2898 Mahan Drive, Suite 1 Tallahassee, Florida 32308
850-921-0460

The Arc Dental Program

Welcome to the Arc of Florida Dental Program

Hours of Operation: Monday-Friday, 8:30 AM EST-4:30 PM EST excluding Holidays
Email Address: dental@arcflorida.org (best way to reach us)

The Arc of Florida Dental program: 1.855.322.6735 (Toll Free) and 850-354-7479

Applicants must reapply every year on or after July 1st. Submission of application does not guarantee approval for funding. Applicants’ funding for services is not continual within a contract year.

Current Funding Period: July 1, 2021-June 20, 2022 (period may end earlier if all funds have been exhausted)

Eligibility: individuals must receive services through the Agency for Persons with Disabilities: WAIVER, WAITLIST, CDC+. If not enrolled, an application should not be completed. To enroll with the Agency, call 1-866-273-2273.

How to Apply for The Arc of Florida Dental Program?

Due to the high frequency of submissions, it may take more than 30 days to process and make determinations on applications. When a determination (approved or not approved) has been made, we will notify the Primary Contact or Waiver Support Coordinator listed on the application. ***IMPORTANT: If the Primary Contact or Waiver Support Coordinator has not been notified by our office then a determination on the application has not been made and the applicant should continue to wait for a decision.

Download APPLICATION HERE (English)  – Adobe Reader Required Download Here
Descarga la aplicación aquí (Spanish)  – Adobe Reader Requerida Decarga aquí

1. Complete Page 1 and sign Pages 2-4 of the Application (DO NOT RETURN Notice of Privacy Practices for Protected Health Information). Not required but if available, please include a Dental Treatment Plan with your application.

***IMPORTANT: incomplete applications cannot be processed.

2. Contact your Dental Provider, only if you have one, to find out if any of your treatment will be covered under your Dental Insurance or Medicaid Managed Care Dental Plan (i.e. Liberty, DentaQuest or MCNA). If treatment is NOT covered by your insurance or plan, be sure to answer the questions on your application regarding why treatment is not covered (i.e. Insurance/Plan had no providers available, Insurance/Plan Denied Services). Not required but if available, please include the Denial Letter with your application.


3. Return completed and signed Applications (Pages 1-4) by Email, Fax, or Mail to:

Email: dental@arcflorida.org

Fax: 850.921.0418

Mail: Attn: Dental Program
The Arc of Florida
2898 Mahan Drive, Suite 1
Tallahassee, FL. 32308


***IMPORTANT: Medicaid Managed Care Dental Plan, and/or Dental Care Insurance Benefits (if applicable) must first be used as payment towards Dental Treatment before program funds can be accessed. The Arc of Florida Dental Program is the “Payor of Last Resort” (see below for more information). Services paid by Medicaid Managed Care Dental Plans are not subject to co-payment.

Disclaimer: emailing Applications may not protect the Applicants’ Protected Health Information and/or Identity.

Frequently Asked Questions:

What is the wait time for a determination regarding an Application?
Applications are processed in accordance with our Contract with the Agency for Persons with Disabilities. Hundreds of applications are received each month and it may take longer than 30 days for processing. Completing pages 1-4 of the Application which includes providing Signatures and attaching a Dental Treatment Plan from your Dentist (if you have one) will speed up processing.

What if I do not have a current Dentist?
Eligible Applicants without current Dentists will receive assistance from Dental Program Staff once the applications have been verified and processed. Staff will identify Program Network Dentists for selection in or near applicants’ homes.

What if there are no Program Network Dentists in or near my home?
Dental Program Staff will assist Eligible Applicants in identifying Program Network Dentists for selection in other areas or seek to recruit Dentists. Applicants’ willingness and ability to travel to other areas enables acquiring dental treatment.

Can I apply to the Dental Program if I have a Medicaid Managed Care Dental Plan and/or Dental Insurance to pay for treatment?
Yes. Applicants must first use benefits from Medicaid Managed Care Dental Plans and/or Dental Insurance before Arc of Florida Dental Program Funds can be accessed on their behalf. Services denied by Plans and/or Insurance may be funded by the program.

What if I need Sedation to complete Dental Treatment?
The Dental Program pays for all types of Sedation (Oral, Gas, IV, Deep, Hospital) and has Network Dentists that perform treatment under those types of Sedation.

What Services are FUNDED by the Dental Program?
Oral Cancer Screening (excluding tests over $100.00)
Crowns
Root Canal
Sedation
Fluoride (once per contract year)
Fillings
Extractions
Dentures/Partials
Bridges
X-rays (excluding Cone Beam CT)
Cleanings (not continual within a contract year)
Exams/Consultations
Behavior Management
Disclaimer: Not an All-Inclusive List. All Dental Treatment Procedures are evaluated on a Case-by-Case Basis.

What Services are NOT FUNDED by the Dental Program?
Implants, associated parts, or procedures to prepare for installation
Veneers
Bone Grafts/Alveoplasty/Gingivectomy/Gingival Flap
Sealant
Braces/Aligners (Orthodontics)
Bleaching
Bonding
Periodontal Trays & Supplies
TMJ Related Treatments (i.e. Botox)
Mouth Guards
Oral Health Education
Laser Therapy
Local Anesthesia (Novocaine/Benzocaine/Lidocaine, Desensitive Medicament)
Gingival Irrigation
Atridox/Antimicrobial Agent
Other Drugs and Medicaments (usually covered under Healthcare Plans by prescription)
Dental Hygiene Appliances, Products and Supplies
Disclaimer: Not an All-Inclusive List. All Dental Treatment Procedures are evaluated on a Case-by-Case Basis.

Note: Treatment Plans are subject to review by The Arc of Florida Dental Program’s Consultation Dentists. Recommendations made by those dentists regarding services to be funded establish the final determination for approval of funds.

Questions regarding the “Payor of Last Resort”
According to federal law, Providers are obligated to bill all Third-Party Payers before filing a claim with Medicaid. There are several Federal and State Statutes that govern this requirement. First Section 1902(a)(25) of the Social Security Act requires participating states to:

“Take all reasonable measures to ascertain the legal liability of third parties…to pay for care and services provided to Medicaid recipients.

It is common for Medicaid beneficiaries to have one or more additional sources of coverage for health care services. Third Party Liability (TPL) refers to the legal obligation of third parties (e.g., certain individuals, entities, insurers, or programs) to pay part or all of the expenditures for medical assistance furnished under a Medicaid state plan. By law, all other available Third-Party Resources must meet their legal obligation to pay claims before the Medicaid program pays for the care of an individual eligible for Medicaid. States are required to take all reasonable measures to ascertain the legal liability of third parties to pay for care and services that are available under the Medicaid state plan.

The Arc of Florida Dental Services Scholarship Program does not have “legal liability” or an obligation to provide dental services to any particular individual. However, the I-Budget Medicaid Waiver has to provide medically necessary services to specific individuals and in fact lists dental services as one of the covered services under the waiver.

While The Arc of Florida is proud to receive funding to provide much needed dental services to Floridians on the I-Budget Waiver and Waitlist, this program does not have a legal obligation to a particular Medicaid recipient and therefore, The Arc of Florida Dental Services Scholarship Program does not replace I-Budget Medicaid Waiver funding for Dental.

Actual Contract Language states:
3. Clients to Be Served
a. General Description
The population receiving services funded by this Contract are the Agency’s clients with developmental and/or intellectual disabilities residing in Florida. The clients to be served shall be children or adults with intellectual and/or developmental disabilities throughout the State who receive services through the DD Waiver whose iBudget cost plan do not include adequate or any funding for comprehensive of preventive dental care, or do not have access to a DD Waiver dentist. The clients to be served shall also include children or adults who receive services through the Waitlist who have comprehensive and/or preventive dental care needs.


ATTENTION WAIVER SUPPORT COORDINATORS:

The Agency for Persons with Disabilities continues to assess the needs of iBudget and CDC+ Consumers.
Medicaid Managed Care Dental Plans:

DentaQuest: 1-888-468-5509, TDD: 1-800-466-7566, Website: http://dentaquest.com/state-plans/regions/florida/

Liberty: 1-833-276-0850, TDD: 1-877-855-8039, Website: http://www.libertydentalplan.com/FLMedicaid

MCNA: 1-855-699-6262, TDD: 1-800-955-8771, Website: http://www.mcnafl.net

Clients that are still unable to receive services after speaking with the Medicaid Managed Care Dental Plan, may utilize the Agency for Healthcare Administration Medicaid Helpline. The Medicaid Helpline is available both online and by telephone: 1-877-254-1055

https://www.flmedicaidmanagedcare.com/complaint/#/

Resources for Parents and Caregivers

How to Help Your Child with ASD Overcome Her Fear of the Dentist and Establish Lifelong Healthy Oral Hygiene Habits

The following link will take you to some great resources and short videos. These videos center around Oral Hygiene, and will help guide parents, caregivers and self-advocates on ideas and strategies to use, as well as give advice on how to help alleviate anxiety, and much more.

https://www.dhsv.org.au/professionals/health-promotion-resources/videos/brushing-up-on-oral-health