Equal Opportunity, Legal Base, Laws and Reporting Welfare Fraud information. Additional Guidance and Clarification for the Coverage of COVID-19 Prevention, Treatment, and Support Services. Partial dual-eligibility places Medicare recipients into the following categories of Medicare Savings Programs: Medicaid Dental Coverage Options in Michigan In Michigan, adults who are dual-eligible recipients of both Medicare and Medicaid may qualify for coverage of certain dental services. Information on Adult Protective Services, Independent Living Services, Adult Community Placement Services, and HIV/AIDS Support Services. The Michigan Department of Health and Human Services' (MDHHS) Division of Environmental Health (DEH) uses the best available science to reduce, eliminate, or prevent harm from environmental, chemical, and physical hazards. Adults without children will not be charged the pediatric premium. The MDHHS redesign proposal heavily leans on input provided by the MDA on behalf of members and focuses on four key pillars: 1)increased reimbursement rates for providers; 2)improved access and provider participation; 3) enhanced care coordination; and 4) building a robust dental benefit package. Once you find a dentist, call and make an appointment. Meaning children with Medicaid must receive dental care that provides the following: Regular dental care maintenance, including teeth cleanings and checkups Tooth restorative care The COVID public health emergency (PHE) is expected to be extended again in January 2023, but the omnibus bill de-links the resumption of Medicaid eligibility redeterminations from the PHE, and allows states to start . The simple answer is no in 2023, but government programs are notoriously challenging to navigate, and the critical line between medical and dental care is fuzzy. To be eligible for Michigan Medicaid, you must be a resident of the state of Michigan in need of health care/insurance assistance, whose financial situation would be characterized as low income or very low income. MyPrioritydental insurance is available as an add-on to MyPriority medical plans (except MyPriorityShort-term). Medicaid Dental Coverage Options in Michigan In Michigan, adults who are dual-eligible recipients of both Medicare and Medicaid may qualify for coverage of certain dental services. Pregnant Medicaid members are able to use their Molina Healthcare Medicaid ID card to obtain dental services. We are also ramping up our efforts to educate consumers, health care providers and the public about positive oral health practices. Delta Dental is one of the Healthy Michigan Plan's benefit administrators. To find out more about Healthy Kids Dental, the dental benefits your child may be eligible to receive and to locate a dentist in your area, please visit www.healthykidsdental.org. Information on the Food Assistance Program, eligibility requirements, and other food resources. Medicaid Certificate of Coverage and Member Handbook; Healthy Michigan Plan Certificate of Coverage and Member Handbook; Have a question? Infant Oral Health Training and Resource Materials for Medical Providers, On-Line Oral Health Training for Medical Providers, Adult & Children's Services collapsed link, Safety & Injury Prevention collapsed link, Emergency Relief: Home, Utilities & Burial, Adult Behavioral Health & Developmental Disability, https://dev.michigan.local/som/json?sc_device=json. Information on Safe Sleep for your baby, how to protect your baby's life. MDHHS implemented the rate increase on October 1st, 2022, and it received CMS approval in November. Prevention of diseases & conditions such as heart disease, cancer, diabetes and many others. Full dual-eligibility means Medicare recipients receive all Medicaid-related benefits. To acquaint yourself with this manual, begin with the Medicaid Provider Manual Overview. 6 0 obj Keeping your web browser up to date is very important. MDHHS News, Press Releases, Media toolkit, and Media Inquiries. The electronic Medicaid Provider Manual contains coverage, billing, and reimbursement policies for Medicaid, Healthy Michigan Plan, Children's Special Health Care Services, Maternity Outpatient Medical Services (MOMS), and other healthcare programs administered by the Michigan Department of Health and Human Services (MDHHS). Information on the Family Independence Program, State Disability Assistance, SSI, Refugee, and other cash assistance. Full dual-eligibility may grant recipients access to routine dental care and some emergency or restorative procedures with prior authorization. Behavioral and Physical Health and Aging Services Administration, Immunization Info for Families & Providers, Michigan Maternal Mortality Surveillance Program, Informed Consent for Abortion for Patients, Informed Consent for Abortion for Providers, Go to Child Welfare Medical and Behavioral Health Resources, Go to Children's Special Health Care Services, General Information For Families About CSHCS, Go to Emergency Relief: Home, Utilities & Burial, Supplemental Nutrition Assistance Program Education, Go to Low-income Households Water Assistance Program (LIHWAP), Go to Children's & Adult Protective Services, Go to Children's Trust Fund - Abuse Prevention, Bureau of Emergency Preparedness, EMS, and Systems of Care, Division of Emergency Preparedness & Response, Infant Safe Sleep for EMS Agencies and Fire Departments, Go to Adult Behavioral Health & Developmental Disability, Behavioral Health Information Sharing & Privacy, Integrated Treatment for Co-occurring Disorders, Cardiovascular Health, Nutrition & Physical Activity, Office of Equity and Minority Health (OEMH), Communicable Disease Information and Resources, Mother Infant Health & Equity Improvement Plan (MIHEIP), Michigan Perinatal Quality Collaborative (MI PQC), Mother Infant Health & Equity Collaborative (MIHEC) Meetings, Go to Birth, Death, Marriage and Divorce Records, Child Lead Exposure Elimination Commission, Coronavirus Task Force on Racial Disparities, Michigan Commission on Services to the Aging, Nursing Home Workforce Stabilization Council, Guy Thompson Parent Advisory Council (GTPAC), Strengthening Our Focus on Children & Families, Supports for Working with Youth Who Identify as LGBTQ, Go to Contractor and Subrecipient Resources, Civil Monetary Penalty (CMP) Grant Program, Nurse Aide Training and Testing Reimbursement Forms and Instructions, MI Kids Now Student Loan Repayment Program, Michigan Opioid Treatment Access Loan Repayment Program, MI Interagency Migrant Services Committee, Go to Protect MiFamily -Title IV-E Waiver, Students in Energy Efficiency-Related Field, Go to Community & Volunteer Opportunities, Go to Reports & Statistics - Health Services, Other Chronic Disease & Injury Control Data, Nondiscrimination Statement (No discriminacion), 2022-2024 Social Determinants of Health Strategy, Go to Reports & Statistics - Human Services. Clarification of Michigan Automated Prescription System (MAPS) Record Retention, Postpartum Extension from 60 Days to 12 Months, COVID-19 Response: Policy for COVID Relief (CR) Facilities to Treat COVID-19 Residents Requiring Nursing Facility (NF) Care in Limited Circumstances, Durable Medical Equipment and Supplies Providers. participating dentist, Pregnant Women Dental EPO network member handbook. For Notices of Proposed Policy, click here. Information & resources for Community and Faith-Based partners. <> Michigan Medicaid covers limited dental services for adults, including dental check-ups, teeth cleaning, X-rays, fillings, tooth extractions, and dentures. The electronic Medicaid Provider Manual contains coverage, billing, and reimbursement policies for Medicaid, Healthy Michigan Plan, Children's Special Health Care Services,Maternity Outpatient Medical Services (MOMS), and other healthcare programs administered by the Michigan Department of Health and Human Services (MDHHS). The program gives coverage to Michiganders with incomes under 138 percent of the Federal Poverty Level about $12,880 for an individual or $27,750 for a family of four in 2022. LifeSmile is an oral wellness program that helps you focus on your oral health and well-being with education and tips for improving and maintaining good dental health habits. What you need to know. If you have any questions, please call theM.O.M. Newer web browsers let you use more features and new technologies resulting in a better browsing experience. 2023 Molina Healthcare, Inc. All rights reserved. Supplemental Medicaid Bulletins- bulletins that have not been incorporated into the manual and must still be retained for reference will appear on the Supplemental Bulletin List. This page contains policy bulletins issued in 2022. A federal program which helps persons admitted into the U.S. as refugees to become self-sufficient after their arrival. PWD uses the Healthy Michigan Plan dental benefits and network, and provides dental benefits for women for the duration of their pregnancy, as well as the 12-month period following the due date. Prevention of diseases & conditions such as heart disease, cancer, diabetes and many others. First, learn how Medicaid covers dental implants differently by exploring its dual nature as health (starts in the body) and dental insurance (begins in the mouth). Review the information in this section before contacting customer service. Gretchen Whitmer's 2022-23 budget proposal, unveiled this week, is good news for dentistry and the oral health of Michiganders. Information is collected to monitor the general health and well-being of Michigan citizens. The governor called for significant investments in two critical areas: $68.7 million in adult dental Medicaid coverage, which will result in $243 million total when related federal funds are included. You will be enrolled automatically and get an ID card from the dental plan. Meridian and Aetna Better Health have Dentaquest, Blue Cross Complete has HMI Dental and UnitedHealthCare has their own dental plan (call 1-800-903-5253). A federal program which helps persons admitted into the U.S. as refugees to become self-sufficient after their arrival. Please update to a modern browser such as Chrome, Firefox or Edge to experience all features Michigan.gov has to offer. Information on the grant awarded for the State Innovation Model Proposal, Offers resources for agencies who operate the Weatherization Assistance Program in the state of Michigan. It outlines everything you need to know about your Molina Healthcare of Michigan Medicaid Health Plan. For Provider "L" Letters, click here. Delta Dental is one of the Healthy Michigan Plan's benefit administrators. It is for the low income uninsured children of Michigan's working families. "We can clearly see the positive impact of Medicaid coverage of dental care . If you have questions about our plan, call HAP Empowered at (888) 654-2200 (TTY: 711) (Provider "L" letters do not represent promulgated policy and are provided tocommunicate new developments,information, policy clarifications, etc. The postpartum period is 3 months following end of pregnancy. Medicare Supplement plansalso known as Medigap plansdon't directly cover dental, but they "pick up some of the out-of-pocket costs like copayments, coinsurance and deductibles," says Worstell.. If you cannot afford child care, payment assistance is available. A routine dental appointment lasts approximately 30 minutes. For other years of approved Medicaid policy bulletins, click here. Points of Light (POL) Initiative POL establishes referral mechanisms between medical and dental practices within a community for infant oral health. Information on American Indian Services, Employment and Training. The state of Michigan's Medicaid program covers dental care for you and your children. Our migrant program works with a number of organizations to provide services for Michigans migrant and seasonal farmworkers. There are two coverage options: Pediatric-only coverage: Required by the Affordable Care Act if you have children age 18 or under. If you need help with transportation to a dental appointment for a covered dental service, click here for the guide to . Michigan Medicaid health insurance through Meridian only has a dental coverage program for those enrolled and under 19 or pregnant For others, there is no plan for Meridian dental care services. Information on DHS Applications and Forms grouped by category. Medicare recipients in Michigan who qualify may be able to enroll in both Medicare and Medicaid, or a Medicaid-managed program, that provides some dental care benefits. Providers using the CD will need to retain all bulletins received throughout the year to use in addition to the CD. If you are hearing impaired, please call Molina Healthcare by dialing our TTY line at 711. Information is collected to monitor the general health and well-being of Michigan citizens. Low-income Households Water Assistance Program (LIHWAP). Archived proposed Medicaid policy distributed for public comment and consultation summaries are available electronically upon request. A smaller zipped copy(14MB) is also available. Child Welfare Medical and Behavioral Health Resources. Detroit February 22, 2023 With the public comment period now closed, reimbursement enhancements that will pump more than $85 million into dental care are on track for implementation effective April 1, 2023. Original Medicare Part A and Part B benefits do not provide coverage for routine dental care, so many recipients need to find solutions to help pay for dental services like checkups, X-rays, and teeth cleanings. Information about the Michigan law that requires certain information be made available to a woman who is seeking an abortion at least 24 hours prior to the abortion procedure. Child Welfare Medical and Behavioral Health Resources. Adult Behavioral Health & Developmental Disability Services. If you are using a dial-up modem, we recommend you use the CD version of the Manual. In most cases, recipients who receive medical services will have their copayments, coinsurance and deductible amounts paid for by their needs-based coverage. A Non-Government Resource For Healthcare All Rights Reserved 2023. Bridge Card Participation Information on Electronic Benefits for clients and businesses, lists of participating retailers and ATMs, and QUEST. Recipients who receive Medicaid-administered help with long-term care services may qualify for dental coverage as part of that programs package of benefits. ; Your Provider will use your Health Plan card and mihealth card to . Provider Payments Information on the direct deposit of State of Michigan payments into a provider's bank account. information about the Department's public safety programs. Using your benefits. We use cookies on our website. Unable to take your feedback now, Please try again later. Information on the Children's Protective Services Program, child abuse reporting procedures, and help for parents in caring for their children. Information on communicable & chronic diseases. information about the Department's public safety programs. Fees payable to providers by Medi-Cal Dental for covered services shall be the LESSER of: a. provider's billed amount b. the maximum allowance set forth in the schedule below 2. xf{ a8 YdD@ '[Mb90BB $[Uwu3Z3=l!B!B!B!B!B!B{>/OU{[}z_:Xzr{oTWWwz5,j~L'?+J/?={BK+Cu~7%B"Uz$IR^9NOUOW]'Mvp+J/?uofk j +rXPr{oTWt3grnO;j~LDy?:!{4$~ If you do not have this software, or a lower version, you can click on the Adobe Acrobat Reader Icon below to download the software free of charge. participating dentist, Healthy Michigan Plan Information on the Safe Delivery Program, laws, and publications. If you cannot afford child care, payment assistance is available. Equal Opportunity, Legal Base, Laws and Reporting Welfare Fraud information. Additionally, the states agency contracts with private insurers to administer benefits and each insurer may have a different process for prior authorization or approval of service, so recipients should contact their provider to confirm which services are covered for their qualifying category. Enroll in the Enhanced Dental and Vision package today. Significant examples of our commitment to improving the oral health of the underserved include administration of Healthy Kids Dental, the Healthy Michigan Plan, Pregnant Women Dental . The researchers, from the University of Michigan, used a survey and interviews to assess the impact of this coverage on the health and lives of low-income people who enrolled. Information on resources in your community and volunteer recruitment and training, and services provided at local DHS offices. Molina Healthcare will provide the names of participating dentists in their area who are available to provide dental services. Information on the grant awarded for the State Innovation Model Proposal, Offers resources for agencies who operate the Weatherization Assistance Program in the state of Michigan. A variety of reports & statistics for programs and services. Healthy Kids Dental is a Medicaid health care program, available for low-income children under age 21. Information on How to Bid, Requests for Proposals, forms and publications, contractor rates, and manuals. We also recommend Aetna for low-cost dental coverage. The modifier and age range fields are applicable to the fee screen and do not reflect coverage parameters. Delta Dental of Michigan is a part of Delta Dental Plans Association. MDHHS discourages printing of the manual because of the cost and loss of functionality (e.g., search capability). Information about audits conducted by the Office of Audit. Recipients who qualify for Medicare Savings Programs that also offer full Medicaid-related benefits coverage may also access some routine dental services and certain extras. ; Take your Health Plan card and mihealth card with you when you visit the doctor, pharmacy, hospital or other medical provider. All other documents on this website are accessible using a dial-up modem. A variety of reports & statistics for programs and services. The program focuses on prevention, early diagnosis, and treatment of medical conditions. Lansing,MI48909 For best viewing experience adjust your personal computer settings to open all PDF files in Adobe Acrobat Reader. Molina provides unlimited round-trip or one-way trips for covered, medically necessary services each calendar year. Delta Dental of Michigan helps improve oral health by fostering public-private partnerships benefiting those who suffer from oral diseases. The effect on dental care utilization from transitioning pediatric Medicaid benefits to managed care (March 2022); Comparative analysis of dental procedure mix in public and private dental benefits programs (October 2021); The effect of the great recession on the demand for general oral health care and orthodontic care (April 2019); The relationship between periodontal interventions and health . Medi-Cal Dental Schedule of Maximum Allowances 1. . Please select one of the states in which Molina Healthcare provides services. This information is not a complete description of benefits. The request must include a company/facility name and address, National Provider Identifier (NPI) (if applicable), telephone number, and a contact person's name. Some of the common procedures of Medicaid coverage for adults in 2022 are: Each state has specific regulations about which dental specialty areas they possess. 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