MAP BASIC Dental Only Plan

• Policies are the same as MAP BASIC except for the Similar Benefits Policy
  • For Adults only
  • Adults applicants can have a similar benefit such as  Medicaid and/or Medicare or private health insurance
• To be eligible for the MAP BASIC Dental Only plan, applicant can not  have or be eligible for MAP, MAP BASIC, CHIP, CSHCN, Medicaid for Children
• Client may be issued retroactive coverage
• Programmed on the VeritySource Certification Form
  • No dental rider, the plans (CUC 100, CUC 150 etc.) define the copayment
  • Prescription Rider B is issued

Adding MAP BASIC Dental Only Tracks

When terminating MAP or MAP BASIC coverage due to client converting to Medicaid/CHIP

• Term MAP/MAP BASIC coverage per usual procedures
• Add a MAP BASIC Dental Only track at enrollment status (use add a track procedures in VeritySource manual)
  • Program Plan and should match the Program plan for MAP BASIC Plan
    • MAP 000= CUC 000
    • MAP 100= CUC 100
    • MAP BASIC 000= CUC 000
    • MAP BASIC 100=CUC 100
    • MAP BASIC 150=CUC 150
    • MAP BASIC 175=CUC 175
    • MAP BASIC 200=CUC 200
• Issue corresponding Dental Rider
• Group Id for MAP BASIC Dental Only is 53220000
• Effective Date will be the date following the end date of the MAP or MAP BASIC coverage
  • example term MAP/MAP BASIC coverage on 1/14/2021 start MAP BASIC Dental Only coverage on 1/15/2021
• End date will equal end date of the MAP or MAP BASIC track
• Do not add a MAP BASIC Dental Only track for
  • Children with Medicaid or CHIP
  • Adults up to age 21 with Regular Medicaid (not SSI)