Skip to main content

Indiana Medicaid Dental Insurance Overview | LADD Dental Group


"DentaQuest provides your dental services under Hoosier Healthwise. Dental care is very important for your health and well-being. You need to have regular check-ups every six months at your dentist's office.

Below are the dental services that are covered under Hoosier Healthwise
 
PlanDental Benefits Covered
Package A Adult
  • One exam and cleaning per year 
  • Bite-wing x-rays once every 12 months, one complete set of x-rays every 3 years
  • Restorations such as fillings and stainless steel crowns
  • Periodontal care includes deep cleanings and surgical treatment for gum disease
  • Partials, full dentures, immediate dentures, and repairs to partials and dentures
  • Extractions
Package A Child
  • Two exams and cleanings per year 
  • Fluoride varnish
  • Sealants
  • Bite-wing x-rays once every 12 months, one complete set of x-rays every 3 years
  • Restorations such as fillings and stainless steel crowns
  • Endodontic procedures such as root canals 
  • Periodontal care includes deep cleanings and surgical treatment for gum disease
  • Partials, full dentures, and repairs to partials and dentures
  • Extractions
  • Sedation and nitrous oxide if medically necessary
Package C CHIP
  • Two exams and cleanings per year 
  • Fluoride varnish
  • Sealants
  • Bite-wing x-rays once every 12 months, one complete set of x-rays every 3 years
  • Restorations such as fillings and stainless steel crowns
  • Endodontic procedures such as root canals 
  • Periodontal care includes deep cleanings and surgical treatment for gum disease
  • Partials, full dentures, and repairs to partials and dentures
  • Extractions
  • Sedation and nitrous oxide if medically necessary
All of this info and more can be found at https://www.mdwise.org/for-members/hoosier-healthwise/benefits-and-services/dental-services"

Cost and Coverage of Medicaid in Indiana

"What services are covered by Medicaid in Indiana? Medicaid services and equipment covered by the government-sponsored medical assistance program vary from state to state. The types of Medicaid insurance services provided by Indiana Medicaid are different from those provided in other parts of the country. How much does Medicaid cost? Medicaid cost estimates differ across the nation and within each state. For instance, while Medicaid coverage in IN will come with a monthly premium for some beneficiaries, others will not have to pay anything for necessary Medicaid services.
For more information on Medicaid costs in Indiana, and for details on what is covered by Medicaid and what is not covered by Medicaid, continue to the following sections:
  • What services are covered by Medicaid in Indiana?
  • What does Medicaid not cover in Indiana?
  • How much is Medicaid’s cost in Indiana? 

What services are covered by Medicaid in Indiana?

You might expect all types of Medicaid insurance to cover the same services and equipment. In fact, the federal government requires that every version of Medicaid coverage include a set of mandatory services. However, every state has its own version of Medicaid. When you go beyond the mandatory services, each state is free to develop its own mix of covered Medicaid services What services are covered by Medicaid in IN? Indiana Medicaid coverage pays for a wide variety of services and equipment for eligible beneficiaries. These Medicaid services include:
  • Doctor’s visits
  • X-ray and laboratory tests
  • Ambulance services
  • Emergency hospital services
  • Eye examinations
  • Nursing home services
  • Emergency medical transportation
  • Occupational, physical and speech therapies
  • Hearing aids and services
It is important to note that children may be eligible for additional Indiana Medicaid services that adults will not qualify for, such as dental services. These services may include regular exams, teeth cleaning, X-rays or even oral surgery, in extreme cases.
Other medical services may be covered as well if your physician determines that they are medically necessary. If your Medicaid coverage plan denies a procedure or a piece of equipment, you can always appeal the decision. Your appeal rights are spelled out in the paperwork you received when you signed up for Medicaid in IN.
If you need a service deemed what is not covered by Medicaid, and need to file an appeal, you will need a prescription or a letter from your doctor. In addition you may need some additional supporting documentation explaining why you need the service, how the service will benefit you, and what, if any alternative treatments are available. Medicaid appeals can take several months to address, so prepare accordingly. 

What does Medicaid not cover in Indiana?

While Medicaid coverage in Indiana insures beneficiaries for a number of helpful services, there are certain procedures and pieces of equipment that Indiana Medicaid will not cover. The Indiana Medicaid program establishes covered services based on medical necessity. Therefore, any health service that is not medically necessary will not be covered in Indiana. The following medical services are decided as what is not covered by Medicaid:
  • Non-emergency transportation
  • Health services provided by relatives
  • Reconstructive, cosmetic and plastic surgeries
  • Obesity surgery without prior approval by Medicaid
  • Acupuncture
  • Foot care
  • Other services that Medicaid does not regard as essential
Even though your Medicaid coverage in IN will not pay for the above, you can still elect to book these medical services. However, you will be financially responsible to pay the fees out of your own pocket. Speak with your doctor and/or your medical coverage provider to discuss any payment plans available to you prior to booking a procedure or a treatment that is not covered by Medicaid types of insurance.

How much is Medicaid’s cost in Indiana?

How much does Medicaid cost in Indiana? Many Medicaid beneficiaries pay no money at all for their state-sponsored health coverage, due to the fact that they earn low incomes. Medicaid in Indiana may cover 100 percent of your healthcare costs if your individual income is less than $981 per month. For a couple, this threshold is $1,328 per month. In every case, your income has to be less than the income limits set by law in Indiana. In addition, you have to possess Medicaid hospital insurance.
If your income is above this threshold, you may still qualify for Medicaid, but you will have to pay a portion of the cost of your coverage.
How much is Medicaid when you are not fully covered? Unfortunately, there is no absolute answer to these types of Medicaid cost estimates. The amount you pay can change based on your income, the size of your household and the exact level of Indiana Medicaid coverage
If your IN Medicaid coverage does not handle your medical expenses 100 percent of the time, you can expect to pay low-cost bills. Since you are receiving Medicaid benefits due to the fact that you are not earning enough money to pay for healthcare on your own, your medical bills well never be exceptionally high. Expenses you may be responsible for include co-pays for doctor visits, co-pays for prescription drugs and low monthly Medicaid coverage premiums.
As stated earlier, medical procedures and treatments not covered by Medicaid are your responsibility. It does not matter if you are 100 percent covered by Medicaid, or if you are only receiving partial Medicaid coverage. In both of these scenarios, you are required to pay the cost out of your own pocket.Once you are enrolled in Medicaid, you will have a better understanding of how to estimate Medicaid costs depending on your coverage plan. All of this info and more can be found at https://medicaid-help.org/Indiana-cost-and-coverage.html".

Comments

Popular posts from this blog

Sedation Dentistry | Adult Sedation Dentistry | Sedation Dentistry in McCordsville

Sedation Dentistry in McCordsville, Indiana  Nearly half of all North Americans don’t go to the dentist every year.   The number one reason, according to the American Dental Association, is fear.  But fear isn’t the only reason.  People have busy lives and little time for repeated visits to the dentist. Some don't see the importance of keeping their teeth.  And there are a host of other reasons as well.  Whatever your reason, or the reasons for someone close to you, know this – you are not alone!  Sedation Dentistry is here to help you, as it has so many other patients, safely and effectively get the care you need in a safe and comfortable environment for the best dental experience you’ve ever had. This isn’t a One Size Fits All Each patient is unique. That means that whatever medications you may be taking, dental treatments needed, or the years away from the dentist – there is a safe and effective way to get the smi...

Dr. Steven Mah | Welcome To The LADD Dental Group Family

 We are thrilled to introduce Dr. Steven Mah , our newest addition to the LADD Dental Group family. Dr. Mah was born and raised in Evansville, IN, where his passion for helping others began. He pursued a Biology degree at the University of Southern Indiana, graduating in 2019. Driven by his dedication to the dental profession, Dr. Mah went on to earn his Doctor of Dental Surgery (D.D.S.) degree from the Indiana University School of Dentistry in 2024. Dr. Mah is excited to join the LADD Dental team and is eager to bring his expertise and compassionate care to our patients. He looks forward to providing top-notch dental care and getting to know each of our wonderful patients personally. Outside of the office, Dr. Mah enjoys spending quality time with friends and family, whether it's through lively board game nights, exploring new and exciting cuisines, or staying active. Lately, he’s developed a passion for pickleball, and you might even find him on the courts in his free time! Pl...

Indiana University School of Dentistry Partnership | Community Based Dental Outreach Program

  We are thrilled to share some incredible news with our valued community! Ladd Dental Group is honored and overjoyed to announce our new partnership with the prestigious Indiana University School of Dentistry and their esteemed community-based dental outreach program. This collaboration marks a significant milestone for us as we join forces with a leading institution in dental education and community service. Together, we aim to elevate oral healthcare accessibility and make a positive impact on the well-being of our community members. At Ladd Dental Group , our commitment to providing exceptional dental care aligns seamlessly with the mission of Indiana University School of Dentistry's community outreach program. As well as, our mission to serve the pediatric, geriatric, and underserved dental communities. This partnership will not only strengthen our ability to deliver high-quality dental services but also enhance our outreach initiatives to serve those in need. We believe ...