MHS Dental Benefits | HIP Dental Plans & Coverage

 The Healthy Indiana Plan has two pathways to coverage HIP Plus and HIP Basic.

HIP Plus

The initial plan selection for all members is HIP Plus which offers the best value for members. HIP Plus has comprehensive benefits including vision, dental and chiropractic. The member pays an affordable monthly POWER account contribution based on income. There is no copayment required for receiving services with one exception: using the emergency room where there is no true emergency.

HIP Basic

HIP Basic is the fallback option for members with household income less than or equal to 100% of the federal poverty level who don't make their POWER account contributions. The benefits are reduced. The essential health benefits are covered but not vision or dental services. The member is also required to make a copayment each time he or she receives a health care service, such as going to the doctor, filling a prescription or staying in the hospital. These payments may range from $4 to $8 per doctor visit or prescription filled and may be as high as $75 per hospital stay. HIP Basic can be much more expensive than HIP Plus.

Health Plan	Benefits
Healthy Indiana Plan (HIP) HIP Basic *age 19-20 years	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 3 years
Healthy Indiana Plan (HIP) HIP Basic *age 21-64 years	Emergency Dental Care Benefits
Healthy Indiana Plan (HIP) HIP Plus *age 19-64 years	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 (D0210 includes bitewings) or panoramic x-rays (D0330) once every 5 years Restorative services (fillings) and extractions (four total per benefit year) Crowns (one per benefit year)
Healthy Indiana Plan (HIP) HIP State Plan Basic HIP State Plan Plus HIP State Plan Plus Copay HIP Maternity *age 19-64 years	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 (D0210 includes bitewings) or panoramic x-rays (D0330) once every 3 years Periodontal services including scaling and root planing Minor restorative services, such as fillings Major restorative services, such as crowns Simple and surgical tooth extractions (based on medical necessity) Orthodontia for members through age 20 (based on medical necessity) Dentures, partials, and repairs (with limits) Dental surgery (with limits)