Does MassHealth Cover Dental? Adult and Under-21 Benefits

Yes, MassHealth does cover dental care. If you are enrolled in MassHealth Standard, CommonHealth, Family Assistance, or CarePlus, you have access to a broad set of dental services at no copay, with more extensive benefits for members under 21. If you are enrolled in MassHealth Limited, your dental coverage is restricted to emergencies only.¹

What follows is what each group gets, what is excluded, and the one proposed change that could cap adult benefits starting July 1, 2026.

What Adults Get

Adults 21 and older on Standard, CommonHealth, Family Assistance, or CarePlus are covered for most routine and restorative dentistry, as long as a provider finds the service medically necessary. That includes:¹

Oral exams, cleanings, fluoride treatments, and X-rays
Fillings, crowns, and root canals (not on third molars)
Extractions and oral surgery
Select gum treatments and deep cleaning (deep cleaning needs prior authorization)
Dentures, partial dentures, and plates
General, nitrous oxide, IV, and non-IV sedation
Silver diamine fluoride and similar cavity-arresting medicament

There are no copays for covered dental services, and there is currently no annual benefit maximum.¹²

What Adults Do Not Get

Several categories are specifically excluded for adults. MassHealth does not pay for braces, immediate (temporary) dentures, sealants, space maintainers, dental implants, or bridges. Cosmetic work such as teeth whitening and veneers is also excluded.¹

Bone grafts sit in a different category. They may be covered as a medical rather than dental service, with authorization going through your health plan or MassHealth directly.¹

What Members Under 21 Get

Children and young adults under 21 receive everything adults receive, plus services the federal Early and Periodic Screening, Diagnosis, and Treatment program requires Medicaid to cover for young members.³ The added services are:¹

Sealants to prevent cavities
Space maintainers after early loss of a baby tooth
Immediate (temporary) dentures
Braces, with prior authorization
Other medically necessary dental services not otherwise listed, with prior authorization

MassHealth recommends a child’s first dental visit when the first tooth erupts, and no later than 12 months of age.³

When Braces Are Covered

Orthodontic treatment is available only to members under 21, and only once in a lifetime. Approval depends on medical necessity, not appearance. MassHealth uses a Handicapping Labio-Lingual Deviations scoring form, and a score of 22 or higher qualifies as a severe and handicapping malocclusion.⁴ A member who does not reach that score can still be approved if they have an autoqualifying condition listed on the form, or if their provider submits a medical necessity narrative with supporting documentation.⁵

The treating dentist must be an orthodontic specialist. The prior authorization packet includes the completed HLD form, X-rays and photographs, and, where applicable, the medical necessity narrative. Adjustment visits are billed quarterly, and each year of treatment requires a separate authorization.⁵

If You Have MassHealth Limited

MassHealth Limited covers emergency dental services only. An emergency is a condition that could put your health in serious jeopardy, cause serious impairment to bodily functions, or result in serious dysfunction of any organ or body part.¹ Routine cleanings, preventive care, and non-emergency restorative work are not covered.

Children’s Medical Security Plan and Integrated Care

The Children’s Medical Security Plan is separate from MassHealth proper. It covers preventive and restorative dental services such as cleanings, fluoride treatments, sealants, and fillings for enrolled children, subject to a $750 annual cap. Orthodontic and cosmetic services are not covered.¹

If you are enrolled in Senior Care Options, One Care, or the Program of All-inclusive Care for the Elderly, your dental benefits run through your plan rather than the standard MassHealth dental program. SCO plans generally cover cleanings, exams, X-rays, fillings, extractions, root canals, dentures, and in some cases implants, with no copay.⁶ Contact your plan directly for the exact list of services and participating providers.¹

What Needs Prior Authorization

Most routine dental services do not require prior authorization. Cleanings, fillings, extractions, crowns, dentures, root canals, oral exams, and X-rays can proceed without advance approval. The services that do require authorization are:¹

Braces (members under 21 only)
Deep cleaning (adults only)
Other medically necessary dental services (members under 21 only)
Bone grafts (authorized through the medical side)

Your dentist submits the request through the DentaQuest provider portal. DentaQuest took over as the dental program’s third-party administrator on February 1, 2026, and all new authorization requests go through its system.⁷

A Possible Annual Cap on Adult Benefits

Adult dental coverage may change later in 2026. Governor Maura Healey’s fiscal year 2027 budget proposed a $1,000 annual cap on adult dental benefits, which the administration projected would save $120 million per year and attributed to anticipated federal healthcare funding losses.⁸⁹ The proposed cap would not apply to members under 21 or to clients of the Department of Developmental Services.

In April 2026, the House Ways and Means Committee rejected the $1,000 figure and recommended a $1,750 cap instead, which Committee Chair Aaron Michlewitz said aligns with the dental limit for public employees and retirees covered by the Group Insurance Commission. That version was projected to save $35 million per year.¹⁰ State Representative Russell Holmes proposed a $2,500 alternative.⁹ Any changes to adult dental coverage are expected to take effect on July 1, 2026, though the final number had not been settled at the time of reporting.⁷

Finding a Participating Dentist

MassHealth only pays for dental care from dentists enrolled in its network, and no referral from a primary care provider is required. You can search for a participating dentist at masshealth-dental.org using the “Find a Dentist” tool, which lets you filter by location, distance, and specialty.¹¹ For help by phone, or to confirm whether a specific dentist participates, call the MassHealth Dental Customer Service Center at 866-616-2699 (TDD/TTY: 711), Monday through Friday, 8 a.m. to 6 p.m.¹²

If getting to an appointment is a problem and you are enrolled in Standard, CommonHealth, or CarePlus, you can request transportation assistance to covered dental visits.¹

1
Mass.gov. Learn About MassHealth Dental Benefits
2
Mass.gov. MassHealth Covered Services
3
Mass.gov. MassHealth Dental Member Handbook
4
Mass.gov. MassHealth Appeal 2203427
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Mass Legal Services. MassHealth Dental Transmittal DEN 95
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AgeSpan. Senior Care Options 2026
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Mass.gov. MassHealth Dental Program Updates
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WWLP. Benefit Cap Savings May Come With Price for Dental Patients
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Boston Herald. Massachusetts Dentists Fear Healey’s Shortsighted MassHealth Cap Proposal
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WWLP. House Democrats Embrace Most of Gov’s MassHealth Budget Plan
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MassHealth Dental Program. Find a Dentist
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MassHealth Dental Program. Contact Us