Eldercare Q & A – Dental, Vision Restored

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Q: Has MassHealth restored dental and vision services for older adults?

A: Yes, effective July 1, 2006, MassHealth has restored a number of services for adults age 21 or older, that had been eliminated. Here is a list of eight services that seniors on MassHealth can now get again – as long as the services are considered “medically necessary:”

Dental Services: exams, preventive services, restorations, root canals, and dentures. Some of these services must be approved in advance by MassHealth.

Vision Services: vision exams, eyeglasses, eyeglass parts, eyeglass dispensing, certain contact lenses, and other visual aids, such as magnifying aids.

Orthotics: mechanical devices, such as braces, or orthotic shoes, to support or correct weakened body parts.

Prosthetics: an artificial extension that replaces a missing part of the body, like an artificial leg or arm.

24-hour substance abuse treatment services: MassHealth will cover certain 24-hour post-medical detoxification substance abuse treatment services.

Acute hospital inpatient administratively necessary days: MassHealth will cover all administratively necessary inpatient stays, which are days in which a person is in a hospital awaiting relocation to another setting.

Chiropractor Services: MassHealth will now cover the services of a chiropractor.

Smoking Cessation Services: group or individual counseling to stop smoking, nicotine replacement prescriptions, such as patches, gum and lozenges. MassHealth will also pay for bupropion, a non-nicotine drug.

Most elders who are on MassHealth are also on Medicare, and many of the restored services listed here are important, because Medicare does not cover them. For example, Medicare does not cover dental care and dentures, or orthopedic shoes, or routine foot care, routine eye care and most eyeglasses. Even with this list of restored services, there are still some “gaps” in health care services, which neither Medicare, nor MassHealth will cover, such as hearing aids or hearing exams for the purpose of fitting a hearing aid.

Elders on MassHealth who have any questions about specific services that have been restored as of July 1, 2006, should call the MassHealth Customer Service Center at 1-800-841-2900 (TTY: 1-800-497-4648). The Customer Service Center hours are weekdays between 8:00 A.M. and 5:00 P.M. Or call 1-800-Age-Info, then press “3” and ask to speak with an Information Specialist.