UCare's MSHO Dental Options
Dental benefits for members of UCare's Minnesota Senior Health Options (MSHO) plan.
In addition to Medicare- and Medicaid-covered dental benefits, MSHO members have additional dental coverage for preventive and restorative dental services that are not covered by Medical Assistance (Medicaid). Members must receive these services from a network dentist.
Below is a list of preventive and restorative codes that may be accessed:
- Scaling and root planing (D4341 and D4342)
- Once every two years and only in an office setting. The member must have pocket depths of 4 mm or greater and documented bone loss visible on x-rays.
- Additional dental exam (D0120)
- One additional per calendar year
- Molar root canal (D3330)
- One per tooth per lifetime
- Root canal re-treatment (D3346, D3347, D3348)
- Rule: One re-treat per tooth per lifetime. Covered only if billed 24 months after original root canal.
- Full mouth series (x-ray) (D0210)
- Rule: Once per five years
- Periodontal maintenance (D4910)
- Four times per calendar year
- PFM crown (D2750)
- One per calendar year
Members will be informed of the portion of the cost they will need to pay for non-network services. Certain limitations apply.
New in 2020
- Additional dental coverage:
- Two crowns per year
- Tissue conditioning for dentures
- New electric toothbrush every three years
Members may call the Customer Services number on their UCare member identification (ID) card for more information.
A one-stop-shop for all of your dental care coordination needs.
Delta Dental Customer Services
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