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Verifying Your Patients’ Oral Health for Overall Health Eligibility and Enrollment Status

We’re committed to providing you with the best opportunities to promote the health and wellness of your patients. The Evidence-based Dental Benefits available to your patients enrolled in our Oral Health for Total Health (OHOH) program help improve their overall health outcomes.

Some of your patients may have eligible conditions and may already be enrolled in OHOH. If you need assistance identifying patients enrolled in the program, please reach out to your dental network manager.

Oral Health for Overall Health – Eligibility, Benefit and Periodontal Reminders

Your patient is eligible for Oral Health for Overall Health if they:

  • Have a dental plan that provides OHOH
  • Have been diagnosed with a covered OHOH medical condition
  • Are enrolled in OHOH
  • Effective Jan. 1, 2022, all Medicare Advantage plans, except for FCHP, include OHOH

BlueDental Prepaid and FHCP dental plans are not eligible for OHOH.

To confirm your patient is enrolled in OHOH, please call 866-445-5148 or log in to the My Patients’ Benefits website and select “Medical Conditions” in the Member Eligibility section. If a patient is enrolled, their conditions and enrollment date are displayed.

Before

After confirming your enrolled patient’s eligible condition(s), select Benefits and open the “Wellness Benefits” tab. This will display the OHOH benefits details. Details on which procedures/CDTs are covered for which conditions are listed in the “Limitations” column.

Before


Root scaling and planning are covered at 100% only if the member’s standard plan offers periodontal coverage.

Please refer to the “Nonsurgical Periodontal Services” tab in the Benefits section to determine if periodontal scaling (CDTs D4341, D4342, D4346) is covered under the member’s standard plan.