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HIP Dental Coverage Levels | HIP Dental Plans Explained

 The Healthy Indiana Plan (HIP) is Indiana’s Medicaid program for adults ages 19-64. The services covered depend on the specific HIP plan:

HIP Basic

  • Covers essential health benefits, including emergency dental services.
  • Does not include comprehensive dental or vision services for adults.

HIP Plus

  • Offers the most comprehensive benefits, including dental and vision coverage for adults.
  • Covers preventive, diagnostic, restorative, endodontic, periodontic, prosthodontic, and oral surgery services.
  • Requires members to contribute to a POWER Account (monthly premium).

HIP State Plan Plus

  • For individuals with additional medical needs, such as those with disabilities.
  • Provides full dental benefits, similar to HIP Plus but with additional benefits.

Key Differences in Enrollment & Qualifications

Plan TypeDental CoverageWho Qualifies?Monthly Contribution?Extra Benefits
HIP Basic❌Emergency Based Service Only Below 100% FPL, no POWER paymentNoLimited benefits, emergency dental/vision only
HIP Plus✅ Full dentalUp to 138% FPL, pays POWER AccountYesNo copays, best coverage
HIP State Plan Plus✅ Full dentalSpecial needs populationsYesMore coverage for medical needs

For patients who do not have full dental coverage under HIP Basic, they should be encouraged to switch to HIP Plus by contributing to their POWER Account.

HIP Plus Dental Coverage Compared to HIP State Plan Plus: 

HIP Plus (Comprehensive Coverage)

  • Dental Services: ✅ Full dental benefits including:
    • Preventive (cleanings, exams, X-rays)
    • Restorative (fillings, crowns)
    • Periodontal treatment (gum disease care)
    • Endodontics (root canals)
    • Oral surgery (extractions, wisdom teeth removal)
    • Prosthodontics (dentures, bridges)
  • Enrollment & Qualification:
    • For individuals up to 138% FPL who pay monthly contributions into a POWER Account.
    • Best benefits, including vision and dental, with no copays for services.

3. HIP State Plan Plus (For Special Populations)

  • Dental Services: ✅ Same full dental coverage as HIP Plus
  • Enrollment & Qualification:
    • For individuals with disabilities or additional health needs who qualify for traditional Medicaid but choose HIP.
    • Offers more benefits than regular HIP Plus, tailored to those needing specialized care.
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Location: 520 W Main St, Greentown, IN 46936, USA

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