retainers, and other appliances): Are a covered service but must meet certain criteria that demonstrate the need to correct the condition to restore function. | Yes | ||
| Athletic Mouth Guards | Athletic mouth guards are soft plastic covers worn over teeth when playing sports. They protect your teeth, lips, and jaw from getting hurt if you get hit or fall. | Athletic Mouth Guards: Covered once per lifetime for children who are enrolled in a contact sport. | Yes |
| Occlusal Guards | Occlusal guards (also called night guards) are special mouthpieces worn during sleep. They protect teeth if there is grinding or clenching. | Night Guards: Covered once every two years. | Yes |
| Anesthesia and Sedation | Dental sedation is medicine that helps patients feel calm and relaxed during dental treatment. Depending on the type, you may feel very relaxed, sleepy, or not remember much of the visit, but the dentist carefully monitors you to keep you safe. | Moderate Sedation (IV): Children who have a behavioral or cognitive condition preventing safe care; and/or are undergoing in office oral surgical procedure where sedation is required; extraction of 5+ teeth, or tooth not adequately anesthetized with local; or is medically necessary for the removal of all four third molars in one procedure. | Yes – For Certain Dental Provider Types |
| Nitrous Oxide or “Laughing Gas”: Children who have a diagnosis of anxiety, behavioral health, cognitive disorder or medical condition that supports the need for management related to the dental procedure. | Yes – For Certain Provider Types |