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INSURANCE AND DENTAL PROVIDER INFORMATION

Texas EPSDT Dental Periodicity Schedule – Dental exam by age one.
http://www.aapd.org/media/Policies_Guidelines/G_Periodicity.pdf

211

Call the 2-1-1 for a free help line that is answered 24 hours a day, 7 days a week. An operator will help you find the resources you need in your community. All calls are answered by real people, not a recording, who can answer your questions in more than 90 languages. The operator can assist you in locating dental services. 2-1-1 is not for life-threatening medical, police, and fire emergencies. If you have an immediate crisis, call 9-1-1. More information on 2-1-1 can be found at www.211.org.


FIND COVERAGE FOR YOUR FAMILY

https://www.insurekidsnow.gov/coverage/tx/index.html

Medicaid and CHIP offer free or low-cost health insurance for kids and teens. Children can get regular check-ups, immunizations, doctor and dentist visits, hospital care, mental health services, prescriptions and more. Children in a family of four earning up to $49,200 a year or more may qualify. Families and individuals can apply online, by phone, by mail or in person.

Call 1-877-541-7905 to talk to someone in Texas about Medicaid and CHIP.  Even if your child has been turned down in the past or you don't know if they qualify, you may be able to get health coverage now.

FIND A DENTIST LOCATOR

https://www.insurekidsnow.gov/coverage/tx/find-a-dentist/index.html

Have you had trouble finding a dentist for your child? Use this Dentist Locator to find a dentist in your community who sees children and accepts Medicaid and CHIP.
Finding a dentist is easy:
Select your state from the drop-down menu.
Select your child's dental plan from the drop-down menu.
Enter a street address or zip code close to where you live or work.
Choose a distance from that street address or zip code that you wish to search within.

If you want to look for a specialty dentist, such as an oral surgeon or dentists who speak your language, expand the Additional Search Criteria and select options that fit your needs.


OTHER LINKS TO HELP FIND A DENTIST IN YOUR COMMUNITY:


LOW COST DENTAL SERVICES

If you have Medicaid, and are 20 years old or younger, call Texas Health Steps (THSteps) at 1-877-847-8377, Monday to Friday from 8 a.m. to 8 p.m., Central Time, for help with getting a dental checkup. If you do not have Medicaid, or if you are 21 years old or older, please use the resources for dental care listed below.


COMMUNITY HEALTH CENTERS/FEDERALLY QUALIFIED HEALTH CENTERS

There are community health clinics throughout the state that are federally and state funded. These clinics are not under the state Oral Health Program's management. These clinics provide medical services and most provide dental services for adults, although some clinics may restrict services to children only. 

The clinics charge discounted co-payment rates for dental services. Their eligibility requirements are based on household income and use a sliding fee scale. You do not have to live in the county where the clinic is located. There may be a waiting list for services. If you are in pain with a toothache or have infection, please mention this when you call the clinic.

Below is an internet link to get a search engine on a computer to find the clinic closest to you. Simply insert your zip code, and a list of clinics with distance, address, phone number, and links to driving directions and maps. Our suggestion is to call the clinic phone number before your visit to check if an appointment is available. Go online at http://findahealthcenter.hrsa.gov/  to find a clinic location. 


TITLE V MATERNAL AND CHILD HEALTH

Title V Maternal and Child Health Fee-for-Service Contractors provide direct services to low income (Texas resident) women and children not eligible for Medicaid/CHIP, CHCIP Perinatal or another payor source and have a gross family income at or below 185% FPL. Dental services are provided for pregnant women up to 3 months postpartum. These services include comprehensive and periodic oral evaluations, radiographs, and preventive and therapeutic dental services.


TEXAS MEDICAID PROGRAMS

Children age 20 or younger whose families are considered low or very-low-income are eligible for Medicaid and have comprehensive dental benefits through MCNA and DentaQuest. Dental benefits are not included for adults (on any Texas Medicaid program), but can be added as a value-added service (services offered in addition to the existing benefits).

TEXAS HAS FIVE MEDICAID PROGRAMS:

STAR
Medicaid for children, newborns, pregnant women and some families with children.

STAR Kids
Medicaid for children and adults under 20 with disabilities.

STAR Health
Medicaid for children who get their coverage through the Texas Department of Family and Protective Services.

STAR+PLUS
Medicaid program for adults (21+) who have disabilities or are 65 and older (aged, blind, disabled)

TRADITIONAL MEDICAID
Medicaid for those who can’t be in managed care, also called fee for service.


 

FORM CMS-416: ANNUAL EPSDT PARTICIPATION REPORTS: