Dental Care

Dental Home

When you become a Nebraska Total Care member, you must choose a Primary Dentist. If you do not choose one we will assign you one. Your Primary Dentist will help coordinate all of your oral health needs. The Primary Dentist is listed on your identification (ID) card.

Your Primary Dentist must be in our network for care to be covered. We can help you find or choose a dentist. Call Member Services at 1-844-385-2192 (TTY 711). We are available Monday to Friday, 8 a.m. to 5 p.m., Central. Or you can find a provider online.

Preventive Care

Preventive care begins at age one or when a child gets their first tooth. Everyone age one and older should see their dentist twice every year. They will clean your teeth to help prevent other problems. The dentist will also do an exam to check for conditions that need treatment.

Covered Services

Preventive and diagnostic care is covered for members age one and older. These services do not need prior authorization. This includes:

• Cleaning and exams
• Floride treatment
• Sealants
• Space maintainers
• X-rays

Treatments for dental conditions are covered but may need prior authorization. Your dentist will help get the authorization. Treatment might include:

• Filling
• Crown
• Root canal
• Full or partial dentures
• Tooth removal
• Orthodontics
• Oral surgery

Excluded Services

Cosmetic services are not covered. Members with coverage limited to services for an unborn child do not have dental coverage. If you are not sure if you have coverage please call Member Services at 1-844-385-2192 (TTY 711).

Urgent Dental Care

If you have an urgent dental need call your primary dentist. This could be pain, injury, or infection. You should receive urgent care within 24 hours. You can also call our 24/7 Nurse Advice Line. The number is 1-844-385-2192 (TTY 711). Press *

Emergency Dental Care

A dental emergency requires immediate treatment. Some examples are:

• Severe pain
• Severe bleeding
• Serious injury to the teeth or gums
• Unusual swelling of the face, gums, or tongue
• Difficulty or pain when opening or closing the jaw

If you have a dental emergency call your primary dentist for direction if you are able. You can also call our 24/7 Nurse Advice Line. The number is 1-844-385-2192 (TTY 711). Press *. If you cannot reach your primary dentist go to the nearest emergency room.

You can go to any hospital emergency room. It can be a hospital that is not in the Nebraska Total Care network. Show the provider your Nebraska Total Care member ID card and your Nebraska Medicaid ID card. Providers outside of our network will need help from us right away so that they can be paid. If they do not complete tasks within 30 days, you may be responsible for paying for service.

Call your primary dentist and Nebraska Total Care after you go to the emergency room. Call within 48 hours of your emergency. This help us make sure you get the follow-up care you need. The phone number is 1-844-385-2192 (TTY 711).

Children With Special Needs

Dental care can be confusing for children with special needs. These children can have extra “practice” visits. It may help them feel more comfortable before the dentist does any work. If your child needs a practice visit talk to your dentist. Any dentist can give this service.