Nearly 600,000 patients have enrolled in the State of Michigan’s Medicaid expansion program, known as the Healthy Michigan Plan (HMP). The plan is designed to emphasize patient responsibility while reducing the need for more costly healthcare services through prevention. Patients are required to share in costs and are provided with incentives for taking steps to improve their health.
The Healthy Michigan Plan is aimed at the working poor – adults between the ages of 19 and 64 whose income is between 100-133 percent of the federal poverty level and who do not qualify for traditional Medicaid but do not have enough income to afford private insurance. Residents eligible for Medicare are not eligible for the Healthy Michigan Plan.
Eligible patients receive a packet from the state containing their health plan options. They must complete this packet and return it to the state to enroll in their selected health plan. Once the state confirms enrollment, the patient will receive an enrollment card from their selected health plan.
What Is Covered?
It is important to note that coverage and reimbursement rates for all enrollees is not the same. Michigan’s 11 Medicaid health plans are charged with offering dental services on their own or contracting with an insurance company to administer the dental benefit for them. Some of the dental plans offer only the same benefits as traditional Medicaid and others offer more extensive coverage. Some reimburse near PPO rates while other reimburse according to the Medicaid fee-for-service fee schedule. It is important to know which dental plan your patient has their coverage under and to verify benefits on the date of service.
How Do I Participate?
Providers are required to participate with each insurance company in order to accept patients covered by that insurer. Providers are also able to determine the number of Healthy Michigan Plan patients they wish to treat. The terms of participation very with each insurance company so dentists are advised to read contracts carefully.
A number of resources have been added to the MDA’s website to assist members, including links to the State’s Healthy Michigan Plan website.