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Medicaid Covers Kids 20 And Under As Part Of EPSDT Benefits
Absolutely, if you are a Medicaid recipient in Michigan, your dental benefits are covered under the EPSDT program, which stands for "Early and Periodic Screening, Diagnostic and Treatment." This program is designed to ensure that children on Medicaid receive the necessary care to identify and treat health issues early, receive appropriate care, and maintain their health as they grow.
As a resident of Michigan, you can enroll your child in one of two Medicaid dental plans, offered by Dentaquest and MCNA Dental. These are the exclusive providers of Medicaid dental insurance for children in the state. Best of all, both plans are free of charge if you're eligible for Medicaid.
Both plans offer similar coverage for children, ensuring they receive a wide range of essential dental treatments as they grow. This includes:
- Teeth cleanings
- Required x-rays
- Oral examinations
- Dental sealants and fluoride treatments
- Dental fillings
- Tooth extractions
- Root canals
- Dental emergency visits
And so much more. By qualifying for Medicaid and enrolling in a Dentaquest or MCNA Dental plan, your child will have comprehensive coverage for a healthy mouth, all at no out-of-pocket costs. If you need to enroll your child, you can visit the Healthcare.gov website for all the information you need to get started.
CHIP May Be An Option For Kids Even If You Don’t Qualify For Medicaid
Many families find themselves in a difficult spot, earning too much to be eligible for Medicaid, yet not enough to comfortably afford the dental insurance and treatment their kids need. That's where CHIP comes in. CHIP, an acronym for Children's Health Insurance Program, is designed to bridge this gap.
Much like Medicaid, CHIP enables you to provide your child with the necessary dental care without the burden of high insurance premiums or hefty co-pays. The cost of CHIP is income-dependent. An annual enrollment fee, capped at $50 per family, per year, is required.
One key difference between CHIP and Medicaid is that Medicaid does not involve co-pays or out-of-pocket expenses. However, CHIP does. The amount you'll need to pay varies based on your income. Families with lower income may pay a nominal $3 to $5 per doctor or dentist visit, while those with higher income may pay between $20 and $35 per visit.
CHIP is available to all kids under the age of 18, which is slightly more restrictive than Medicaid, which covers kids up to the age of 20.
Expectant mothers can also enroll their unborn child in CHIP. Michigan's CHIP is limited to U.S. citizens and legal permanent residents who are also Michigan residents.
In contrast to Medicaid, which offers just two plans for kids in Michigan, CHIP offers a wider range of plans from top insurers like UnitedHealthCare, Aetna, and BlueCross and BlueShield of Michigan. A comprehensive list of plans can be found on the Michigan Health and Human Services website.
Just like Medicaid, CHIP will cover all necessary dental services for your child to maintain a healthy smile. This includes checkups and cleanings, fillings, extractions, emergency care, and all other medically necessary treatments.
Medicaid Doesn’t Typically Cover Adults, Except For Emergency Treatment
In Michigan, children are eligible for Medicaid coverage until they reach the age of 21, while CHIP coverage extends only until they turn 18. Once they cross these age thresholds, they transition from children's Medicaid or CHIP coverage to adult status, where the coverage is primarily limited to emergency services.
For adults, Medicaid typically covers urgent dental procedures, such as tooth extractions for damaged teeth or splinting for loose or dislodged teeth. However, preventive, periodontal, restorative, and oral surgery services are usually not included for healthy adults.
But don't lose hope. If you or your child have physical or developmental disabilities, you may be eligible for broader coverage under Medicaid. Additionally, seniors in Michigan who are aged 65 and above could qualify for extended benefits.
Got More Questions About Medicaid And CHIP? Check Out These Resources!
We understand that deciphering Medicaid and CHIP coverage in Michigan can be quite a challenge. We trust that our previous summary was insightful. However, if you're keen to delve further and learn about coverage, income limits, and other particulars, we've assembled some useful links below. Explore them, and arm yourself with all the information you require:
- Medicaid & Chip – Michigan Department of Health & Human Services
- CHIP – Medicaid.gov
- Medicaid & CHIP in Michigan – Medicaid.gov
- Get Coverage – Healthcare.gov
Need A Medicaid Or CHIP Dentist In Lake Orion? Come To Kids Tooth Team!
Dental care is undeniably crucial for children of all ages. A healthy mouth not only safeguards your child's overall health but also sets the foundation for lifelong oral hygiene habits. Hence, it's vital to introduce your child to a dentist at a young age and ensure regular visits as they grow.If you're in search of a Medicare or CHIP dentist, Dr. Kasey Stark and the team at Kids Tooth Team are ready to assist. As a board-certified pediatric dentist, Dr. Kasey provides care to children and families from all backgrounds. To learn more or schedule an appointment, feel free to book online. We're always welcoming new patients in Lake Orion and the surrounding areas, and we can't wait to meet your little one!
