Indiana Medicaid Dental Coverage | HIP Dental Coverage

 Indiana's Medicaid dental programs offer varying dental benefits tailored to specific populations. Here's a breakdown of dental coverage across the different plans:

Traditional Medicaid: This program provides dental services primarily for individuals who are aged, blind, or disabled. Covered services include:

• Diagnostic and preventive care (e.g., exams, cleanings)
• Restorative services (e.g., fillings)
• Extractions
• Prosthetic services (e.g., dentures)

Specific coverage details and limitations can vary, so it's advisable to consult the Indiana Medicaid member handbook or contact Member Services for precise information.

Healthy Indiana Plan (HIP): Designed for adults aged 19-64, HIP offers different dental benefits based on the specific plan: 

• HIP Basic: This plan offers extremely limited emergency dental benefits, and is primarily an emergency based plan: 

• HIP Plus: Members making monthly contributions receive comprehensive dental benefits, including:

  • Two oral exams every 12 months
  • One cleaning every 6 months
  • Emergency oral exams
  • One complete bitewing x-ray series per member every 12 months
  • Full-mouth radiograph series or panoramic x-rays once every 5 years
  • Restorative services (fillings) and extractions (four total per benefit year)
  • Crowns (one per benefit year)

• HIP State Plan Plus: Aimed at individuals with specific medical conditions, this plan offers enhanced dental benefits:

  • Two oral exams every 12 months
  • One cleaning every 6 months
  • Emergency oral exams
  • Two fluoride treatments every 12 months for members through age 20
  • One complete bitewing x-ray series per member every 12 months
  • Full-mouth radiograph series or panoramic x-rays once every 3 years
  • Periodontal services, including scaling and root planning
  • Restorative services (fillings)
  • Major restorative services (crowns)
  • Extractions
  • Orthodontia for members through age 20 (based on medical necessity)
  • Dentures, partials, and repairs (with limits)

Specific coverage details and limitations can vary, so it's advisable to consult the Indiana Medicaid member handbook or contact Member Services for precise information.

Hoosier Healthwise: This program serves children up to age 19 and pregnant women, offering comprehensive dental services such as:

• Two oral exams every 12 months for children under 21
• One oral exam every 12 months for adults 21 and over
• One cleaning every 6 months
• Two fluoride treatments every 12 months for members through age 20
• One complete bitewing x-ray series per member every 12 months
• Full-mouth radiograph series or panoramic x-rays once every 36 months
• Periodontal services, including scaling and root planing
• Sealants for members up to age 20 (one per tooth, per lifetime)
• Restorative services (fillings)
• Extractions
• Orthodontia for members through age 20 (based on medical necessity)
• Dentures, partials, and repairs (with limits)

Specific coverage details and limitations can vary, so it's advisable to consult the Indiana Medicaid member handbook or contact Member Services for precise information.

For the most accurate and up-to-date information, it's recommended to consult the Indiana Medicaid member handbook or contact Member Services directly.