Indiana Medicaid Dental Coverage

Updated August 2026

Indiana's HIP waiver creates a two-tier structure that affects dental coverage directly. Under the Section 1115 waiver terms approved by CMS, HIP Plus includes dental benefits — coverage for preventive, basic restorative, and in some cases major services, delivered through the member's managed care organization. HIP Basic provides limited or no dental coverage for most adult services.

HIP Plus only

Adult dental coverage

Under 21

Full EPSDT dental coverage

800-457-4584

FSSA member services

Adult dental depends on your HIP tier — HIP Basic generally has none

Adult dental coverage in Indiana Medicaid depends on which HIP tier you are enrolled in. HIP Plus members (those who pay POWER account contributions) receive dental benefits through their managed care plan. HIP Basic members generally do not receive dental coverage. Contact your health plan to confirm your current dental benefits.

Dental coverage for adults: HIP Plus vs. HIP Basic

The specific dental benefits available through HIP Plus vary by health plan. Anthem, CareSource, MHS, and UnitedHealthcare each administer dental through their plan networks. Members should contact their health plan directly to confirm what dental services are covered, which dentists are in-network, and whether prior authorization is required for restorative work.

Members who are unsure which HIP tier they are on can check by calling the FSSA Member Services line at 800-457-4584 or logging into the FSSA Benefits Portal.

What HIP Plus dental typically covers

While exact benefits vary by plan and can change with contract renewals, HIP Plus dental benefits generally include:

  • Preventive care — cleanings (prophylaxis), exams, and X-rays
  • Basic restorative services — fillings for decayed teeth
  • Tooth extractions
  • Emergency dental treatment for pain or infection
  • Some plans may cover additional services — verify with your plan

Dental coverage for children: comprehensive EPSDT benefits

Children enrolled in Hoosier Healthwise (Indiana's Medicaid/CHIP program for children) receive comprehensive dental coverage under the federal EPSDT (Early and Periodic Screening, Diagnostic, and Treatment) mandate. EPSDT requires states to cover all medically necessary dental services for Medicaid-enrolled children under age 21 — not just a list of approved services, but anything that is medically necessary.

  • Preventive care: dental exams, cleanings, fluoride treatments, and sealants
  • Diagnostic X-rays
  • Fillings and restorative care
  • Extractions
  • Orthodontics when medically necessary
  • Oral surgery
  • Emergency dental treatment

Finding a dentist who accepts Indiana Medicaid

Indiana HIP Plus plans typically do not cover orthodontics for adults, cosmetic dental procedures, or implants. Major services like crowns and root canals may be covered with prior authorization on some plans but not others. Call your health plan's member services number to get a current list of covered dental services before scheduling an appointment.

Indiana Medicaid dental providers operate within each health plan's network. The FSSA member portal lists over 50,000 providers statewide. To find a dentist accepting Indiana Medicaid: log into the FSSA Benefits Portal, select your health plan, and use the provider directory. Alternatively, call your health plan's member services line and ask for a list of in-network dentists in your county.

Indiana Medicaid (Healthy Indiana Plan)

  • FSSA Member Services: 800-457-4584
  • FSSA Benefits Portal: fssabenefits.in.gov
Visit the official Indiana Medicaid website

Related guides