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Expanded Dental Coverage Now Available Through MLTC Plans

The Department of Health (DOH) announced last week that, effective Jan. 31, 2024, partially capitated Managed Long Term Care (MLTC) plans, Medicaid Advantage Plus (MAP) plans, and Programs of All-Inclusive Care for the Elderly (PACE programs) will cover dental crowns and root canals. In addition, replacement dentures and implants will no longer require a letter from the patient's physician for determination of medical necessity.

The Department reminded plans that they are required to submit any internal guidance for approving crowns, endodontics, replacement dentures, and implant-related services to the Department. The deadline for submission of these internal policies was Jan. 31, 2024. They may be submitted here. Questions regarding changes to the dental benefits can be sent to the Department here.

In addition to announcing these coverage changes, DOH has released the 2024 Dental Manual and updated Fee Schedule on eMedNY here.

Contact: Karen Lipson, klipson@leadingageny.org