Did you know that all clients of the Developmental Disabilities Administration (DDA) can receive some enhanced medical benefits, such as annual physical exams and dental cleanings up to three times a year? Including individuals on DDA’s No Paid Services Caseload?
These enhanced benefits are in addition to other covered services offered to all Apple Health recipients. You don’t need approval from DDA to request these services, just go directly to your provider.
Enhanced Frequency of Benefits for DDA Clients:
- Periodic oral exam once every 4 months
- Prophylaxis once every 4 months (includes
(SRP or periodontal maintenance—see below)
- Topical fluoride treatment once every 4 months
- Scaling and Root Planing (SRP) once per quadrant every 12 months
- Periodontal Maintenance once every 6 months (must be 6 months after SRP)
- Sealants every 2 years
In addition, clients of DDA can get stainless steel crowns (on back teeth) and general anesthesia with prior authorization.
Dental Coverage for Adult Apple Health Recipients Includes:
- 1 Initial Comprehensive Exam
- 1 Periodic Exam
- 1 Prophylaxis (cleaning)
- Limited Exam (as needed)
- 1 filling per tooth every 2 years
- 1 Complete X-Ray Series every 3 years
- 4 Bitewing X-Rays every 12 months
- Root canal for upper and lower anterior (front) teeth only
- Complete and Partial Dentures, with Prior Authorization (other restrictions may
- Simple extractions, Surgical extractions, Biopsies, Incise and Drain
In addition to other medical coverage provided to all Apple Health recipients, adult clients with developmental disabilities are able to receive one preventive yearly physical.
For more information about your benefits contact the Health Care Authority at 1-800-562-3022. Be sure to identify yourself or your family member as a client of DDA for information related to enhanced benefits for people with developmental disabilities.