Program Overview
UHC Dental Plan serves the Texas Children's Medicaid and CHIP program throughout the state. UHC Dental provides dental coverage for Medicaid and CHIP dental members. Our dental plan offers you a large network of General Dentists and Dental Specialists across Texas. We work with our network dentists to make sure you or your child gets the quality dental care needed for a healthy smile!
For more information about Texas Medicaid and CHIP, visit the Texas Health and Human Services Commission website at Texas Health and Human Services or download our Member Handbook Texas Medicaid Home Page (uhc.com) to see a list of all covered benefits and services.
CHIP Dental Benefits
Your child receives statewide coverage for the following services:
- Exam, cleaning and fluoride treatments
- X-rays, fillings, crowns, and root canals
- Teeth removal and other medically necessary treatments
- Fillings Services that are not needed for dental health
- Cosmetic dental care
- General anesthesia or intravenous/conscious sedation
- Orthodontia (braces)
NOTE: The summary of benefits above is only intended for general informational purposes and may not reflect all updates or nodifications to the plan benefits. Please contact us to confirm your current benefits.
CHIP Co-pays and Cost Sharing
Effective January 1, 2014
| Enrollment Fees | Charge | |
| At or below 151% of FPL* | $0 | |
| Above 151% up to and including 186% of FPL | $35 | |
| Above 186% up to and including 201% of FPL | $50 | |
| Co-pays (per visit): | ||
| At or below 151%FPL: | ||
| Office Visit (non-preventative) | $5 | |
| Non-Emergency ER | $5 | |
| Generic Drug | $0 | |
| Brand Drug | $5 | |
| Facility Co-pay, inpatient (per admission) | $35 | |
| Cost-sharing Cap | 5% (of family's income)** | |
| Above 151% up to and including 186% of FPL | ||
| Office Visit (non-preventative) | $20 | |
| Non-Emergency ER | $75 | |
| Generic Drug | $10 | |
| Brand Drug | $35 | |
| Facility co-pay, Inpatient (per admission) | $75 | |
| Cost -sharing Cap | 5% (of family's income)** | |
| Above 186% up to and including 201% of FPL | ||
| Office Visit (non-preventative) | $25 | |
| Non-Emergency ER | $75 | |
| Generic Drug | $10 | |
| Brand Drug | $35 | |
| Facility Co-pay, Inpatient (per admission) | $125 | |
| Cost-sharing Cap | 5% (of family's income)** |
***The federal poverty level(FPL) refers to income guildines established annually by the federal government.
**per 12-month term of coverage.
Contact UHC Dental's Call Center for information about your benefits toll-free at 1-877-901-7321.
How much do I have to pay for services not covered by the CHIP Dental Program or services that are over the yearly maximum?
Schedule Members do have to pay for services that are:
- Non-covered services.
- Non-preventive services given after the member has reached their yearly maximum