What is happening with the Medicaid dental program later this year?

For the last few years, the Arkansas Department of Human Services (DHS) has partnered with MCNA and Delta Dental to manage and pay for your dental services. In the fall, the Medicaid program itself (Fee-For-Service, or FFS) will manage and pay for your dental services.

This means you will use your Medicaid ID when you go to the dentist, not an MCNA or Delta Dental card, and your dentist will bill Medicaid directly.

When will my dental services change to FFS?

• New beneficiaries who become eligible for Medicaid dental benefits on or after August 15, 2024, will be enrolled in FFS.
• Beneficiaries who recently lost Medicaid dental benefits but regain it on or after August 15, 2024, will be enrolled in FFS.
• All other beneficiaries will transition to FFS on November 1, 2024.

What dental card will I provide to my dentist?

• If you are currently enrolled in FFS, you should continue to use your Medicaid ID card for all dental services.
• New beneficiaries or those who regain their eligibility on or after August 15, 2024, should use their Medicaid ID card for all dental services.
• All beneficiaries who are enrolled in Delta Dental or MCNA should use their Medicaid ID card for all dental services beginning November 1, 2024. Delta Dental or MCNA cards can be discarded.

What dental services are covered in the Dental FFS Program?

• Services such as oral evaluations, x-rays, topical fluoride, sealants, crowns, and root canals
• Orthodontic care such as braces
• Dental services in a long-term care setting
• Some benefit limitations may apply, based on the Medicaid program you’re enrolled in or other factors. Contact your dental provider to determine whether the services you need are covered.

Is my dentist eligible to participate in Medicaid FFS?

• All dental providers who participated in Delta Dental and MCNA are Medicaid-enrolled dental providers.
• Dental providers with Indian Health Services, Tribal, and Urban Indian Organization are Medicaid enrolled dental providers.
• Please contact your dentist to confirm they will continue serving Medicaid patients.

How can I find a dentist who accepts Medicaid?

• Call the ConnectCare help line at 1-800-275-1131 (TDD 1-800-285-1131) for help finding a dentist.
• Look it up online. Medicaid-enrolled dentists in your area can be found at humanservices.arkansas.gov/u/dentist. You’ll need to enter your location and select “Dental” as the Provider Type.

Will I have to pay for any dental services?

• Dental services are limited to $500 per year for adults. The only time you will have to pay is if services are more than $500 or if you get services not covered by Medicaid.
• There is no dollar limit on medically necessary services for children. There is a copay for children in ARKids-B.

I am currently enrolled in Delta Dental or MCNA. Who do I contact for dental claims and coverage from now until November 1, 2024?

• All eligible claims for services provided before November 1, 2024, will be paid for by Delta Dental or MCNA. You can call these companies for questions related to claims.
  • MCNA – 1-866-864-2499
  • Delta Dental – 1-844-341-6262

I am currently enrolled in FFS for dental services. Who do I contact for dental claims and coverage?

• All eligible claims for services will continue to be paid for by Medicaid. You can call 1-800-275-1131 (TDD 1-800-285-1131) for questions related to claims and coverage.

I am in the middle of dental treatment (e.g., orthodontics, crowns, dentures, etc.). Will my remaining services be covered?

• All services in progress will be covered, but Delta Dental, MCNA, and Medicaid will share the responsibility of paying your dentist based on the dates and types of treatment.
• Delta Dental and MCNA will pay for all authorized orthodontic services already in progress (for example, braces that are already installed) prior to November 1. Medicaid will pay for authorized orthodontic services started after that.
• Delta Dental and MCNA will pay for claims for other multi-visit treatments if the crowns or other prosthetic appliances are delivered to you before November 1. Medicaid will pay claims for multi-visit treatments in which the crowns or other prosthetic appliances are delivered to you on or after November 1.