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/  Updates to Services Included in Oral Health for Overall Health

Updates to Services Included in Oral Health for Overall Health

In an effort to continually improve the value and effectiveness of our Oral Health for Overall HealthSM program, we’ve updated some of the services offered:

  • D4355 (the removal of plaque and tartar that interfere with the dentist’s ability to perform a dental exam) is now covered at 100% once every 24 months for all conditions.
  • Periodontal root scaling and planing (D4341/D4342) are covered at 100% when a member is enrolled in the program, regardless of standard coverage. This applies to members who are enrolled because they’ve been diagnosed with diabetes, CAD, stroke, ESRD, COPD, or MetS, or who are pregnant. This change went into effect in January.
  • Effective January 1, 2024, D0431 (oral cancer screening) will no longer be covered; it will be replaced by D0120 (periodic oral exam). Two exams will be covered 100% per calendar year with no out-of-pocket expense when provided by a participating provider.

We encourage you and your staff to proactively identify patients eligible for the program and recommend that they enroll and/or take advantage of these valuable benefits. If they have Florida Blue medical and dental plans, remind them that, if eligible, they’re automatically enrolled.