The Michigan Department of Health and Human Services will implement a new service delivery model for adult dental benefits effective April 1, 2023. The following groups will be eligible:
- Medicaid beneficiaries ages 21 years and older (including Healthy Michigan Plan).
- Pregnant women enrolled in Medicaid Health Plans (MHP).
- Integrated Care Organizations (ICO).
- Program of All-Inclusive Care for the Elderly (PACE).
Health plans will be responsible for the beneficiary’s dental services, which must be obtained through the health plan’s dental provider network. The new model replaces Healthy Michigan Plan and pregnant women dental benefits. Therefore, questions regarding prior authorizations should be directed to the beneficiary’s health plan.
Dental benefits for Healthy Michigan Plan beneficiaries ages 19-20 will be provided by the Medicaid health plan. Beneficiaries not enrolled in an MHP, ICO or PACE will receive dental services through the Medicaid fee-for-service program. Beneficiaries enrolled in Healthy Kids Dental and under the age of 21 will receive dental coverage through Healthy Kids Dental.
For specific dental coverage questions, please call the Michigan Medicaid beneficiary help line at 800-642-3195 (TTY: 866-501-5656) or email firstname.lastname@example.org to confirm your dental benefits.