Dental Benefits under the Healthy Kids plan

This is a general listing of the dental benefits offered under the Healthy Kids plan. Families will receive more detailed information from their child’s dental plan once enrolled.

Florida Healthy Kids dental plans include:

Preventive Services
  • Office Visits
  • Cleanings/Prophylaxis
  • Topical fluoride application, limit one every six months
  • Sealants, limits one application per tooth every 3 years
  • Space maintainers
Oral Exam
  • Initial Oral Exam
  • Periodic Oral Exam, limit one every 6 months
  • Intraoral periapical
  • Bitewings, limit one every 6 months
  • Complete set of x-rays, limit one every 3 years
  • Panoramic x-rays, limit once per year
Restorative Services (Fillings and Crowns) – Treatment may require Prior Authorization
  • Amalgam restoration (silver fillings)
  • Composite/Resin restorations (white fillings)
  • Prefabricated stainless steel crowns
  • Crowns
Oral Surgery (Extractions) – Treatment may require Prior Authorization
  • Extractions
  • Biopsies
  • Surgical treatment of diseases
  • Injuries, deformities and defects
Endodontic Services (Root Canals) – Treatment may require Prior Authorization
  • Root canal therapy on primary and permanent teeth
  • Apicoectomy, surgery involving the root surface
Periodontal Services – Treatment may require Prior Authorization
  • Gingival curettage, including local anesthesia
  • Gingival flap procedure
  • Scaling and root planing
Removable Prosthodontics (Dentures) – Treatment requires Prior Authorization
  • Upper, lower or complete set of dentures, limited to once per the lifetime of the child Orthodontic Services (Braces) – Treatment requires Prior Authorization
  • Services are limited to those circumstances where the child's condition creates a disability and impairment to their physical development. Not covered for cosmetic purposes.
Analgesia and Sedation – Treatment may require Prior Authorization
  • The administration of a drug to temporarily stop the feeling of pain in a child.
  • Limited to children who have severe physical or mental disability or are difficult to manage. Service is limited to 3 times every 12 months
  • Intravenous administration of drugs
  • Non-intravenous administration of drugs, limit 3 times per year
Injectable Medications
  • The injection of medication to treat illness or disease.
Palliative Treatment
  • Covered services necessary to relieve pain and discomfort on an emergency basis.
Hospitalization – Treatment requires Prior Authorization
  • Hospitalization for dental treatment is covered only if a child's health is so jeopardized that procedures cannot be safely performed in the dental office; and/or, the child is so uncontrollable due to emotional instability or developmental and sedation has been

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