Michigan Straight Medicaid Dental Coverage


Does Medicaid Cover Dental Services In Michigan

Impact of Medicaid expansion coverage on health and work lives of low-income Michigan residents

Original Medicare Part A and Part B benefits do not provide coverage for routine dental care, so many recipients need to find solutions to help pay for dental services like checkups, X-rays, and teeth cleanings. Many recipients enroll in a separate insurance policy in order to get those benefits. Medicare recipients in Michigan who qualify may be able to enroll in both Medicare and Medicaid, or a Medicaid-managed program, that provides some dental care benefits.

Medicare-Medicaid Full and Partial Dual Eligibility

Dual eligibility occurs when an individual who receives Medicare also qualifies for Medicaid-related assistance based on low income. Recipients can be classified as full dual-eligibles or partial dual-eligibles. Qualification can affect the benefits and coverage you receive.

Each state has the ability to set the income and asset limits necessary to qualify for assistance, and these limits can change each year. Residents of Michigan should verify the current years limits in order to determine which eligibility category they fall under. Additional factors, such as certain disabilities and marital status, can impact eligibility.

Full dual-eligibility means Medicare recipients receive all Medicaid-related benefits. In most cases, recipients who receive medical services will have their copayments, coinsurance and deductible amounts paid for by their needs-based coverage.

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Eligibility For The Healthy Michigan Plan

If any of these apply to you, you might be eligible for coverage through the Healthy Michigan Plan:

  • 19-64 years old
  • Income at or below 133% of federal poverty level
  • Do not qualify for or are not enrolled in Medicare
  • Do not qualify for or are not enrolled in other Medicaid programs
  • Are not pregnant at the time of application
  • Are a resident of Michigan

The Healthy Michigan Plan no longer requires work requirements. You may need to report work for other programs like food stamps.

Learn more about Healthy Michigan plans here.

N4001-13 Approved MHC01152021

How To Find Dental Service Providers That Accept Michigan Medicaid

There are a couple ways to find a dental service provider that accepts Michigan Medicaid. The easiest one is to give us a call at My Community Dental Centers, . We have twenty-seven locations throughout Michigan, including locations in the Upper Peninsula. All of our locations happily accept Michigan Medicaid, so there is no need to put off getting needed dental care or preventive dental care.

You can also connect with the Delta Dental PPO Network and they will help you find a dentist in your area that accepts Medicaid. We are a proud member of this network as well.

When you have questions about Medicaid and your oral health, give us a call at MCDC. We know that navigating the Medicaid system can be difficult and overwhelming, and we are here to help. Our staff of professionals are experts in what Michigan Medicaid will and wont cover and what your out of pocket costs will be, so dont wait. Give us a call right now to find out more.

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Is The Healthy Michigan Plan The Same As Medicaid

The Healthy Michigan Plan is a type of Medicaid coverage. Medicaid is a partnership between federal and state governments. They work together to provide coverage. The federal government gives rules and resources. States run the Medicaid plan. This means Medicaid is different from state to state. Some states like Michigan have expanded Medicaid coverage. This means coverage includes extra benefits.

Unitedhealthcare Senior Care Options Plan

Dental Insurance for Individuals

UnitedHealthcare SCO is a Coordinated Care plan with a Medicare contract and a contract with the Commonwealth of Massachusetts Medicaid program. Enrollment in the plan depends on the plans contract renewal with Medicare. This plan is a voluntary program that is available to anyone 65 and older who qualifies for MassHealth Standard and Original Medicare. If you have MassHealth Standard, but you do not qualify for Original Medicare, you may still be eligible to enroll in our MassHealth Senior Care Option plan and receive all of your MassHealth benefits through our SCO program.

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American Disabilities Act Notice

In accordance with the requirements of the federal Americans with Disabilities Act of 1990 and Section 504 of the Rehabilitation Act of 1973 , UnitedHealthcare Insurance Company provides full and equal access to covered services and does not discriminate against qualified individuals with disabilities on the basis of disability in its services, programs, or activities.

What Does Medicaid And Meridianhealth Plan Of Michigan Consider An Emergency

Michigan Medicaid health insurance through Meridian only has a dental coverage program for those enrolled and under 19 or pregnant For others, there is no plan for Meridian dental care services.

Michigan Medicaid does have benefits that will cover adults through its Healthy Michigan plan. To check eligibility for Healthy Michigan benefits, click here.

However, the Meridian handbook states that they still treat a few emergency dental procedures if you do not meet the criteria.

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Children’s Oral Health Initiative

The Centers for Medicare & Medicaid Services is committed to improving access to dental and oral health services for children enrolled in Medicaid and CHIP. We have been making considerable progress in our efforts to ensure that low-income children have access to oral health care. From 2007 to 2011, almost half of all states achieved at least a ten percentage point increase in the proportion of children enrolled in Medicaid and CHIP that received a preventive dental service during the reporting year. Yet, tooth decay remains one of the most common chronic childhood diseases.

To support continued progress, in 2010 CMS launched the Children’s Oral Health Initiative and set goals for improvement by FFY 2015. To achieve those goals, we have adopted a national oral health strategy through which we are working diligently with states and federal partners, as well as the dental provider community, children’s advocates and other stakeholders to improve children’s access to dental care.

To support state Medicaid and CHIP programs in achieving their improvement goals, we developed Keep Kids Smiling: Promoting Oral Health Through the Medicaid Benefit for Children and Adolescents . It provides an overview of the children’s dental benefit in Medicaid, support for evidence-based policies at the state level, and details of successful strategies with state examples.

Unitedhealthcare Dual Complete Plans

Dentrix Enterprise Customer Success – Michigan Community Dental Clinics

Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Enrollment in the plan depends on the plans contract renewal with Medicare. This plan is available to anyone who has both Medical Assistance from the State and Medicare. This information is not a complete description of benefits. Call TTY 711 for more information. Limitations, co-payments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year.

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Other Ways To Pay For Your Dental Implants

If you cant or dont want to apply for a CDG, there may be another way to fund your dental implants. Acton Implants offers financing options for those who cannot afford to make a lump sum payment at the time of treatment. This option can work for those on a budget who cannot afford to make payment all at once. Give us a call to find out if you qualify for financing.

There are also other grants that you can apply for to get your dental implants covered without having to pay for them yourself.

Oral Health Promotion Goals

Goal #1 – Increase access to school-based Oral Health Disease Prevention Programs for targeted dentally at-risk children in Ottawa County.

Goal #2 – Reduce dental disease for children that are provided dental services on the Miles of Smiles mobile dental unit.

Goal #3 – Provide Ottawa County elementary schools and Head Start Centers with oral health education and resources.

Goal #4 – Increase access to care for at risk- adults in Ottawa County.

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Talk To Acton Implants Today

If youre struggling with tooth loss, Acton Implants will work closely with you to figure out a way that you can get the implants you need even if you cant afford them. Part of our mission is to provide dental implants to everyone and so our costs are lower. Give us a call or talk to us online to set up an appointment.

Unitedhealthcare Connected Benefit Disclaimer

How Do I Find Out Who My Medicaid Provider Is

This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the Member Handbook. Limitations, copays and restrictions may apply. For more information, call UnitedHealthcare Connected® Member Services or read the UnitedHealthcare Connected® Member Handbook. Benefits, List of Covered Drugs, pharmacy and provider networks and/or copayments may change from time to time throughout the year and on January 1 of each year.

You can get this document for free in other formats, such as large print, braille, or audio. Call , TTY 711, 8 a.m. – 8 p.m., local time, Monday – Friday . The call is free.

You can call Member Services and ask us to make a note in our system that you would like materials in Spanish, large print, braille, or audio now and in the future.

Language Line is available for all in-network providers.

Puede obtener este documento de forma gratuita en otros formatos, como letra de imprenta grande, braille o audio. Llame al , TTY 711, de 08:00 a. m. a 08:00 p. m., hora local, de lunes a viernes correo de voz disponible las 24 horas del día,/los 7 días de la semana). La llamada es gratuita.

Puede llamar a Servicios para Miembros y pedirnos que registremos en nuestro sistema que le gustaría recibir documentos en español, en letra de imprenta grande, braille o audio, ahora y en el futuro.

Los servicios Language Line están disponibles para todos los proveedores dentro de la red.

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What Is The Healthy Michigan Plan

The Healthy Michigan Plan is run by the Michigan Department of Health and Human Services . It covers ten essential health benefits:

  • Ambulatory patient services
  • Mental health and substance use disorder treatment services, including behavioral health treatment
  • Prescription drugs
  • Preventive and wellness services and chronic disease management
  • Pediatric services, including oral and vision care

Some health plans offer extra benefits to Healthy Michigan Plan members like transportation services, care management and virtual care. Find what extra Priority Health offers here.

Does Medicaid Cover Dental Implants

Each state has its own guidelines when determining if Medicaid extends to dental procedures. Even in states where dental is covered by Medicaid, many dentists refuse to take it due to low reimbursement rates and heavy administrative overhead. Yet those from lower-income families are those most often in need of tooth replacement.

Unfortunately, neither Medicare nor Medicaid covers dental implants for low-income families or seniors in our state. This is a major problem as many seniors suffer from severe dental problems and have no means of remedying them without health insurance covering them.

Below, well discuss what Medicaid does cover and alternatives to getting the implants that you need.

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Does Medicaid Cover Dental For Adults: Dentures Implants

Determining whether Medicaid covers a specific dental procedure for adults requires some detective work. The included treatments vary by state, reason, plan, and cost of alternative methods.

First, each state has unique rules about which dental specialty areas they choose to include.

Second, Medicaid is health insurance across the country, which means all recipients might enjoy benefits for medically necessary services.

Third, the least expensive alternative rule affects what your plan might pay for implants, dentures, orthodontia, and other services.

Finally, pregnant women, the medically needy, and those dually eligible for Medicare have extra considerations.

Per The Meridianhealth Handbook :

Making the Case for Adult Dental Coverage in Medicaid

Emergency care is for a life-threatening medical situation or injury that a person would seek care for right away to avoid severe harm. The handbook goes on to state some examples of emergencies which include:

Tooth abscess with severe swelling

Meridian suggests that going to the emergency room is the right plan of action for both of these types of dental emergencies. While in the ER, a healthcare worker can provide care to get you healthy with the benefit of the Meridian in-network care program.

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Individuals Under Age 21

EPSDT is Medicaid’s comprehensive child health program. The program’s focus is on prevention, early diagnosis, and treatment of medical conditions. EPSDT is a mandatory service required to be provided under a state’s Medicaid program.

Dental services must be provided at intervals that meet reasonable standards of dental practice, as determined by the state after consultation with recognized dental organizations involved in child health, and at such other intervals, as indicated by medical necessity, to determine the existence of a suspected illness or condition. Services must include at a minimum, relief of pain and infections, restoration of teeth and maintenance of dental health. Dental services may not be limited to emergency services for EPSDT recipients.

Oral screening may be part of a physical exam, but does not substitute for a dental examination performed by a dentist as a result of a direct referral to a dentist. A direct dental referral is required for every child in accordance with the periodicity schedule set by the state. The Centers for Medicare & Medicaid Services does not further define what specific dental services must be provided, however, EPSDT requires that all services coverable under the Medicaid program must be provided to EPSDT recipients if determined to be medically necessary. Under the Medicaid program, the state determines medical necessity.

Get Empowered At Our Eastpointe Practice

If you live in or around Eastpointe, you can consider us your one-stop-shop for your dental health needs! We take pride in being an office with a doctor who provides the best healthcare possible to our patients while accepting most insurances and providing financing options for x-rays, root canals, and many other treatments.

Were here to help you in times of healthcare crisis.

Please dont hesitate to contact our team if you or a family member needs an emergency dentistry procedure or you have questions about your insurance information, payment options, or dental care.

We are always available to provide answers to any of your questions. Call us to make an appointment today!

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What Does Medicaid Cover In Missouri

Up until recently, Medicaid did not cover any type of dental work at all. Today, adults can get fillings, extractions, and other routine dental work covered. While thats a step in the right direction, there are thousands of Missouri residents who arent getting the coverage they really need and its severely reducing their quality of life.

Not only do they have to deal with the fact that some of their teeth are missing, but during that period, their jawbones are receding, making it more difficult to get dental implants in the future. That begs the question: What options are at the disposal of those who are currently on Medicaid, Medicare, or without any dental coverage whatsoever?

Choice Of Birth Center

How Do I Find Out Who My Medicaid Provider Is

If you become pregnant while you are a Healthy Michigan Plan member:

Where you have your baby is an important choice. That’s why you can pick from nearly 100 hospitals across Michigan.

We encourage you to tour the hospital’s birthing center. This way you will be familiar with it. And you’ll be more relaxed when you have your baby.

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The Cosmetic Dentistry Grants Program

The CDG program is funded by qualifying dentists and private donors all across the USA and Canada. The program gives away over $1 million in grants each year. While Medicaid or Medicare may not cover the costs associated with dental implants, it may cover costs related to your examination. This can include x-rays.

Individuals Age 21 And Older

States may elect to provide dental services to their adult Medicaid-eligible population or, elect not to provide dental services at all, as part of its Medicaid program. While most states provide at least emergency dental services for adults, less than half of the states provide comprehensive dental care. There are no minimum requirements for adult dental coverage.

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Finding An Emergency Dentist With Meridian Health Plan Of Michigan

Your teeth do more than give you a dazzling smile. Theyre vital to living your day-to-day life. Teeth help you to speak, eat, and express yourself.

When your teeth are damaged or lost, it can not only be a painful and traumatic experience it can have a lasting impact on your confidence and your long-term physical, mental, and even behavioral health.

The trouble is that trauma and dental emergencies can come at the most unforeseen times. Anything from a runaway baseball in the park to an unintentional headbutt from a new puppy can be enough to damage a tooth.

In these situations, it is clear that you need a dentist that provides emergency healthcare services for Medicaid and Meridian dental insurance. Michigan residents searching for healthcare services from a provider that accepts Meridian Dental Care are always welcome at Patient Empowered Dentistry.

The good news is that swift and decisive action from skilled emergency dentists can help save your teeth and your smile, not to mention safeguarding your oral health!

Our emergency dentist can help with many services, from on-the-spot fixes to cosmetic dentistry, and is happy to work with patients to provide dental benefits through their dental insurance or with low-cost financing options.

Search Online And Contact Practices Directly

Health: Medicaid Patients Left in the Lurch – nytimes.com/video

If speaking to an emergency dentist directly is more your style, patients can perform an online search and ask their nearest emergency dental care provider if Medicaid, Meridian, or Delta Dental covers treatment at their office. It may take some trial and error, but youll be able to get a feel for the provider by scrutinizing their website before making contact.

  • Does the office take Medicaid or Meridian of Michigan insurance coverage?
  • Is the office in-network for your insurance plan?
  • How many providers are there in the office, and do they have specialties?
  • Will they provide payment options such as a sliding fee scale if the procedure is not covered using your MeridianHealth program?

These are all critical questions to ask your provider.

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