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Who We Serve
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Claim Your Medicaid Oral Health Benefits

Complete the form below to receive your reward.

Please briefly explain your license request below

Member Incentive Type

Member Incentive Type*

$20 Amazon Gift Card—Opioid Awareness $20 Amazon Gift Card—Oral Health and Pregnancy $20 Roblox Gift Card—First Molar Sealants and Education Bluetooth Speaker—Second Molar Sealants and Education $20 Amazon Gift Card—Oral Evaluation or Preventive Services $20 Amazon Gift Card—Emergency Department for Non‐Traumatic Dental Avoidance

Take the online pain medication safety course. (Ages 21 and older)

Take quiz

Member Information

First Name*

Last Name*

Date of Birth*

Member ID Number*

Your DentaQuest Member ID number is the 9- or 10-digit number on the front of your card

Mailing address*

City*

State*

Zip code*

Dentist Information

Location Name*

Provider Name*

Date you received care*

Complete the following quiz to claim your gift card. Answers are not shared and will not affect qualifying for your gift card.

1. Babies should have a dental appointment when they get their first tooth.

A. True B. No

2. Dental care is safe during pregnancy.

A. True B. No

3. Where can you find a dentist that takes your insurance?

A. The DentaQuest.com member page B. By calling DentaQuest member services at 1-888-468-5509, TTY 711 C. Either A or B

Answers:
1.A, 2.A, 3.C, 4.A, 5.A

Earn your $20 Amazon Gift Card!

I had a preventive dental visit during my pregnancy, watched the online video about preventing early childhood cavities and took the quiz.

Yes

Complete the following Oral Evaluation or Preventive Services for Children (Under 21) Quiz. Answers are not shared and will not affect qualifying for your gift card. To be completed by child under age 21.

What can make cavities in teeth?

A. Eating candy and gummies B. Eating fruit and vegetables C. Not brushing your teeth D. Both A and C

What drink is best for healthy teeth?

A. Juice B. Water C. Pop/soda D. Energy drink

Why are teeth important?

A. They help us eat B. They help us talk C. They are part of our smile D. All of the above

You can remove bacteria that causes tooth cavities by brushing your teeth.

A. True B. False

Who should see the dentist?

A. Adults B. Kids C. Both A and B

Answers:
1.D, 2.B, 3.D, 4.A, 5.C

Earn your $20 Amazon Gift Card!

Age 0 - 20 years: within 180 days of enrollment had one of the following qualifying services:

I had a dental check up! I had a topical fluoride treatment! I got my second molars sealed! I completed an age-appropriate online oral health quiz!

Complete the following quiz to claim your gift card.

1. Your child has a toothache. What should you do?

A. Call your dentist office and schedule an appointment as soon as possible B. Wait and see if the toothache goes away on it's own C. Go to the emergency department

2. You or your child has a toothache, but you do not see a dentist. What should you do?

A. Go to the DentaQuest.com member page to find a dentist B. Call DentaQuest member services at 1-888-468-5509, TTY 711 C. Either A or B to find a dentist

3. When should you call your dentist for an appointment as soon as possible?

A. You or your child has a broken tooth or a tooth has been knocked out B. You or your child has pain from a cavity or lost filling C. Both A and B

4. When should you go to a hospital emergency room for oral care?

A. You or your child have a serious mouth injury or infection making it difficult to breathe or swallow B. You or your child might have a fractured or dislocated jaw C. Both A and B

5. I followed up with a dentist within 30 days of a dental related emergency room visit:

A. Yes B. No

Answers:
1.A, 2.C, 3.C, 4.C, 5.A (if B [no], please make an appointment with your dentist as soon as possible)

Emergency Department Information

Location Name*

Date youmber received care*

Earn your $20 Amazon Gift Card!

I or my child:

Had a dental related Emergency Department (ED) visit Followed up with my dentist within 30 days of my ED visit Completed the online educational quiz

Earn your $20 Roblox Gift Card!

Ages 9 and younger:

I had a sealant on a permanent molar! I watched the “Teeth Tips” video!

Earn your Bluetooth speaker!

Ages 10 - 14 years

I had a sealant on a permanent molar! I watched the “Teeth Tips” video!

While actively enrolled with the plan. Once per member per calendar year. Member may earn other Healthy Behavior rewards, but the total dollar amount of combined rewards cannot exceed $50 dollars in the calendar year. Rewards cannot be transferred. If you leave the plan for more than 180 days, you may not receive the reward.

Benefit Disclaimers

DentaQuest is a Dental Plan with a Florida Medicaid contract. The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the Dental Plan. Limitations, copayments, and/or restrictions may apply. Benefits, dental network, premium and/or co-payments may change. DentaQuest complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

Non-Discrimination/Taglines: DentaQuest complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. This information is available at no-cost in other formats and languages. Please contact our customer service number at 1-888-468-5509, TTY 1-800-466-7566. Monday through Friday from 8a - 7p ET.

ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Comuniquese con nuestro numero de servicio al cliente al 1-888-468-5509 (TTY: 1-800-466-7566), de lunes a Viernes, de 8a - 7p ET.

ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Kominike tanpri avek sevis kliyantel la, swa nan 1-888-468-5509 (TTY: 1-800-466-7566), lendi pou vandredi ant 8a - 7p ET.

CHÚ Ý: Nếu bạn không nói được tiếng Anh, hãy gọi cho chúng tôi theo số 1-888-468-5509, TTY 1-800-466-7566. Chúng tôi có quyền truy cập vào các dịch vụ thông dịch viên và có thể giúp trả lời các câu hỏi của bạn bằng ngôn ngữ của bạn. Chúng tôi cũng có thể giúpbạn tìm một nhà cung cấp dịch vụ chăm sóc sức khỏe có thể nói chuyện với bạn bằng ngôn ngữ của bạn.