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Florida Healthy Kids Corporation
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Plan Overview

The Healthy Kids Corporation has been providing affordable healthcare coverage to uninsured children in Florida since 1990. MCNA is a Florida Corporation providing exceptional dental services to its members since 1992. MCNA has been chosen by Healthy Kids to provide comprehensive dental care services to children statewide.

This section provides the information you will need to understand your child's dental benefit plan. Under this dental plan your child can visit any dentist under the primary dentist listing, just call to make an appointment! It is that simple.

MCNA is proud of its commitment to ensure superior dental care. We follow state and federal guidelines for quality management to ensure quality dental care and give you the confidence that your child is in good hands.

Please, feel free to call our Member Services Department at our toll free number, 1-855-858-MCNA (1-855-858-6262), for further information or any question you may have.

We are excited to be offering this fantastic program and we hope you will work closely with us to assure your child's dental health.

General Information

What is Healthy Kids Corporation?

The Healthy Kids Corporation is a not for profit corporation that has been helping the children of Florida since 1990. They have been able to provide easy to afford healthcare to otherwise uninsured children. In their constant effort to improve the lives of the children they serve, they are now providing dental health care coverage throughout the state. Managed Care of North America, Inc. (MCNA) is honored to be chosen to provide this service for your children.

Who can be a member?

All children can be members of The Healthy Kids program if they are:

  • Not covered by another healthcare provider or insurance;
  • Not eligible to receive Medicaid, Medicare or Children's Medical Services benefits; and
  • 5 to 18 years of age

How do I make my child a member?

It is simply a phone call away. In order to make your child a Healthy Kids member you must enroll them during an open enrollment period. To find out more call Healthy Kids toll free at 1-888-FLA-KIDS (1-888-352-5437).

Identification Card

When you sign up for our Healthy Kids program, we will send you a full welcome package which will include your new identification card(s). Please remove your child's ID card and keep it with you always. Remember you need to bring it to each dental visit. If you accidentally lose this card or if you see the information on the card is not correct, please contact us immediately at MCNA Member Services Department's toll free number 1-855-858-MCNA (1-855-858-6262) so that we can send you a replacement card immediately.

What are my rights as a member of this program?

You and your child have a right to:

  • Be treated with respect and kindness while protecting you and your child's privacy and dignity.
  • Be given the opportunity to obtain dental services regardless of race, nationality, religion or physical handicap.
  • Receive information about your child's dental health plan.
  • Know what services are available to you as members of this plan and to be helped quickly and courteously.
  • Know who your child's participating dentist is and to feel confident that you may change that dentist if you need to.
  • Given information by your child's participating Dentist about your child's diagnosis, planned care, possible alternative care, any risks and the expected outcome.
  • Refuse treatment and to ask your child's participating dentist what can happen if you choose to refuse treatment.
  • Contribute in making decisions along with the participating dentist about your child's dental care needs.
  • Criticize or file a complaint (grievance) about MCNA or the dental service your child received from the participating Dentist.

What are my responsibilities as a member of this program?

You and your child have the responsibility to:

  • Have your child's Membership ID card with you at all dental visits and to show it prior to service.
  • Be respectful of the participating Dentist and their staff.
  • Be respectful of the rights of other patients.
  • Follow the office rules and regulations about patient care and conduct of your child's participating dentist.
  • Provide the participating Dentist and their office with true and complete information necessary to give your child proper care.
  • Keep all appointments and arrive on time.
  • Contact the participating Dentist's office as soon as you know you are unable to make the appointment.
  • Pay any fees associated with missed appointments and services that are otherwise not covered by your child's dental plan.
  • Obtain services from only participating member general dentists and/or specialists with the exception of dental emergencies when outside of the service area.
  • Follow the plan of treatment for dental care agreed upon by you and the participating Dentist and/or dental staff.

How does the program work?

Getting started is simple!

  • Open your MCNA Network Listing and choose a Participating Dentist nearest you or one that you know.
  • Next, call the dentist office and tell them your child is a member of MCNA and the Healthy Kids Dental Plan.
  • Ask the office if they are participating with MCNA.
  • If they are participating, let them know you would like to make an appointment. Please remember, your child can only be seen by a Participating Dentist.
  • When you arrive at the appointment, you will show the office staff the MCNA ID card.
  • If you have any questions you may call our MCNA Member Hotline toll free at 1-855-858-MCNA (1-855-858-6262) Monday through Friday 8:00 a.m. - 8:00 p.m. eastern standard time.

How can I cancel the appointment?

If you need to cancel your child's dental appointment, please contact the Dentist at least 24-hours before the scheduled appointment. At that time you can try to reschedule or call again to reschedule.

Dental Benefits

  • Children - Covered services include exams, x-rays, cleanings, fluoride, fillings, extractions, and other services.

Below is a detailed list of covered services:

Preventive Services

  • Covered services include: office visits for oral prophylaxis (protective treatment for disease), topical fluoride (gel that prevents tooth decay) application, oral hygiene education, sealants and space maintainers.
  • What this means: Oral prophylaxis to remove coronal plaque (bacteria on teeth), calculus and stains and includes scaling and polishing procedures. Topical Fluoride application is the placement of fluoride gel or liquid to a tooth. Sealants are applications to pits and fissures (cracks) of permanent teeth. Space maintainers for needed maintenance of a posterior space for a permanent incoming tooth to a prematurely lost milk tooth.
  • Limitations: Limited to one Oral Prophylaxis every six months. The application of fluoride to a tooth is limited to once every 6 months and its application to a tooth before a restoration is not covered by this plan. Space maintainers are limited to fixed appliances, must be passive in nature and where the space must be maintained for at least six months.

Oral Examinations

  • Covered services include: office visits for a complete visual diagnosis of mouth, teeth and support structures.
  • What this means: this exam includes: recording the exam on paper, determining if there are cavities, pulp testing when indicated (this is referring to the blood vessels inside teeth), review of x-ray, written treatment plan. A limited oral examination for a specific problem is also covered here on an temporary basis to relieve pain or suffering.
  • Limitations: After the first examination, this service is limited to once every six month basis.

Analgesia

  • Covered services include: the administration of a drug or agent to temporarily stop the feeling of pain in the conscious child.
  • What this means: this is easily explained in the covered services.
  • Limitations: Limited to enrollees who have a severe physical or mental disability or are difficult to manage. Service is limited to three times a year (Twelve month period).

Injectable Medications

  • Covered services include: The injection of medicine by a Dentist in the treatment of an illness or disease.
  • What this means: this is easily explained in the covered services.
  • Limitations: None at this time.

Sedation

  • Covered services include: the intravenous and non-intravenous administration of drugs or agents.
  • What this means: this is easily explained in the covered services.
  • Limitations: Non-intravenous sedation is limited to three times every 366 days.

Oral Surgery Services

  • Covered services include: extractions, biopsies, surgical and adjunctive treatment of diseases, injuries, deformities, and defects of the oral and maxillofacial (of or relating to the upper jaw and face) areas.
  • What this means: coverage includes local anesthesia and routine post-operative care.
  • Limitations: NO BENEFIT IS PROVIDED FOR THE EXTRACTION OF NON-INFECTED PRIMARY TEETH WHEN NORMAL LOSS IS IMMINENT, THE EXTRACTION OF ASYMPTOMATIC TEETH WHICH SHOW NO SIGNS OF INFECTION, INCLUDING BUT NOT LIMITED TO THE REMOVAL OF THIRD MOLARS.

Palliative Treatment

  • Covered services include: services necessary to relieve pain and discomfort on an emergency basis.
  • What this means: explained in the covered services.
  • Limitations: Limited to those instances where circumstances contraindicate (the method of treatment is contrary to) more definitive treatment or services.

Endodontic Services

  • Covered services include: office visits and treatment for pulp capping, therapeutic pulpotomies (the removal of the top portion of the blood vessels in the tooth), root canal therapy, apexification and apicoectomies.
  • What this means: Root canal therapy on primary teeth with succedaneous teeth must include the placement of a resorbable filling. Apexification is the clinical treatment involving the necrosis of the pulp of incompletely formed deciduous and permanent teeth subsequent to trauma or dental caries (cavity). Apicoectomy is a surgery involving the root's surface.
  • Limitations: Root canal therapy is limited to those situations where the teeth have a restorable crown; the prognosis of the tooth is not questionable and the exfoliation of the deciduous tooth is not anticipated within eighteen months. Apiceoctomy therapy is reimbursed only if one or more of the following conditions exist:
    • overfilled canal or canal cannot be filled due to excess root curvature;
    • fractured root tip is not reachable;
    • broken instrument in canal;
    • perforation of the root in the apical one-third of canal;
    • root canal filling material lying free in periapical tissues and acting as irritants;
    • root canal therapy is a failure; or
    • periapical pathology not resolved by root canal therapy.

Periodontal Services

  • Covered services include: gingivectomy, gingival curettage (gum scraping to remove bacteria), gingival flap procedure, scaling and root planing. Services also include any necessary postoperative care.
  • What this means: Gingival curettage is the surgical procedure of debriding (or surgical excision of dead, devitalized, or contaminated tissue and removal of foreign matter from a wound) the soft tissue wall of the periodontal pocket by curettage. This service is performed under local anesthesia in conjunction with root instrumentation. Gingival flap procedure is the surgical debridement of the root surface and the removal of granulation tissue following removal of the soft tissue flap and include root planing involves instrumentation of the crown and root surfaces of the teeth to remove plaque (bacteria on teeth), calculus and stains.
  • Limitations: None at this time.

Restorative Services

  • Covered services include: those necessary to eliminate carious (cavity, decay) or post eliminate carious (cavity, decay) or post traumatic lesions from teeth and to restore the anatomic shape, function and look of teeth.
  • What this means: Services include the following:
    • amalgam restorations (silver fillings);
    • resin restorations, including composite and glassionomers (white fillings);
    • prefabricated stainless steel crowns for both deciduous and permanent teeth; and
    • specified crown types.
  • Limitations: Services are limited to:
    • Essential services necessary to restore and maintain dental health;
    • One restoration per tooth surface except for the occlusal (wear) surface of permanent maxillary 1st and 2nd molars;
    • One restoration for a mesial (tooth situated toward the middle of the front of the jaw along the curve of the dental arch) or distal (that which is situated farthest from the middle and front of the jaw, as a tooth or tooth surface) lesion; and
    • One posterior one-surface resin restoration every three years per tooth number/letter surface.
  • Exclusions:
    • Restorations placed for cosmetic reasons are not covered.
    • Restoration is not covered on primary teeth if loss is expected within six months.
    • Sealants (a plastic protective coating for healthy teeth) applied in conjunction with preventive resin are not covered.
    • Crown provided solely for cosmetic reasons are not covered.
    • Fixed bridges or fixed partial dentures are not covered.

Consultation Services

  • Covered services include: examination of your child's oral health, evaluation of condition, recommendation of treatment, documentation in child's dental records and a written report to the requesting doctor.
  • What this means: the consult must be given by a licensed dental specialist whose recommendations for treating the specific problem are requested by another dentist.
  • Limitations: None at this time.

Orthodontic Services

  • Covered services include: fixed appliance therapy and monthly maintenance visits.
  • What this means: this service must be given a trained orthodontist or pediatric dentist.
  • Limitations: to those circumstances where the child's condition is such that they have an impairment to their physical development. Monthly visits are for a maximum of 24 visits. Limited or interceptive treatment is not covered. This service can not be covered for cosmetic purposes or split phase treatment; the only exception is for cleft palate.

Hospitalization for Dental Treatment

  • Limitations: Only if the procedures can not be safely performed in the dental office for fear of endangering the child and/or the child's emotional instability, developmental disability, or ineffective sedation where hospitalization for treatment is necessary.

Radiographic Examination (x-rays)

  • Covered services include: intraoral, extraoral and panoramic radiographs necessary to make a diagnosis of dental disease or trauma.
  • What this means: this service must determine if the child has cavities, retained roots and unerupted teeth, foreign bodies or root and other disease.
  • Limitations: to radiographs of intraoral, periapical, bitewing, occlusal and panoramic radiographs needed to make a diagnosis and to develop a plan of treatment. A complete set of intraoral radiographs is once in a three year period. Bitewing are limited to once in a six month period and a panoramic is once per year.

Removable Prosthodontics

  • Covered services include: the making, fixing, relining and adjusting of an appliance for the replacement of extracted teeth under the direction of a dentist. What this means: all dentures, if seated immediately after extractions or after a gum/jaw healing, must work properly.
  • Limitations: complete dentures may be provided once for upper and once for lower or a complete set only once per lifetime of the child. There may be an exception if the piece is no longer working properly because of the child's physical condition or the condition of the denture. Partial dentures are not covered if the child has at least eight posterior teeth in occlusion (the alignment of the teeth of the upper and lower jaws when brought together).

What is the difference between a General Dentist and a Specialist?

There may be a time when your child may require the help of a specialist who specializes in root canals or extractions. These specialists simply have more training in specific areas of dental health and are able to better assist their patients when it is necessary. Examples of specialists include: Periodontists who focus on the health of gums or an Orthodontist who specializes in braces. However, most of your child's work will be performed by the General Dentist.

What if my child needs a specialist?

If your child's participating General Dentist believes your child needs to be seen by a specialist, they will send a referral form to MCNA for evaluation. MCNA will provide the name of the specialist through a mailed referral to your home. MCNA has agreements with dental specialists in all the fields of dentistry in order to provide your child with the service they may need. You will then contact the specialist and make an appointment for your child. Remember to bring the referral and your child's Member ID with you to the appointment.

If your child has a dental emergency they are covered at participating General Dentists. Simply call your child's doctor and they will assist you. If you are traveling and are more than 50 miles from a participating dentist, you can visit a licensed Dentist near you. Your child can receive treatment to relieve pain and discomfort from this licensed dentist and you will be reimbursed for any covered dental service. To receive reimbursement, please send the information listed within 12 months of receiving the service. (Please remember to keep a copy for your records).

What if my child has a dental emergency?

Please mail the following information to MCNA:

  • The Member's Name, ID Number, address and telephone number.
  • The original paid receipt.
  • The Dentist's name, address and telephone number.
  • Any documentation that might be helpful concerning the dental emergency.

Mailing Address:

MCNA Dental Plans
Attn: Claims Department
200 West Cypress Creek Road, Suite 500
Ft. Lauderdale, FL 33309

What if I have a problem?

We urge you to communicate with your child's Participating Dentist. If you can not resolve your concern with the dentist, please feel free to contact our MCNA Member Services Department toll free at 1-855-858-MCNA (1-855-858-6262). Our Department will document your concern and our Member Services Representative will do their best to work through the problem to your satisfaction.

If the representative cannot resolve the matter, you are free to file a formal complaint by mail to:

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

Please be aware a grievance must be filed within 12 months of said incident. The committee will respond within a sixty days of receipt of the complaint with a decision. All committee decisions are final. Please be aware that you also have the right to submit a grievance to the Department of Insurance. You can do so in writing to:

Department of Insurance
200 Gaines Street, Rm. 124, Larson Bldg.
Tallahassee, FL 32399
Phone: 1-850-922-3137

Remember we are here to help you. Simply call our MCNA Member Hotline toll free at 1-855-858-MCNA (1-855-858-6262) Monday through Friday 8:00 a.m. - 8:00 p.m. eastern standard time.

How can I contact MCNA?

MCNA Member Services Representatives are well trained in dental terminology and understand how your plan works. We also have Spanish speaking representatives for your convenience. Simply call our MCNA Member Hotline toll free at 1-855-858-MCNA (1-855-858-6262) Monday through Friday 8 a.m. - 8 p.m. eastern standard time.

How can I get help if I don't speak English?

Please call us to ask for help. You can call the MCNA Member Hotline toll-free at 1-855-858-6262 (TTY toll-free: 1-800-955-8771). Our Member Hotline is open from 8 a.m. to 8 p.m., Eastern Time, Monday through Friday. MCNA has staff that speaks English, Spanish, and Creole. We can also help you in other languages.

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

Plan Type: CHIP
Age Range: 5-18
States Served: Florida
Member Services: 1-855-858-6262
Find a Dentist Near You
Print Your ID Card
Documents and Downloads
Member Handbook (English)
Manual del Miembro (Español)
Provider Directory (Region 1)
Provider Directory (Region 2)
Provider Directory (Region 3)
Provider Directory (Region 4)
Provider Directory (Region 5)
Provider Directory (Region 6)
Provider Directory (Region 7)
Provider Directory (Region 8)
Provider Directory (Region 9)
Provider Directory (Region 10)
Provider Directory (Region 11)
For more information about Florida Healthy Kids Corporation, visit: https://www.healthykids.org/