Maine Oral Health Program - Information for Providers

MaineCare Policy for Fluoride Varnish Application

  • MaineCare’s dental policy covers fluoride varnish application by dental providers. In September 2008, MaineCare began covering the application of fluoride topical varnish in physician offices.
  • 10-144 Chapter 101 MaineCare Benefits Manual Chapter II External site disclaimer Section 90 (page 19)
  • 90.04-31 Topical Fluoride Varnish Eff. 10/1/08 Therapeutic application of topical fluoride varnish is covered for members under the age of twenty-one (21) with moderate to high caries risk. MaineCare will cover application two (2) times per calendar year. For members with high caries rates or new restoration within eighteen (18) months, as are documented in the member’s record, MaineCare will cover up to three (3) applications per calendar year. Coverage is allowable for physicians with subspecialties of general or family practice, preventative medicine, pediatric, or internal medicine.