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Dental care

Dental care is a very important part of staying healthy, especially for young children. Your dentist will give you regular check-ups and take care of your dental care. Members are eligible for a routine dental exam and cleaning once every 6 months.*

Which dentists can I go to?

If you need help finding a Keystone First dentist, go to Find a Provider and select Dental. You do not need a referral to see the dentist.

Some of the dental benefits for members under age 21:

  • Braces**
  • Check-ups and cleanings
  • Dental surgical procedures
  • Dental emergencies
  • X-rays
  • Extractions (tooth removals)
  • Fillings
  • Sealants
** If braces were put on before the age of 21, services are covered until treatment for braces is completed, or age 23, whichever comes first, as long as you continue to be a Keystone First member.  If you change to another health plan, coverage will be provided by that health plan.

For a complete list of benefits for members under 21, please check the Keystone First member handbook.

Dental benefits for members over age 21, who are eligible for dental benefits, are eligible for:

  • 1 dental exam and 1 cleaning, every 6 months.
  • Pulpotomies (removal of pulp) for pain relief.
  • Re-cementing of crowns (re-gluing the crown).

For information on dentures, please visit the Keystone First member handbook.

You may be able to get other services for special situations. You must get special approval for these. It is called a benefit limit exception. For more information on dental benefit limit exceptions, please read the Keystone First member handbook. You can also call Member Services at 1-800-521-6860 for more information about your dental benefits.

There may be co-pays for some dental services. Please see the member co-payment schedule (PDF) for more information.

* Dental care may not be covered for all members age 21 and older.