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.
Effective July 1, 2021, kids, age 18 and under are enrolled in Dental Wellness Plan Kids.
All members have two dental carrier options to choose from:
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.
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.
Dental Benefits
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).
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, gender identity, 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).
