Medi-Cal is a program that provides free or low-cost healthcare services to people who meet certain eligibility requirements. The Medi-Cal Dental Program helps you get dental services, such as checkups, cleanings, x-rays, root canal treatments and other procedures to prevent or repair damage to your teeth. With this guide, you can understand the details of the Medi-Cal Dental Program in California and learn how to take full advantage of its benefits.
Before Dental Services through Medi-Cal
The Medi-Cal program is for people who are considered low-income. The program is managed by the state and overseen by the federal government. If you have insurance through your employer or another source, you’ll need to use those benefits first — and Medi-Cal will be secondary. The Medi-Cal dental program provides dental services to low-income Californians who are eligible for Medi-Cal. You must be a California resident and meet income eligibility requirements to participate.
The Medi-Cal dental program is designed to provide basic dental services to prevent or treat tooth decay. It is not intended to replace regular dental visits or replace missing teeth. The program covers a yearly dental exam, one cleaning per year, X-rays and diagnosis and treatment of tooth decay.
How to Enroll in Medi-Cal Dental Program
First, find out if you are eligible. Visit the California Department of Health Care Services website to start an application or call 800-300-1506 from 7 a.m. to 7 p.m. daily to speak to a representative.
Complete an application. You can fill out an application online or obtain an application in person from your county’s Medi-Cal office. Then take a printed form to the Medi-Cal office or ask them to send you an application by mail. You may also be able to fill out an application online.
Take your application to your county’s Medi-Cal office to schedule an appointment with a representative and to schedule a blood test if necessary.
Bring proof of identity, residency and financial status to your appointment. You’ll need to show two documents that prove you’re a California resident, two documents that show your identity and one document that shows your financial status.
Who participates in the Dental Program?
You may be able to find a dentist who participates in the Medi-Cal dental program by going to the Dental Health and Dental Medi-Cal website and using their online tool to find providers near you. Alternatively, you can contact your county’s Medi-Cal office to ask if they know of any participating providers in your area. You can also call the California Association of Oral Health Professionals at 800-99-ORAL or visit their website to search for a dentist who participates in the Medi-Cal dental program. You can also use their online “Find a Dentist” tool to narrow your search by location, specialty, languages spoken and accepted insurance.
Medi-Cal Dental Program Benifits
The Medi-Cal dental program covers a yearly dental exam, one cleaning per year, X-rays, diagnosis and treatment of tooth decay, fillings, root canals, tooth removal and dentures. The program does not cover oral surgery, endodontic therapy, dental implants, orthodontics, crowns or bridgework. The program may cover more than these items, but these are the basic services provided. Be sure to ask your provider about any charges outside the program’s dental services to ensure you understand your costs.
How much does the Program cost?
As a Medi-Cal enrollee, you’ll pay no out-of-pocket costs to use the dental program. However, you must provide proof of your Medi-Cal status with each dental visit to receive these benefits. Your provider can bill the California Department of Health Care Services for payment. They will likely use a paper billing system such as a CR-80 or an online billing system such as CAL-END. The California Department of Health Care Services will make payments to your dental provider up to 90 days after they submit the bill. If your provider needs payment sooner, they may request payment directly from you.
Tips for Using the Medi-Cal Dental Program
Find a dentist who participates in the Medi-Cal dental program. You may need to search for a while before you find a provider who participates in the program. Be patient and open to trying new providers; you may find a gem.
Don’t be afraid to ask questions. If you don’t understand something or have questions, be sure to ask your provider. You are the one who will be receiving the treatment, so it is important that you understand.
Follow up if you don’t hear back. If you have submitted an application and haven’t heard back within 30 days, you can call the California Department of Health Care Services and request that your application be expedited.
Use your benefits. Once you have used your yearly dental exam, one cleaning and X-rays, ask your provider if you need any follow-up care. If you have tooth pain, infection or other dental problems, ask your provider about treatment options.
Final Words
In this article, we have discussed what you need to know before getting dental services through Medi-Cal. We have also discussed how to enroll in Medi-Cal and the Medi-Cal dental program. We have talked about the providers who participate in the Medi-Cal dental program, what is covered under the Medi-Cal dental program, how much it costs to use the Medi-Cal dental program, and tips for using the Medi-Cal dental program.
