Reducing barriers to care

The leading unmet health care need for the millions of U.S. children and adults with special health care needs is adequate dental care. Effective January 1, 2024, Delta Dental of New Jersey and Connecticut will help break down barriers to care by providing eligible covered members with an enhanced benefit.

What are special health care needs?

As defined by the American Academy of Pediatric Dentistry, special health care needs include any physical, developmental, mental, sensory, behavioral, cognitive, or emotional impairment or limiting condition that requires medical management, health care intervention, and/or use of specialized services or programs. The condition may impact people of any age, may be congenital, developmental, or acquired through disease, trauma or environmental cause, and may impose limitations in performing daily self-maintenance activities or substantial limitations in a major life activity.

What is included in this benefit? 

• Additional dental examinations and/or consultations that can be beneficial prior to treatment to help patients learn what to expect and what is needed for a successful dental appointment.
• Up to four total dental cleanings in a benefit year.
• Treatment delivery modifications (including anesthesia) necessary for dental staff to provide oral health care for patients with sensory sensitivities, behavioral challenges, severe anxiety, or other barriers to treatment.