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HIP Dental Plans | HIP Dental Coverage Breakdown

 The Healthy Indiana Plan (HIP) is Indiana’s Medicaid program based individual and family income, and it has different levels of coverage based on the specific plan and eligibility. Here’s a breakdown of the differences between HIP, HIP State Plan, and HIP State Plan Plus in terms of dental coverage:

  1. HIP Basic

    • Extremely Limited dental coverage (typically emergency-only services like extractions and pain management).
    • Does not include routine cleanings, exams, or restorative care (fillings, crowns, etc.).
    • For those who do not make POWER Account contributions.  
    • Not recommended for individuals needing dental work.

  2. HIP Plus

    • Provides comprehensive dental benefits, including preventive, restorative, and emergency care.
    • Available to members with certain medical conditions or disabilities who qualify for enhanced benefits.
    • Works similarly to traditional Medicaid coverage. 
    • There is a $4 copay for all dental work performed.  
    • There are a number of different plans that fall under the HIP Plus umbrella.

  3. HIP State Plan Plus

    • Includes the same comprehensive dental benefits as the HIP State Plan but with additional perks.
    • Offers lower out-of-pocket costs and better access to services.
    • Requires members to make monthly POWER Account contributions, which help fund their care.
    • Preferred option for those who can contribute, as it provides better coverage and lower costs.

If you or a patient are deciding between these plans, HIP State Plan Plus is typically the best option for full dental benefits. 



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