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Dental Plans
Dental benefits for most Iowa Medicaid members are provided through dental plans. Adult Medicaid members aged 19 and older are enrolled in the Dental Wellness Plan.
All members can choose Delta Dental or MCNA Dental to provide their dental coverage. Both dental carriers offer the same benefits and have their own network of dentists and dental providers.
List items for Iowa Medicaid Dental Providers
Delta Dental is for those eligible for Traditional Medicaid, CHIP (Hawki), or IHAWP (Iowa Health and Wellness Plan) programs.
MCNA Dental is for those eligible for Traditional Medicaid or IHAWP (Iowa Health and Wellness Plan) programs.
Dental Provider Resources
List items for Dental Provider Resources
- Dental Wellness Plan Dental Covered Services (300.74 KB) .pdf (Comm. 712)
- Dental Wellness Plan Excluded Services - Annual Benefit Maximum (ABM) (112.5 KB) .pdf (Comm. 711)
- Iowa Medicaid DWP CDT Codes Requiring Prior Authorization or Additional Documentation with the Claim (180.06 KB) .pdf (Comm. 710)
- Dental Request for Prior Authorization (470-0829) (107.33 KB) .pdf
Changes to Dental Carrier
All members are able to change their dental carrier during their annual choice period or for reasons of Good Cause. Learn more about Good Cause on the Iowa Health Link webpage.
If you would like to change your dental carrier, or verify your annual choice period, please call Iowa Medicaid Member Services at 1-800-338-8366.
Back to topDental Benefits
With an Iowa Medicaid dental health plan, you'll have access to such dental care and services as:
- Diagnostic and Preventive Dental Services
- Exams
- Cleanings
- X-rays
- Fluoride
- Fillings for Cavities
- Surgical and Non-Surgical Gum Treatment
- Root Canals
- Dentures and Crowns
- Extractions
IMPORTANT NOTICE: Members in a medical institution have full benefits and do not have to pay monthly premiums. Medical institution includes Nursing Facility, Skilled Nursing Facility or Intermediate Care Facilities for Persons with Intellectual Disabilities (ICF/IDs).
Back to topDental Plan: Member Materials
List items for DWP Member Materials
- Informational Letter 1804-MC-FFS-D: Adult Dental Redesign (June 2017) (178.08 KB) .pdf
- Informational Letter 1788-D: Medicaid Adult Dental Program Redesign (May 2017) (190.61 KB) .pdf
- University of Iowa Public Policy Center Dental Wellness Plan Evaluation
- Dental Wellness Plan Now Has Two Dental Carriers: Informational Letter 1696 (July 2016) (143.27 KB) .pdf
- Dental Wellness Plan Administrators: Informational Letter 1667 (May 2016) (137.15 KB) .pdf
- Dental Wellness Plan Announcement: Informational Letter 1353 (February 2014) (143.74 KB) .pdf
Dental Wellness Plan Rights and Responsibilities
- To receive timely, appropriate, and accessible dental care
- To obtain a second opinion regarding a dental diagnosis
- To choose the provider of your choice from the providers available within your dental carrier’s network
- To change your dental carrier as allowed by program policy
- To appeal a decision that you do not agree with
- To be treated with respect and dignity
- To be treated without discrimination with regard to race, color, national origin, sex, sexual orientation, religion, age, disability, political belief or veteran status
- To participate in decisions regarding your dental care, including the right to refuse treatment
- To be knowledgeable about your dental coverage
- To obtain routine and ongoing care from your provider in an office setting
- To contact your provider before emergency room visits with the exception of situations requiring emergency care.
- To carry your current medical assistance card and Dental Wellness Plan card at all times and present it when accessing dental care.
- To call the number on the reverse side of your member ID cards if you move or have incorrect information printed on your medical cards
- To be responsible for any medical bills if you do not present your Iowa Medicaid card or Dental Wellness Plan card at the time of your visit
- To be responsible for any dental bills for services provided by a practitioner who is not participating in the Iowa Medicaid program or is not enrolled with your dental carrier
All Dental Wellness Plan and Dental Wellness Plan Kids members have the right to file an appeal with their dental carrier. For benefit or service-related issues, please contact your dental carrier to learn about your appeal rights with them. If an Iowa Medicaid member is dissatisfied with the dental carrier’s decision, the member can access the State Fair Hearing appeal process through the Department of Human Services (DHS).
For more information on appeals see pages 22-23 of the IA Health Link Member Handbook (602.86 KB) .pdf ( Espanol (584.7 KB) .pdf ).
Learn more about the appeal process here: Appeals
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