Colorado Medicaid dental update center

July 1, 2026: standard adult dental limit changed to $3,000

DentaQuest's revised adult summary and member notice establish a $3,000 benefit maximum for standard Health First Colorado adults age 21 and older for each July 1–June 30 benefit year. Qualifying emergency treatment and covered removable full or partial dentures are excluded from the dollar maximum. Other service rules, including clinical criteria, frequency, network participation, documentation, and prior authorization, still apply.

This replaced the no-annual-limit adult policy that began July 1, 2023. An older HCPF dental web page still displayed the prior rule when this guide was checked. We therefore use the dated July 2026 DentaQuest documents for current adult care and call out the conflict rather than silently blending the two statements.

July 1, 2026: Cover All Coloradans child dental rules changed

Current official materials state that children ages 0–18 enrolled through Cover All Coloradans have a $1,100 annual dental limit beginning July 1, 2026. Orthodontics is not covered for CAC children. Enrolled pregnant and postpartum CAC members do not have that $1,100 cap.

Those rules should not be copied to standard Health First Colorado children ages 0–20, who have no annual dental dollar maximum and receive EPSDT protections. Program identity matters before age-based rules are applied.

July 1, 2026: Denver-metro ride broker changed

Health First Colorado's current non-emergency medical transportation page places Denver and nearby metro counties in MediDrive's service area. Members who lack transportation may qualify for a ride to covered care, including dental appointments. The current number is 855-489-4999 (TTY 711), and routine trips generally should be requested at least two business days ahead.

NEMT is not guaranteed for every member or trip and is not emergency transportation. Wheelchair-accessible vehicles and mileage reimbursement can be available under program rules and advance approval. Call 911 for an emergency.

Known source conflicts and how this guide resolves them

• Adult limit: use the revised July 2026 DentaQuest member summary and change notice, not older HCPF copy saying adults have no limit.
• DentaQuest phone: current state materials, the handbook, and current benefit summaries consistently list 855-225-1729. One plan landing page has displayed an inconsistent digit sequence, so use 855-225-1729 or the number on the current member card or summary.
• HCBS supplemental dental: eligible DD/SLS waiver members may have additional benefits, but a linked older DentaQuest summary can repeat obsolete underlying adult-limit language. Confirm current supplemental and base benefits separately with DentaQuest and the case manager.
• Directory status: provider-search entries can be self-reported or lag operational changes. Call the exact office about network participation, age, service, and appointment availability.

How members and offices can stay current

1. 1

   Use dated official documents

   Prefer the current DentaQuest member summary, member notice, handbook, or HCPF program page that states an effective date.

2. 2

   Check the member's real record

   General policy cannot show active eligibility, benefit usage, service history, pending claims, or an individual authorization.

3. 3

   Recheck near care

   Verify the exact provider, location, date, service, program, and other insurance shortly before treatment.

4. 4

   Save the decision notice

   A written authorization, denial, or claim explanation documents the plan's case-specific action and available review path.

5. 5

   Report a possible guide error

   Use the editorial policy's correction contact and include the page, statement, and official source without sending private member information.