Michigan Medicaid expands covered dental services for adults

Published: Apr. 3, 2023 at 9:52 AM EDT
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LANSING, Mich. (WILX) -The Michigan Department of Health and Human Services (MDHHS) expanded dental benefits for adult Medicaid beneficiaries and increased rates for dental providers. Benefit enhancements and service delivery began April 1.

The $85.1 million investment in increased reimbursement and $30 million in redesigned benefits will not result in any loss of services, and many recipients will have new services added. For beneficiaries who are 21 years and older, the following services will now be covered:

  • X-rays
  • Teeth cleanings
  • Fillings
  • Extractions
  • Dentures
  • Deep teeth cleanings (New)
  • Sealants (New)
  • Root canals (New)
  • Crowns (New)
  • Care to keep your gums healthy (New)

As a first step in the redesign, a policy that substantially increased reimbursement rates for Medicaid dental services was implemented Jan. 1, 2023. Providers are now being paid at 100% of the Average Commercial Rate, ensuring access and incentivizing providers to treat Medicaid beneficiaries.

“The reimbursement rates for providers were very low under the old adult dental Medicaid program,” said Dr. Vince Benivegna, President of the Michigan Dental Association. “Dentists would lose money by treating adult dental Medicaid patients. As small business owners this was not sustainable. The new rates recognize the value of quality care and will allow more dental health providers to treat Medicaid patients.”

Medicaid beneficiaries will not lose any dental care benefits with these changes; however, the way services are delivered may change slightly. Medicaid beneficiaries aged 21 years and older, including Healthy Michigan Plan beneficiaries and pregnant women who are enrolled in a Medicaid Health Plan, Integrated Care Organization or Program of All-Inclusive Care for the Elderly will receive dental benefits through their health plan. The health plan becomes responsible for the beneficiary’s dental services obtained through the health plan’s dental provider network.

Dental services for beneficiaries who are not enrolled in a health plan will be provided through the Medicaid FFS program.

For questions, beneficiaries can call the Beneficiary Help Line for free at 800-642-3195 (TTY: 866-501-5656) or send an email to beneficiarysupport@michigan.gov.

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