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Individual & Family Plan dental coverage

man and child brushing their teeth

Dental care and oral health

Your dental health is an important part of your overall health. Although UCare Individual & Family Plans are not dental plans, some essential dental services and care are covered depending on your plan and age. Explore this guide to learn more.

Adult members age 19 and older

For adult plan members, only some medically necessary dental services are covered by your plan. Check your member contract for more information.


Members under age 19

Oral health and hygiene are important, especially for UCare's youngest members. Under the Affordable Care Act, all individual and family plans offered in Minnesota must cover 10 essential benefits, including pediatric dental services. For UCare Individual & Family Plan members under the age of 19, many maintenance and major dental services are covered.

Dental coverage for members under age 19

The following in-network pediatric dental services are covered for members under age 19. For more information about pediatric dental services coverage, check your member contract.

Your plan covers in-network pediatric check-up dental services for members under the age of 19.

  • Periodic oral evaluation – one every six months
  • Limited oral evaluation – one every six months
  • Oral evaluation – one every six months
  • Periodontal evaluation – one every six months
  • Dental x-rays – complete series (including bitewings) – one every five years
  • Dental x-rays – periapical and occlusal films – one set every six months
  • Bitewings – one set every six months
  • Vertical bitewings – up to eight films – one set every six months
  • Panoramic film – one film every five years
  • Cephalometric radiographic image
  • Oral / Facial photographic images
  • Interpretation of diagnostic image
  • Diagnostic models
  • Prophylaxis – one every six months
  • Topical application of fluoride (excluding prophylaxis) – two every year
  • Sealant – per tooth – unrestored permanent molars – one sealant per tooth every three years
  • Space maintainers – fixed and removable – unilateral and bilateral
  • Re-cementing space maintainers

Your plan covers in-network orthodontics for members under the age of 19 to help restore oral structures to health and function and to treat serious medical conditions, such as:

  • Cleft palate and cleft lip
  • Maxillary/mandibular micrognathia (underdeveloped upper or lower jaw)
  • Extreme mandibular prognathism
  • Severe asymmetry (craniofacial anomalies)
  • Ankylosis of the temporomandibular joint (TMJ)
  • Other major skeletal conditions

The following orthodontia dental services are not covered:

  • Cosmetic services, such as appliances, aligners and braces to improve the appearance of the teeth

Your plan covers in-network major dental care restorative services for members under the age of 19.

  • Amalgam and resin-based composite filings
  • Root canal
  • Extractions
  • Periodontal scaling and root planing once every two years
  • Full mouth debridement once per lifetime
  • Crowns – limited to one per tooth, per five years
  • Some inlays and onlays – one per tooth, per five years
  • Complete and partial dentures, bridges – limited to one in a five-year period; adjustments, repairs, relines, and rebases, every three years
  • Some complex oral surgery
  • Implants – one every five years

The following major dental services are not covered:

  • Temporary services (such as provisional crowns and interim dentures)
  • Cosmetic dental services