The following medical-related dental services are eligible for coverage under Medica’s medical benefit document. Click specific topics below for more detailed information on these eligible services, including explanation of prior authorization requirements, covered services and exclusions.
For a Medica member to receive coverage for eligible Medica-related dental services on the medical plan, services must be rendered by a participating provider (physician, referral physician, dentist or oral surgeon) and in many cases require prior authorization by Medica.
Questions regarding care management and prior authorization should be directed to the Medical/Dental Care Manager at 952-992-2232 or 1-800-448-5512 (option 4).
Excluded services include but are not limited to:
- Dental implants and all associated charges in conjunction with implants.
- Cosmetic surgery/cosmetic dental treatment.
- Orthodontics other than those for cleft lip and palate for dependent children.
- Any other dental procedure or treatment, whether the dental treatment is necessary because of a primary dental condition or due to manifestation of a medical condition.
- Tooth extractions.
- Fluoride treatments.
Please instruct all Commercial members to call Commercial Customer Service at 952-945-8000 or 1-800-952-3455 if they have questions (TTY: 952-992-3190 or 1-800-841-6753).
Medicare members should call Center for Healthy Aging Customer Service at 952-992-2300 or 1-800-234-8755 (TTY: 952-992-3650 or 1-800-234-8819) and Medicaid members should call State Public Programs Customer Service at 952-992-2322 or 1-800-373-8335 (TTY: 952-992-2357 or 1-800-234-8819).
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