Denti Cal Beneficiary Handbook  

Handbook for Dentists  

Denti Cal Beneficary Handbook

Denti Cal Website   

The Medi-Cal Program currently offers dental services as one of the program's many benefits. Under the guidance of the California Department of Health Care Services, the Medi-Cal Dental Program aims to provide Medi-Cal beneficiaries with access to high-quality dental care. This website provides important information about the Medi-Cal Dental Program for beneficiaries and providers.

ABC News – Denti Cal benefits restored

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Click here for Dental – OUTSIDE of Medi-Cal

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Adult Medi Cal Dental Benefit 
Full Restoration Effective January 1, 2018

Medi-Cal offers comprehensive preventative and restorative dental benefits to both children and adults.

You can find a Medi-Cal dentist on the Denti-Cal Provider Referral List, or by calling 1-800-322-6384.

 

Adult Dental benefits   Senate Bill 97 – 2017  fully restored adult optional dental benefits 

  • Laboratory processed crowns,
  • posterior root canal therapy,
  • periodontal services,
  • and partial dentures, including denture adjustments, repairs, and relines.
  • Pregnancy-related services
  • Emergency services
  • Services provided to residents of an Intermediate Care Facility/Skilled Nursing Facility
  • Services provided to consumers of the Department of Developmental Services

Dental Provider Handbook

DHCS Medi-Cal Dental Program

denti-cal.ca.gov  

Links & Resources

californiahealthline.org/ February 2014  

 

Los Angeles County Medi-Cal
ONLINE Enrollment

or just call toll free # 866-613-3777
Email:   [email protected]

Covered CA Instructions if you do it through their portal​

DPSS Website DPSSBenefits.LACounty.Gov

Direct Phone # for Medi Cal
866.613.3777
Direct Phone # 866.613.3777

8 comments on “Denti Cal

  1. My son has private dental insurance thru he’s father’s employer and denti-cal as secondary. He has a dentist appointment and I was told that I have to pay the deductible and co insurance because denti cal won’t pay for that.

    Is that true?.

      • Yes, they are providers

        they are doing 2 fillings but she said that because on the eligibility it shows he has cigna

        denti cal won’t pick up the deductible and co insurance

        that they want me to pay the day of he’s visit.

        • Medi-Cal will cover services that are not available under the private policy in addition to deductibles and copayments. https://ca.db101.org/ca/programs/health_coverage/medi_cal/faqs.htm

          Do you have a pre-paid managed care plan? HMO? Is your dentist part of that plan? On Medi Cal? On CIGNA? https://www.denti-cal.ca.gov/Beneficiaries/Beneficiary_Frequently_Asked_Questions/

          ***********************

          your dentist cannot ask you to pay for any treatment that is covered by Medi-Cal Dental.
          The dentist cannot charge you for private insurance cost-sharing amounts such as
          deductibles, co-insurance or copayments.

          What if I get a bill from the dentist?

          First, you should call your dental office and ask them why they sent you the bill. The dental
          ofce will explain the charges and why they are asking you to pay. For example, if you have
          a share of cost amount, you will need to pay that amount before the dentist can ask
          Medi-Cal Dental to pay for the treatment. Or, if you get an agreed upon treatment that
          is not covered by Medi-Cal or other insurance, you will have to pay the dentist for that
          treatment.

          If you still have questions about what your dentist is charging you and/or what Medi-Cal
          Dental pays for, call the TSC.
          Medi-Cal Dental Telephone Service Center:
          1-800-322-6384

          What happens if I have other dental insurance?

          Your dentist must bill your other dental insurance before asking Medi-Cal Dental to pay
          for any treatment. The Medi-Cal Dental Program does not pay any benefts you can
          get through other dental insurance including other government programs, TRICARE
          (CHAMPUS) or Workers’ Compensation. Coverage provided under Medi-Cal is secondary to
          all other coverage.

          If you have other dental insurance that does not pay for a service that is covered by
          Medi-Cal Dental, or pays less than the amount paid by Medi-Cal Dental, your dentist will
          send a claim to Medi-Cal Dental for any unpaid amount. Your dentist cannot ask you to pay
          for any treatment that is covered by Medi-Cal Dental.
          https://www.denti-cal.ca.gov/DC_documents/beneficiaries/DC_member_handbook_english.pdf

    • Reply from San Mateo via Covered CA Agent Support

      I received this back from a county representative from San Mateo County:

      “For individuals enrolled in Medi-Cal, then they are automatically enrolled in Denti-Cal. Clients may call 1-800-322-6384 for a list of providers in their county or visit the DHCS website for a list of Denti-Cal providers. They may check out the state website for Denti-Cal: https://www.denti-cal.ca.gov/ for more information.

      If they come in to one our offices or call, the worker may direct them to the 800# or may provide them with some numbers to local dental providers.

      Calling the 800# would be easier if all they want is to get information on where they can go to see a dentist. They just need to present their Medi-Cal BIC card to a dental office that excepts Medi-Cal/Denti-Cal. If the client has lost their State Medi-Cal BIC card they may call or visit their county of residence Medi-Cal office to request a BIC card.

      Hope this is helpful.”
      See also Denti Cal Manual page 4

      My Medi Cal brochure page 13

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