Benefits for Adults
Your Dental Plan with the Connecticut Dental Health Partnership offers coverage for the following benefits:
Important to note:
- HUSKY Health covers certain MEDICALLY necessary dental services. Adults are ages 21 and older. Covered CT, for adults ages 21 - 64.
- 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 will have to pay for services if the service is provided by a dentist that does not participate in the CTDHP network, or 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.
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| 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: One Per Calendar Year. Members with chronic medical or dental conditions who may require more exams can be authorized. | No |
| Problem Focused Exam: Four per calendar year | No | ||
| Comprehensive Exam: One Per Lifetime | 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. | 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. | Yes – For Certain Dental Provider Types | ||
| Panoramic X-ray: One panoramic or one full-mouth series every 3 years. | Yes – For Certain Dental Provider Types | ||
| Preventive Care | Services that help keep teeth and gums healthy and prevent dental problems before they start. | Cleanings: One Per Calendar Year. Members with chronic medical or dental conditions who may require more cleanings can be authorized. | No |
| Fluoride treatment: Once every 6 months. | No | ||
| 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 | ||
| Apicoectomy: One per tooth. | Yes | ||
| Extractions | Removal of teeth including wisdom teeth and infected teeth that cannot be restored. | Simple Extraction: Covered for all teeth including supernumerary or extra teeth. | Yes – For Certain Dental Provider Types |
| Surgical Extraction: Covered for all teeth including 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: Covered, 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 | ||
| Orthodontic Therapy | Appliances or tools to help move teeth into better position or alignment to enable functional use of the mouth. | Braces: Limited benefit requiring qualifications that demonstrate untreated congenital conditions, facial forms of cancer or trauma, or surgical facial reconstruction. | 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): When 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”: Members with 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 | ||
| *Members must have specific medical diagnosis to qualify including diabetes, certain heart diseases, end stage renal disease, and members undergoing treatment for head, neck, and throat cancers. | |||