Additional details regarding MCHCP member plans and waiting periods

0
271

Delta Dental of Missouri is the chosen carrier for Missouri Consolidated Health Care Plan (MCHCP) with membership of 47,000 employee and retiree subscribers – totaling nearly 88,000 Missourians.

We are excited to serve as the dental benefits provider for MCHCP, and work with you – our network dentists – to bring exceptional benefits and care to MCHCP members.

We would like to provide our dentists with the following details regarding MCHCP specific plan benefits:

  • The 12-month waiting period for major services will NOT apply to members with an effective date of January 1, 2024. It will also NOT apply to any new enrollees that provide proof of 12 months of prior coverage with major services prior to their enrollment in the MCHCP plan.
  • The missing tooth clause will be waived with submission of a prior carrier’s explanation of benefits (EOB) for the extraction(s) if the member was effective January 1, 2024, AND had prior coverage through the State of Missouri or their public entity employer at the time of the extraction(s).
  • Exams and prophylaxis/cleanings are payable once in any six-month period.
  • For all members, the plan also includes two additional problem-focused exams – the addi­tional benefit is payable twice in any benefit period.
  • For members who qualify for the Health Smiles, Health Lives® benefit, the plan includes two additional cleanings – the benefit is payable twice in any benefit period.
  • All services categorized as preventive on the MCHCP plan do not apply to the member’s annual maximum.

Additional MCHCP member plan, benefit and eligibility information will be available online in the provider portal. If you have any questions, please reach out to our customer service team at service@deltadentalmo.com.

Print Friendly, PDF & Email