A woman with a beautiful smile is shown enrolling in HMSA's Oral Health for Total Health program
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If you’ve been diagnosed with a qualifying medical condition and need to enroll in Oral Health for Total Health, simply fill out the form below. If you have HMSA medical and dental plans, we may have already enrolled you. 

Qualifying medical conditions include COPDcoronary artery diseasediabetes, end-stage renal disease, metabolic syndrome, oral cancer,  pregnancySjögren’s syndrome, and stroke.

You may also print and mail a paper form to enroll.