Healthy Behaviors

What are the required Dental Healthy Behaviors?

Healthy Behaviors include completion of both:
  • An Oral Health Self-Assessment
    • This is a short survey that asks questions about your dental health. You will want to contact your dental carrier to complete the assessment (Delta Dental or MCNA Dental).
  • A Preventive Dental Service
    • ​Go to the dentist and get a dental wellness exam. This may include an exam or teeth cleaning.
For further information on Healthy Behaviors, please see the Dental Wellness Plan Healthy Behaviors webpage. 
 

Is there a paper copy or printable copy version of the Oral Health Self-Assessment that members can mail in?

Not at this time. You are able to contact your dental plan and complete the survey over the phone.
 

Why do I have to complete both Dental Healthy Behaviors?

An Oral Health Self-Assessment and Preventive Dental Service help you prevent dental problems and maintain a healthy mouth.
 

What happens if I don't complete my Healthy Behaviors?

If you do not complete your Healthy Behaviors each year, you may be charged a monthly premium.
 
Members who will not be charged a monthly premium
  • Members with individual earnings less than 50 percent of the Federal Poverty Level ($5,832 per year for an individual, or $7,865 for a family of two)
  • Pregnant women
  • Members in an institutional facility
  • Home- and Community-Based Services (HCBS) Waiver members
  • Members receiving hospice care
  • American Indians who are eligible to receive or have received an item or service:
    • From an Indian Healthcare provider
    • Through referral under contract health services
  • Breast and cervical cancer treatment program members
  • Medically exempt
  • Members who claim hardship

How much is the monthly premium?

Monthly premiums are $3.00 per month.
 

What if I can't afford the monthly premium? Will I lose my dental benefits?

If you are not able to make your monthly premium payment, you may claim financial hardship. To claim financial hardship, you can check the hardship box on your monthly statement and return the payment coupon or call Iowa Medicaid Member Services.
 
Members who do not complete their Healthy Behaviors and do not pay their monthly premium after 90 days, depending on their income, will have reduced benefits only.
 
Contact Iowa Medicaid Member Services directly at 1-800-338-8366 or 515-256-4606 (when calling from within the Des Moines area), Monday through Friday, 8 a.m. to 5 p.m. For telephone accessibility assistance if you are deaf, hard-of-hearing, deaf-blind, or have difficulty speaking call Relay Iowa TTy at 1-800-735-2942.
 

What if I don't claim financial hardship? Will I lost my dental benefits?

Members who do not complete their Healthy Behaviors and do not pay their monthly premium after 90 days, depending on their income, will have Basic (reduced) benefits only.
 

Members who do not complete their Healthy Behaviors and do not pay their monthly premium will receive reduced benefits only. Can the member pay their current month's premium to start receiving full benefits the following month?

No. Once benefits have been reduced, with the completion of Healthy Behaviors, members have the opportunity for full benefits the following year.
 

I need to complete Healthy Behaviors each year to receive full dental coverage the following year. If I am receiving reduced benefits only, will my dental exam be covered so that I can meet the Healthy Behavior requirement for full benefits the following year?

Yes. All Healthy Behaviors are included in the reduced benefits package.
 

Are there premiums for both Iowa Health and Wellness Plan and IA Health Link members through the dental carriers?

Yes.
 

I am in the Iowa Health and Wellness Plan. Does a dental exam still count toward Healthy Behaviors for medical benefits?

Yes.
 

Are members who have only dentures required to complete both Healthy Behaviors?

All members need to see a dentist. Members who have dentures need to be seeing a dentist annually to be screened for oral cancer and to ensure their dentures are fitting properly.
 

I have completed my Healthy Behaviors, why did I receive a statement?

It is possible that Iowa Medicaid does not have information on the completed activities. If you have completed your Healthy Behaviors, please call Iowa Medicaid Member Services directly at 1-800-338-8366 or 515-256-4606 (when calling from within the Des Moines area), Monday through Friday, 8 a.m. to 5 p.m. For telephone accessibility assistance if you are deaf, hard-of-hearing, deaf-blind, or have difficulty speaking call Relay Iowa TTy at 1-800-735-2942.
 
 

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Iowa Medicaid Member Services (Monday to Friday from 8 a.m. to 5 p.m.)
1-800-338-8366 (Toll Free) 
515-256-4606 (Des Moines Area)
515-725-1351 (Fax)
 
For telephone accessibility assistance if you are deaf, hard-of-hearing, deaf-blind, or have difficulty speaking, call Relay Iowa TTY at 1-800-735-2942.
 
Llame al 1-800-735-2942, a Relay Iowa TTY (teléfono de texto para personas con problemas de audición, del habla y ceguera) si necesita asistencia telefónicamente.