Dental Wellness Plan Background Information


What is the Dental Wellness Plan?

The Dental Wellness Plan provides dental coverage for adult Iowa Medicaid members, age 19 and older. Dental Wellness Plan members have two dental carrier options to choose from. You can choose Delta Dental or MCNA Dental to provide your dental coverage.
 
All Dental Wellness Plan members will receive full dental benefits in their first year of eligibility. Members who complete their Dental Healthy Behaviors each year will continue to receive full benefits. Members who do not complete their Dental Healthy Behaviors may be charged a monthly premium.
 

Will I still receive Iowa Medicaid dental coverage before I transition to a dental carrier?

You will receive coverage through the Iowa Medicaid Fee-for-Service (FFS) dental program during your transition period.
 
To verify when you will begin coverage with a dental carrier, please contact Iowa Medicaid Member Services 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.
 

Who is included in the Dental Wellness Plan?

Most adult Medicaid members age 19 and over.
 

Who is excluded from the Dental Wellness Plan?

Some adult members will not transition to the Dental Wellness Plan and will receive their dental benefits through the Iowa Medicaid Fee-for-Service (FFS) dental program. Members in the following programs will not transition to the Dental Wellness Plan:
  • Program of All-Inclusive Care for the Elderly (PACE)
  • Health Insurance Premium Payment Program (HIPP)
  • Presumptively Eligible
  • Persons eligible  only for the Medicare Savings Program
  • Medically Needy
  • Periods of retroactive eligibility
  • Nonqualified immigrants receiving time-limited coverage for certain emergency medical conditions

My Child is on hawk-i, will they be in the Dental Wellness Plan program?

No. Children in the hawk-i dental program will continue to receive their dental benefits as they do today.
 

My child is Fee-for-Servicewill they be in the Dental Wellness Plan program?

No. Children in the FFS dental program who are under the age of 19 will continue to receive their dental benefits as they do today.
 

I have a senior dental plan. What is the difference between a senior dental plan and the Dental Wellness Plan?

Senior dental plans are commercial dental insurance options that require a monthly payment for dental coverage. The Dental Wellness Plan provides dental coverage for most adult Iowa Medicaid members at no cost to the member. Dental coverage under the Dental Wellness Plan is a benefit that is included in Iowa's adult Medicaid program.
 
It is your decision if you would like to continue paying for your dental coverage through a commercial senior dental plan. However, you will also have coverage through the Dental Wellness Plan.
 
For additional information about your available dental benefits through the Dental Wellness Plan, you may contact the appropriate plan below:

What's new for 2018? (Effective July 1, 2018)

Effective July 1, 2018, every adult member enrolled in the Dental Wellness Plan has an annual benefit maximum of $1,000 per fiscal year (July 1 - June 30). For more information about these changes, please visit the Benefits and Services web page
 
 

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.