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Members2023-08-23T07:17:05+00:00
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Dental Benefits to Cover Your Needs

MCNA is a dental plan for the Texas Health and Human Services Commission (HHSC) Medicaid and CHIP programs for the entire state of Texas.

Texas Medicaid and CHIP provide dental and medical benefits for more than 4 million Texans. These programs help people with little or no money get dental and health benefits that they may not be able to get otherwise. As a managed care dental plan under contract with HHSC, MCNA covers services needed to keep teeth and gums healthy for good oral health for life. We work to make sure our members have access to preventive care, oral health education, and dentists close to where they live.

MCNA has a large network of General Dentists and Specialists across Texas to make sure you receive the high quality dental care you need. Your Texas Medicaid and CHIP dental coverage with MCNA includes great benefits, such as:

…and more preventive, diagnostic, and therapeutic benefits to ensure healthy teeth and a beautiful smile!

Dental Benefits to Cover Your Needs

MCNA has a large network of General Dentists and Specialists across Texas to make sure you receive the high quality dental care you need. Your Texas Medicaid and CHIP dental coverage with MCNA includes great benefits, such as:

…and more preventive, diagnostic, and therapeutic benefits to ensure healthy teeth and a beautiful smile!

Enjoy a gift card from us!

MCNA rewards our members who take care of their oral health!

Parents or guardians of our Texas Medicaid and CHIP members can earn a $20 Amazon.com Gift Card* per child! Members aged 18 and older can also earn this reward. To learn more, call MCNA toll-free at 1-855-691-6262.

* Restrictions Apply

Enjoy a gift card from us!

MCNA rewards our members who take care of their oral health!

Parents or guardians of our Texas Medicaid and CHIP members can earn a $20 Amazon.com Gift Card* per child! Members aged 18 and older can also earn this reward. To learn more, call MCNA toll-free at 1-855-691-6262.

* Restrictions Apply

Even More to Smile About!

We offer extra benefits to all of our members to promote good oral health. You can get these FREE benefits in addition to your standard dental benefits and Amazon.com Gift Card!

Become a Member of MCNA Dental

If you live in Texas, your children may qualify for Medicaid or CHIP dental care! To join, call the Enrollment Broker. Tell them you choose MCNA Dental for your dental services. You will automatically have access to great dental care and receive an Amazon.com Gift Card.

You can reach the Enrollment Broker at 1-800-964-2777.

Please call our dedicated Texas Member Hotline at 1-855-691-6262 if you have any questions.

Member Resources and Documents

Frequently Asked Questions

Who is MCNA?2020-02-11T11:32:21+00:00

MCNA is the largest dental insurer in the nation for state-sponsored Medicaid and CHIP programs. We have been in business for over 25 years, and over 5 million members trust their smile to MCNA. We are proud to provide the dental benefits for children and adults in the Texas Medicaid and CHIP program.

How do I become a member with MCNA?2022-09-01T07:29:26+00:00

Becoming a member of MCNA gets you access to great dental care and an Amazon.com Gift Card. You can learn more about how to join in the Become a Member of MCNA Dental section.

What are my dental benefits with MCNA Dental?2020-02-11T11:36:28+00:00

We offer dental benefits to cover most everyone’s dental needs.

  • Preventive and diagnostic benefits, including dental cleanings, exams, x-rays, fluoride, sealants, and more.
  • Therapeutic benefits to treat cavities, gum or tooth pain, or other dental problems including fillings, extractions, root canals, dental emergencies, and more.

You can find more information about benefits in your Member Handbook.

Does MCNA offer any extra benefits?2022-09-01T07:30:21+00:00

Yes! You can read more about our Amazon.com Gift Card and other Value-Added Services we offer our members.

How much do I have to pay for dental services?2020-03-03T09:52:40+00:00

Members in the Medicaid program do not have to pay for covered dental services.

If you are a member in the CHIP program you might have to pay a copayment for certain covered services. This includes non-preventive services. You do not have to pay a copayment for things like exams, x-rays, cleanings, and sealants. If your child gets dental services before dental coverage with CHIP starts, you will have to pay for them.

CHIP copayments vary based on your family’s income. The total amount that you have to pay cannot be more than 5% of your family’s income during one enrollment period. Your copayment amount is on the back of your child’s MCNA member ID card. You can view a list of CHIP Office Visit Copayments according to a family’s federal poverty level.

What is a Main Dental Home Provider?2020-02-11T11:37:31+00:00

A Main Dental Home Provider can be a general dentist or a pediatric dentist who will oversee all dental care. We call this your Main Dentist. Your MCNA Dental ID card includes the name of your Main Dentist and their phone number. Please call the Main Dentist to schedule a dental visit. A child can start seeing a Main Dentist as early as 6 months of age.

How do I locate an MCNA dentist near me?2020-05-06T13:41:52+00:00

Find a dentist using our online Medicaid Provider Directory or CHIP Provider Directory.

How do I get my Member Handbook?2020-03-25T10:23:42+00:00

You will get your Member Handbook in the mail when you join MCNA Dental. You can download your Member Handbook in English and Spanish. To download your Member Handbook, click the links in the Member Resources and Documents section.

If you need another hard copy of your Member Handbook, call the MCNA Dental Member Hotline at 1-855-691-6262. We will send it to you free of charge within 5 business days. You can also call our Member Hotline to request a different version of your Member Handbook.

Can I get my member materials in another language or format?2020-02-12T08:17:49+00:00

Yes! Materials you receive are available in English and Spanish. Braille and large-print versions are also available for visually impaired members. Call our Member Hotline at 1-855-691-6262 for more information.

How do I replace a lost or stolen member ID card?2020-02-12T08:25:46+00:00

If you lose your member ID card, please call our Member Hotline at 1-855-691-6262 to ask for a new one.

What are my member rights and responsibilities with MCNA Dental?2020-02-12T09:34:00+00:00

View the Member Rights and Responsibilities page for more information. You can also find a full list of your member rights and responsibilities in your Member Handbook.

Where can I learn about MCNA’s Notice of Privacy Practices?2020-02-11T11:39:10+00:00

You can learn about MCNA’s Privacy Policy on our corporate website.

What is a Member Advocate?2020-02-12T09:35:59+00:00

An MCNA Member Advocate can help you get the dental care you need. Our Member Advocates will:

  • Tell you about your rights and responsibilities
  • Tell you about the MCNA Complaint and Appeals processes
  • Assist you in writing and filing a complaint or an appeal, and keep track of it until the issue is resolved
  • Tell you about your dental benefits and help you get dental care
  • Assist you in finding resources in your community to help meet your needs

View our Member Advocate Flyer to learn more. Call MCNA’s Member Hotline at 1-855-691-6262 to speak with a Member Advocate and see how they can help you.

What should I do if I have a complaint/grievance or appeal?2020-03-03T14:33:40+00:00

We want to help. If you have a complaint/grievance or appeal, please contact our Member Hotline at 1-855-691-6262. A Member Advocate will help you. When you call we will explain what happens during the complaint/grievance or appeal process and tell you how to write your complaint/grievance or appeal and send it to us. We will also send you any forms you may need to complete your appeal.

If you call to ask for an appeal, you must also write out and sign your appeal and send it to MCNA.

You can send your written complaint/grievance or appeal to:

MCNA Dental
Attn: Member Advocate
4400 NW Loop 410, Suite 250
San Antonio, TX 78229

If you are a Medicaid member, view our Medicaid Complaints and Appeals page.

If you are a CHIP member, view our CHIP Complaints and Appeals page.

How do I request a State Fair Hearing?2020-03-03T15:08:57+00:00

You have the right to ask for a State Fair Hearing. You must first exhaust MCNA’s appeal process. In a State Fair Hearing, you may name someone to represent you (such as a doctor or other medical provider). You must ask for a State Fair Hearing within 120 days of the date on the original decision letter from MCNA. To make a request, you may write a letter that includes the name of your representative and send it to:

MCNA Dental
Attention: Member Advocate
4400 NW Loop 410, Suite 250
San Antonio, TX 78229

You can also ask for a State Fair Hearing by calling MCNA toll-free at 1-855-691-6262. Call this number at any time to ask questions or check the status of a State Fair Hearing. If you call to ask for a State Fair Hearing, you must also write out your request, sign it, and send it to MCNA.

Once you ask for the State Fair Hearing, you will get a packet of information letting you know the date, time and location of the hearing. Most State Fair Hearings are held by telephone. The Texas Health and Human Services Commission will give you a final decision within 90 days from the hearing.

How do I ask for an External Medical Review?2022-05-01T07:07:02+00:00

If you, as a member of the dental plan, disagree with MCNA’s internal appeal decision, you have the right to ask for External Medical Review with a State Fair Hearing. An External Medical Review is an optional, extra step you can take to get your case reviewed for free before your State Fair Hearing. You, your parent, your authorized representative, or your legally authorized representative (LAR) must ask for the External Medical Review within 120 days of the date MCNA mails the letter with the decision. If you do not ask for the External Medical Review within 120 days, you may lose your right to an External Medical Review.

You, your parent, your representative, or your LAR can ask for an External Medical Review in these ways:

  1. Call MCNA at 1-855-691-6262.
  2. Email MCNA at ga@mcna.net.
  3. Fill out the ‘State Fair Hearing and External Medical Review Request Form’ that came with the internal appeal decision letter from MCNA. You can also download a copy. Mail or fax it to MCNA:

    MCNA Dental
    200 West Cypress Creek Road, Suite 500
    Fort Lauderdale, FL 33309

    Fax: 1-954-628-3330

If you have questions about the External Medical Review Process or want to check on the status of an External Medical Review request we can help. Call MCNA toll-free at 1-855-691-6262, Monday – Friday, 7 a.m. – 7 p.m. CST. You can also learn more about the External Medical Review Process in MCNA’s Medicaid Member Handbook.

What is Medicaid fraud in the State of Texas?2020-02-11T11:40:32+00:00

The Health and Human Services Commission (HHSC) and MCNA Dental want to help you learn more about Medicaid fraud. Choose one of the links below to read the special Medicaid Fraud Notice from the HHSC.

How do I report Waste, Abuse, or Fraud?2020-02-12T09:32:33+00:00

Call the OIG Hotline at 1-800-436-6184 or visit https://oig.hhsc.texas.gov/report-fraud. You can report directly to MCNA:

MCNA Dental
Attn: Special Investigations Unit
4400 NW Loop 410, Suite 250
San Antonio, TX 78229

You can also call MCNA’s toll-free Fraud Hotline at 1-855-392-6262. You can find more information about Waste, Abuse, and Fraud in your Member Handbook.

Where can I learn more about good oral health?2020-02-11T11:40:44+00:00

You can learn more about good oral health online at MCNA’s Kids Zone. We offer colorful children’s activities to help you learn in a fun way.

You can also follow MCNA on Facebook, Twitter, and YouTube for frequent oral health education tips and information.

Where can I read about financial literacy?2020-02-11T11:41:09+00:00
Where can I read about health literacy?2020-02-13T09:19:35+00:00
How do I join CHIP, STAR, and STAR Kids?2020-03-04T09:11:24+00:00

Call the Enrollment Broker helpline to find out more about the CHIP, STAR, and STAR Kids programs.

  • For CHIP and STAR, call 1-800-964-2777 (TTY: 1-800-735-2989).
  • For STAR Kids, call 1-877-782-6440 (TTY: 1-800-735-2989).

You can call Monday to Friday, from 8 a.m. to 6 p.m. Central Time. The helpline staff will tell you what you need to do to join or change your plan.

What is prior authorization?2020-08-07T09:25:50+00:00

Prior authorization is a decision by your dental or health insurer or plan before you receive it that a health care service, treatment plan, prescription drug, or durable medical equipment is medically necessary. This process is sometimes also called pre-authorization, prior approval, or pre-certification. Prior authorization isn’t a promise your dental or health insurance or plan will cover the cost.

MCNA’s Pre-Authorization and Claims Submission Guide for Texas providers explains all that your dentist needs to know about dental benefits that need prior authorization. You may contact the Member Hotline at 1-855-691-6262 to ask about the status of prior authorization requests. We can also help you learn more about the prior authorization process.

Latest Member News

Update Your Contact Info with Texas Medicaid

Texas Medicaid renewals are coming back. Make sure the Texas Health and Human Services Commission (HHSC) can reach you. HHSC may need to send you a notice that your renewal is due or ask you for information.

Be sure to update your contact information through a Your Texas Benefits online account. It’s easy! Create a Your Texas Benefits account or download the Your Texas Benefits mobile app to view your account information, update your contact information and respond to requests from HHSC. Go to YourTexasBenefits.com to get started.

MCNA’s Member Portal

MCNA’s Member Portal is a fast and easy way to check your dental claims history. We welcome you to sign up and create your Member Portal account today!

Create Account

Already have an account? Log in instead.

MCNA’s Member Portal

MCNA’s Member Portal is a fast and easy way to check your dental claims history. We welcome you to sign up and create your Member Portal account today!

Create Account

Already have an account? Log in instead.

Find a Dentist Near You

MCNA has a large network of general and specialty dentists throughout Texas. You can choose a dentist from MCNA’s online Provider Directory. The directory is always current.

View Provider Directory

Please call our Member Hotline at 1-855-691-6262 if you need help to find a dentist.

MCNA’s Kids Zone includes interactive dental games, quizzes, downloads, videos, and more!

Visit MCNA’s Kids Zone

Follow Us on the Web!

MCNA has profiles on Facebook, TwitterYouTube, and Instagram!
Stay connected with our latest news and events, oral health tips, videos, and more when you follow us.

Latest YouTube Videos

“The Smile Squad, Episode 1: ‘Plight of Plaque!'”

Plaque is back! He and his candy henchmen are causing trouble in Mouthtropolis. Watch MCNA’s Smile Squad take them down and save the day from disease and decay!

“Tooth Trivia”

Toby the Dental “X-Pert” joins his friends Emma and Zach to play Tooth Trivia and to learn some cool dental tips!

“Emma’s First Dental Visit”

Toby the Dental “X-Pert” explains what children can expect on their first visit to the dentist!

“Effects of Sugar”

Toby the Dental “X-Pert” researches cavities and effects sugar can have on your teeth. Watch for some tips to keep those cavities away!

“Because I Said So!”

Have you ever asked your mom or dad why you have to brush your teeth and they said “Because I Said So”?! Here are 5 really good reasons why it is important to brush your teeth!

We Care About Your Smile and Are Here to Help You!

If you have any questions, please call our toll-free Texas Member Hotline at:

1-855-691-6262

You can call Monday through Friday, 7 a.m. – 7 p.m. (excluding national holidays). If you call after our regular business hours, you can leave a message on our secure voice mailbox. We will return your call the next business day.
MCNA has staff that speaks English and Spanish. We can also assist you in other languages.
For hearing impaired members, our TTY line is available at 1-800-735-2989.

External Medical Review

You can ask for an External Medical Review with a State Fair Hearing.
An External Medical Review is an optional, extra step you can take to get your case reviewed for free before your State Fair Hearing.
Call MCNA’s Member Hotline at the number listed above to make your request.

Interpreter Services Are Available

If you need interpreter services when you go to the dentist, we can help.
Our Member Hotline staff will arrange interpreter services for you at no cost.
Please call us as soon as you have made an appointment with your dentist if you need these services.