Illinois All Kids Medicaid Dental

ILLINOIS MEDICAID

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DentaQuest provides dental coverage to adults, pregnant women and children who are eligible for Illinois Medicaid and are members of All Kids and HFS Adult Dental Program.

Member Benefits

Prevention

Oral exam (every six months for children and every 12 months for adults)
Teeth cleaning
X-rays every 12 months
Fluoride treatments
Sealants (age requirements apply)

Treatments

Crowns
Root canals
Extractions (teeth removal)
Other medically necessary care

Additional

Emergency dental care
Orthodontia (braces) (age requirements apply)
Teledentistry

NOTE: The summary of benefits above is only intended for general informational purposes and may not reflect all updates or modifications to the plan benefits. Please contact us to confirm your current benefits.

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Important Plan Documents and Information

Protected Health Information (PHI) Release Form

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Customers may submit complaints to DentaQuest telephonically or in writing on any HFS Dental Program issue other than decisions that deny, delay, reduce, or terminate dental services. Some examples of complaints include: the quality of care or services received, access to dental care services, provider care and treatment, or administrative issues.

If the Customer chooses to appeal the decision, a Customer Services Representative will assist by providing the information on how to initiate the appeals process.

The toll-free number to call to file a complaint is: (888) 281-2076

The address to file a complaint is:

DentaQuest of Illinois, LLC
Complaint Representative
P. O. Box 2906
Milwaukee, WI 53201-2906

Customers have the right to appeal any adverse decision DentaQuest has made to deny or reduce dental services.

A Customer may contact his/her caseworker for assistance in filing an appeal. In addition, DHS will help a Customer file an appeal.

Appeals must be filed within 60 days following the date the denial letter was mailed by DentaQuest.

Customers request a hearing by calling the Fair Hearings Section at 1-855-418-4421 (TTY: 1-312-793-2697 or 1-800-526-0857) or by fax at 1-312-793-2005 or by writing to:

HFS, Bureau of Administrative Hearings
401 South Clinton Street, 6th floor
Chicago, IL 60607

Appeals are reviewed by HFS under its existing administrative appeal procedure, and matters are heard before an Administrative Hearing Officer. DentaQuest approves and allows payment for any services ordered rendered by HFS or any Court of Jurisdiction, provided the Customer is eligible.