Special Healthcare Needs Benefit

Dental patient in wheelchair and front desk worker at dental office talking and smiling.

Reduce barriers to care

According to the Medicaid and CHIP Payment and Access Commission, dental care is among the top unmet health needs for adults with intellectual and developmental disabilities, and these adults are the "largest marginalized population with unmet oral health needs." Delta Dental’s Special Healthcare Needs Benefit reduces barriers to care by providing eligible members with enhanced benefits.

What's covered under this benefit?

If your employer has opted to offer enhanced benefits for covered members with special healthcare needs, you and/or a covered dependent may qualify for the following. If you're unsure of whether your employer-provided Delta Dental benefit plan includes this enhanced benefit, call your human resources department for additional information.

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Additional dental visits
Additional visits to the dentist’s office and/or consultations prior to the first treatment to help patients learn what to expect and what is needed for a successful appointment.
Additional dental cleanings
Up to four total dental cleanings in a benefit year so appointments can be shorter.
Treatment delivery modifications
Including anesthesia and nitrous oxide, necessary for dental staff to provide oral health care for patients with sensory sensitivities, behavioral challenges, severe anxiety or other barriers to treatment.

Extra benefits for at-risk conditions

Many Delta Dental member companies offer additional cleanings for members with qualifying, coexisting health conditions. These enhanced benefits are designed to reduce health risks and improve outcomes.

  • Diabetes: Gum disease can worsen diabetes. More frequent cleanings help control blood sugar.
  • Pregnancy: Dental care supports a healthy pregnancy and may reduce risks including low birth weight.
  • Heart health: Good oral hygiene lowers the risk of infective endocarditis, a serious heart infection.
  • Weakened immunity: Conditions like cancer, HIV or organ transplants increase infection risk—extra cleanings help protect your health.
  • Radiation therapy: Head and neck radiation raises cavity risk. Dental visits before treatment are recommended.

You may also qualify for enhanced coverage if you’re undergoing:

  • Renal failure or dialysis
  • Chemotherapy or immunosuppressive treatment

To activate these benefits, talk to your dentist and ensure your condition is documented.