The state contracts with Delta Dental and Blue Cross Blue Shield of Michigan. member handbook, Healthy Michigan Plan EPO network member handbook. The Overview describes how information is organized and how to navigate through the document. Equal Opportunity, Legal Base, Laws and Reporting Welfare Fraud information. Please visit MyMolina.com if you would like to review your healthcare coverage. Information is collected to monitor the general health and well-being of Michigan citizens. EPSDT is a mandatory service required under a state's Medicaid program. Inability to access dental care can result in poor oral health. On If you are using a dial-up modem, we recommend you use the CD version of the Manual. 6 0 obj Child Welfare Medical and Behavioral Health Resources. Information on the Children's Protective Services Program, child abuse reporting procedures, and help for parents in caring for their children. We are also ramping up our efforts to educate consumers, health care providers and the public about positive oral health practices. The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit provides comprehensive and preventive health care services for children under age 21 who are enrolled in Medicaid. 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). Coverage effective across all 50 states and D.C. as of Oct. 1 Beginning in October, all 50 states and D.C. will prioritize dental coverage for Medicaid enrollees who are pregnant or postpartum through at least 60 days after pregnancy, the Centers for Medicare & Medicaid Services announced Sept. 22. Additional factors, such as certain disabilities and marital status, can impact eligibility. To apply for eligibility you can fill out and application at MI Bridges or contact your local Department of Health and Human Services office. Information on Safe Sleep for your baby, how to protect your baby's life. Information about the health care programs available through Medicaid and how to qualify. Birth, Death, Marriage and Divorce Records. Health Care Coverage information and resources. Michigan Department of Health and Human Services BENEFIT PLANS 09/22/2022 Page 1 of 13 . All non-pregnant Medicaid members can call the Michigan Medicaid Dental line for help with finding a dentist at 1-800-642-3195 or Medicaid Dentistry. The web Browser you are currently using is unsupported, and some features of this site may not work as intended. 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. In most cases, recipients who receive medical services will have their copayments, coinsurance and deductible amounts paid for by their needs-based coverage. To enable bookmarks in Internet Explorer: Now, open the PDF in IE and all the bookmarks are available. The Michigan Domestic & Sexual Violence Prevention and Treatment Board administers state and federal funding for domestic violence shelters and advocacy services, develops and recommends policy, and develops and provides technical assistance and training. EDITOR'S NOTE: This article was first posted in March 2022 but has been updated to reflect the passage of the Consolidated Appropriations Act, 2023 (the omnibus spending bill). MDHHS implemented the rate increase on October 1st, 2022, and it received CMS approval in November. We also recommend Aetna for low-cost dental coverage. Healthy Kids Dentalis a Medicaid health care program, available for low-income children under age 21. 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. 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 . Information on assistance with home repairs, heat and utility bills, relocation, home ownership, burials, home energy, and eligibility requirements. Information on Adult Protective Services, Independent Living Services, Adult Community Placement Services, and HIV/AIDS Support Services. New Family Planning Eligibility Group, COVID-19 Response: Application Period for COVID Relief (CF) Facilities to Treat COVID-19 Residents Requiring Nursing Facility (NF) Care in Limited Circumstances, Submission of a State Plan Amendment (SPA) Request for the Home Help Program, Temporary Rate Increases for Incontinence Volume Purchase Contract, Non-routine Therapy Prior Authorization Requirements for Nursing Facility Residents, Michigan's Revised Statewide Transition Plan for Home and Community-Based Services Waiver Programs, Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Dental Periodicity Schedule, Coordination of Benefits for MI Choice services for participants who receive services for accidental bodily injury covered by personal injury protection (PIP) insurance through an automobile insurance company, COVID-19 Response: Updates to Bulletins MSA 20-76, MSA 21-43 and HASA 22-04, Nursing Facility Quality Measure Initiative Resident Satisfaction Survey Data, Notice of Intent to Submit a Section 1915(b) Waiver Renewal Application for the Healthy Kids Dental Program, Michigan Department of Health and Human Services (MDHHS) Request for comment on Behavioral Health Home and Community-Based Services (HCBS) for Heightened Scrutiny (HS) settings within the Ten Prepaid Inpatient Health Plan (PIHP) Regions, Medicaid Reimbursement for Vaccine Administration Services, Notice of September 14, 2022, Durable Medical Equipment and Supplies Medicaid Provider Liaison Meeting, Request for Comment on Home and Community-Based Settings for Mi Choice Waiver Program, Michigan Department of Health and Human Services (MDHHS) Request for Comment on Home and Community-Based Settings for MI Choice Waiver Program, Clarification of Pharmacy Professional Dispensing Fees for COVID-19 Home Tests, Medicaid Coverage and Reimbursement of COVID-19 Testing and Treatment Services under the American Rescue Plan Act of 2021, Update to Emergency Medical Services Delivery of COVID-19 Related Services, Notice of June 15, 2022 Durable Medical Equipment and Supplies Medicaid Provider Liaison Meeting Notice, Attending Provider Field on the Institutional Hospital Claim Format, Home Help Agency Caregiver Wage Increase Requirements for Unapproved Home Help Agency Providers, Changes to Quality Assurance Supplement (QAS) Calculation and Payment Methodology for MI Health Link (MHL) for Calendar year (CY) 2022, Changes to the Quality Assurance Supplement (QAS) Calculation and Payment Methodology for MI Health Link (MHL) for Calendar Year (CY) 2022, Lead in Water Removal of Galvanized Plumbing and Blood Lead Reference Value Change State Plan Amendment (SPA) Request, Public Comment on Heightened Scrutiny Settings for Region 5-Mid-State Health Network, CMHSPs, PIHPs, Wraparound Services Providers, Guide to Distributing and Documenting Mandated Home Help Agency Caregiver Pay Increases, Direct Care Worker Premium Pay for April 1, 2020 through September 30, 2021, MI Choice Agencies, PIHPs/CMHSPs, Wraparound Services Providers. There are two coverage options: Pediatric-only coverage: Required by the Affordable Care Act if you have children age 18 or under. It outlines everything you need to know about your Molina Healthcare of Michigan Medicaid Health Plan. You will be enrolled automatically and get an ID card from the dental plan. Through our national network of Delta Dental companies, we offer dental coverage in all 50 states, Puerto Rico and other U.S. territories. Michigan Medicaid Provider Manual >> Dental Chapter >> Section 2.1 Prior Authorization Requirements in Cases of Misutilization Find a Healthy Michigan Plan (Provider "L" letters do not represent promulgated policy and are provided tocommunicate new developments,information, policy clarifications, etc. 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. The Michigan Domestic & Sexual Violence Prevention and Treatment Board administers state and federal funding for domestic violence shelters and advocacy services, develops and recommends policy, and develops and provides technical assistance and training. Children's Special Health Care Services information and FAQ's. A report released in January from George Washington University found that up to 2.5 million patients of community health centers, which treat both underserved rural and urban communities, could lose coverage as a result of eligibility redeterminations, costing the health centers somewhere from $1.5 billion to $2.5 billion in revenue. Molina provides unlimited round-trip or one-way trips for covered, medically necessary services each calendar year. Check eligibility, explore benefits, and enroll today. endobj 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. Using your benefits. Adult Behavioral Health & Developmental Disability Services. Information on DHS Applications and Forms grouped by category. The online version of the Manual isupdated quarterly to incorporate any policies transmitted via policy bulletins since the last Manual update. A federal program which helps persons admitted into the U.S. as refugees to become self-sufficient after their arrival. The average Medicare Advantage monthly premium decreased in Michigan compared to last year from $35.13 in 2021 down to $28.74 in 2022. Prevention of diseases & conditions such as heart disease, cancer, diabetes and many others. Join or renew membership today by calling 800-589-2632 or apply online. To be eligible, you must have an annual household income (before taxes) that is below the following amounts: Select Household Size 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. Low-income Households Water Assistance Program (LIHWAP). Information on the Children's Foster Care program and becoming a Foster Parent. Information on resources in your community and volunteer recruitment and training, and services provided at local DHS offices. A federal program which helps persons admitted into the U.S. as refugees to become self-sufficient after their arrival. 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). Information about injury and violence prevention programs in Michigan. Resources: Verify Beneficiary Eligibility Dental Responsibility at a . There are 191 Medicare Advantage plans available in . A smaller, If you would like to receive a CD version of the. For Provider "L" Letters, click here. or Once Michigan resumes Medicaid eligibility reviews that were waived during the pandemic, some people may be disenrolled from Medicaid. Information on child support services for participants and partners. Information on Safe Sleep for your baby, how to protect your baby's life. Information on treatment and services for juvenile offenders, success stories, and more. If you are using a dial-up modem, we recommend you use the CD version of the Manual. Information on resources in your community and volunteer recruitment and training, and services provided at local DHS offices. Please contactMedicare.govor 1-800-MEDICARE (TTY users should call1-877-486-2048) 24 hours a day/7 days a week to get information on all of your options. If you need dental care right away, a stand-alone plan from Humana can provide comprehensive benefits . information about the Department's public safety programs. 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. Please identify the project number of the proposed Medicaid policy or consultation summary if known. Michigan did accept federal funding to expand Medicaid under the ACA. We use cookies on our website. If you are pregnant, you can find a Molina dentalprovider by visiting MolinaHealthcare.com, select Medicaid, then Find a Provider to view the Molina dentistsnear you. Information on child support services for participants and partners. Child Welfare Medical and Behavioral Health Resources. Visiting the dentist on a regular basis for cleanings, X-rays and other needed services will prevent pain and discomfort in the future when small problems, if left untreated, could turn into larger problems or even dental emergencies. CMS approved the Healthy Michigan demonstration that allows the state to require premiums (not to exceed 2 percent of the individual's income) for New Adult beneficiaries with incomes over 100 percent of the FPL, and copayment liability (if applicable) for all New Adult beneficiaries 0-133 percent of the FPL billed on an aggregated basis after the first six months of enrollment. Information about audits conducted by the Office of Audit. Information on DHS Applications and Forms grouped by category. Provider Payments Information on the direct deposit of State of Michigan payments into a provider's bank account. Keeping your web browser up to date is very important. Medicaid dental coverage for populations under the age of 21 must include the following: Relief of pain and infections Restoration of teeth Maintenance of dental health This means Medicaid will cover preventative services such as check-ups, cleanings, x-rays and sealants. ;xZ`zPd K_KJt(A1vPoodw>|Z'sM{X||h48WI#?ZI}OzlE-? Birth, Death, Marriage and Divorce Records. You will receive the current published version of the manual that is available at that time. Michigan's Women, Infants & Children program, providing supplemental nutrition, breastfeeding information, and other resources for healthy mothers & babies. Prevention of diseases & conditions such as heart disease, cancer, diabetes and many others. The low percentage of participation of Americans in Medicaid may be due to the facts that: Legislation policy and planning information. Molina Healthcare will provide the names of participating dentists in their area who are available to provide dental services. Newer web browsers let you use more features and new technologies resulting in a better browsing experience. It is easiest to navigate the manual using bookmarks. 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. For additional pertinent coverage parameters, such as documentation and billing indicators, refer to the Medicaid Code and Rate Reference tool, which is accessible via the External Links menu within CHAMPS. Information on the Children's Foster Care program and becoming a Foster Parent. Information about audits conducted by the Office of Audit. Best Medicare dental coverage for seniors. For pregnant women, oral health complications are associated with poor pregnancy outcomes like low birth weight and preterm birth.State Medicaid programs are required to cover dental services for children under 21, but services for adults, including pregnant women, are optional. Get benefit help and information for you and/or your child in your language. A variety of reports & statistics for programs and services. By using our website, you consent to our use of cookies in accordance with our Privacy Policy. Information is collected to monitor the general health and well-being of Michigan citizens. Equal Opportunity, Legal Base, Laws and Reporting Welfare Fraud information. Michigan Medicaid - Michigan Dental Association Michigan Medicaid Home Government/Insurance/Advocacy Dental Benefits Michigan Medicaid Member's Only Content You must be a member to view this content. <> Information on American Indian Services, Employment and Training. Contact Customer Service: 888.975.8102 (TTY 711) Monday-Thursday, 7:30 a.m.-7 p.m. oW~G\y^y"]&gasklV[rOd$P&(}sS"Oo. Any questions should be directed to Provider Inquiry, Michigan Department of Health and Human Services, phone toll-free 800-292-2550 or email at providersupport@michigan.gov. Children who are covered by Medicaid are entitled to Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services when they go to the dentist. Archived proposed Medicaid policy distributed for public comment and consultation summaries are available electronically upon request. Information on the Children's Protective Services Program, child abuse reporting procedures, and help for parents in caring for their children. Can't find what you're looking for? To acquaint yourself with this manual, begin with the Medicaid Provider Manual Overview. Child Welfare Medical and Behavioral Health Resources. <> There are two programs in the state of Michigan. 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, Due to the size of this document (approximately 16MB), you may experience a delay before it opens. The Healthy Michigan Plan (HMP) provides dental benefits to Michigan residents at a low cost to increase access to care for low-income populations who do not qualify for or who are not enrolled in other Medicare or Medicaid programs. The least costly alternative rule concerns . The documents will be e-mailed to you. <> Information on DHS Applications and Forms grouped by category. Information on Adult Protective Services, Independent Living Services, Adult Community Placement Services, and HIV/AIDS Support Services. Together, they provide a network of dentists for children ages 0-20. 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. All other documents on this website are accessible using a dial-up modem. Information on the Family Independence Program, State Disability Assistance, SSI, Refugee, and other cash assistance. 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. The Healthy Michigan Plan (HMP) provides dental benefits to Michigan residents at a low cost to increase access to care for low-income populations who do not qualify for or who are not enrolled in other Medicare or Medicaid programs. Information & resources for Community and Faith-Based partners. Please update to a modern browser such as Chrome, Firefox or Edge to experience all features Michigan.gov has to offer. 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. Equal Opportunity, Legal Base, Laws and Reporting Welfare Fraud information. The overall average rate change for individual/family health coverage is a 5.5% increase for 2023. information about the Department's public safety programs. If you would like to view historical versions of proposed Medicaid policy that were released for public comment or you would like to obtain a consultation summary of any bulletin, e-mail msadraftpolicy@michigan.govwith your request. Facts that: Legislation policy and planning information provide the names of participating dentists their... Hours a day/7 days a week to get information on the children 's Foster care program becoming... 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Up our efforts to educate consumers, health care providers and the public about positive oral health.!, click here, if you are currently using is unsupported, and other territories! Now, open the PDF in IE and all the bookmarks are available electronically upon.. The Affordable care Act if you would like to review your Healthcare coverage since the last Manual update Services participants. Michigan 's Women, Infants & children program, child abuse Reporting procedures, and some of. About your molina Healthcare will provide the names of participating dentists in their who! Summaries are available Services for juvenile offenders, success stories, and it CMS. ( A1vPoodw > |Z'sM { X||h48WI #? ZI } OzlE- your Community and volunteer recruitment and training may. In accordance with our Privacy policy and get an ID card from the dental.! Epsdt is a 5.5 % increase for 2023. information about injury and violence prevention in! Accordance with our Privacy policy via policy bulletins since the last Manual update, recipients who receive Medical will... That were waived during the pandemic, some people may be disenrolled from.! Can provide comprehensive benefits in the state of Michigan Payments into a Provider bank... For public comment and consultation summaries are available that: Legislation policy and planning information reviews that were during.

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