Prenatal Dental Care Information

Date: September 18, 2024
Attention: Obstetric Care Providers

Call to action: Texas Children’s Health Plan (TCHP) would like to remind obstetric care providers about the availability of dental benefits for pregnant Medicaid members. The CDC and ACOG both recommend routine dental care during pregnancy, but TCHP has noted a limited number of pregnant women are familiar with dental benefits. Routine dental care during pregnancy is safe and can improve maternal oral health, decreasing future dental issues for the mother and improving oral health for the baby.

Dental Care is covered for Pregnant TCHP members on STAR, CHIP and STAR Kids:

STAR Adult members (21+)
- Texas Children’s Health Plan provides preventive and comprehensive dental care for STAR adult members through Texas Children’s Health Plan’s Healthy Rewards Program
  - Healthy Rewards dental services are fulfilled through FCL Dental
- Benefits include 2 routine exams and cleanings, plus routine extractions, x-rays, fillings, and emergency exams
- More information is available here: https://www.texaschildrenshealthplan.org/benefits/healthy-rewards/extra-help-families/dental-services
- Medicaid non-emergency transportation also covers rides to visit the dentist, as well as medical visits
STAR, CHIP and STAR Kids Pediatric members (birth – 20 years)
- Dental services are available to members from birth through 20 years as part of the benefit for comprehensive wellness care.
- Dental services are available through a managed care model with one of three Dental Maintenance Organizations (DMOs), DentaQuest, MCNA Dental or UnitedHealthcare Dental.
  - Members can find their DMO on the back of their ‘Your Texas Benefits Medicaid Card.’
  - For help with finding a dentist for a TCHP Member click here and scroll to ‘Find a Dental Provider.’
- Medicaid non-emergency transportation also covers rides to visit the dentist, as well as medical visits

How this impacts providers: OB-Gyn providers are encouraged to screen pregnant women for oral health. OB-Gyn providers should provide education on the importance of dental care during pregnancy and refer members to the appropriate dental provider:

For routine dental care if it has been more than six months since the last dental visit
For acute dental care if any oral health problems are identified

Next step for Providers: Obstetric care providers should share this reminder with their staff and encourage pregnant members to obtain dental care to maintain oral health and to treat disease early. Coordination of care for dental referral and transportation is essential to remove barriers to care.

Providers can support TCHP members by:

Coordinating referral to dental providers
- Adult: https://www.texaschildrenshealthplan.org/benefits/healthy-rewards/extra-help-families/dental-services or call FCL Dental through 1-866-548-8123
- Pediatric (0 – 20): refer members to the DMO listed on their ‘Your Texas Benefits Medicaid Card’
Directing members to learn about their dental benefits on TCHP’s website. Click here for the Member Benefits Page or by calling our Member Services at:
- CHIP: 1-866-959-6555
- STAR: 1-866-959-2555
- STAR Kids: 1-800-659-5764
Informing members that transportation assistance to dental visits is available through TCHP. For help arranging for a ride to dental visits members can call 888-401-0170 or visiting https://www.texaschildrenshealthplan.org/benefits/transportation-assistance
TCHP can also assist providers with coordinating dental services for members in need of routine or acute dental care. For TCHP assistance, please refer members to our Care Coordination team by calling 832-828-1430 or emailing casemanagementphysicianreferral@texaschildrens.org.

Additional Resources for Providers:

Below are some additional resources for more information on the importance of routine dental care during pregnancy:

If you have any questions, please email Provider Relations at: providerrelations@texaschildrens.org.

For access to all provider alerts: https://www.texaschildrenshealthplan.org/providers/provider-news/provider-alerts.