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Medical Benefits Expanded in 2018

Medi-Cal Dental Keeps California Teeth Happy

The California Medical Assistance Program (Medi-Cal) is California's Medicaid program serving low-income individuals, including families, seniors, persons with disabilities, children in foster care, pregnant women, and childless adults living in California with limited income and resources.

If you are enrolled in Medi-Cal, you are automatically enrolled in Medi-Cal Dental. No further steps are needed; simply present your Medi-Cal card to your Western Dental dentist for any covered benefit.

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The Medi-Cal Dental Program covers a variety of dental services for Medi-Cal beneficiaries, such as:

• Exams and x-rays (1 per year for adults, 2 per year under 21)
• Cleanings (1 per year for adults, 2 per year under 21)
• Emergency services for pain control
• Fluoride treatments
• Tooth extractions
• Fillings
• Root canal treatments (front teeth and back molars)
• Crowns (prefabricated/laboratory)
• Scaling and root planing
• Periodontal (gum) maintenance
• Complete and partial dentures
• Other medically necessary dental services

Baby teeth turn into grown up teeth

Caring for baby teeth is just as important as caring for adult teeth and sets kids on a positive course for their own oral health. While Medi-Cal Dental won’t cover every dental service (dental implants and braces, for example), there is no yearly limit for children’s covered dental services. Medi-Cal payment for certain dental services for beneficiaries 21 years of age or older is limited to $1,800 per person for each calendar year. Dental services that are medically necessary may be allowed to go over the $1,800 limit, and there is no yearly limit for beneficiaries 21 years of age or older who live in a nursing facility.

How to Apply for Medi-Cal

If you are eligible for Medi-Cal but are not currently covered, you’ll need to apply to receive Medi-Cal Dental benefits.

You can apply in person, by mail, over the phone or online. Application forms and contact information can be found on the California Department of Health Care Services website.

(By the way, anyone who qualifies for SSI, or Supplemental Security Income, is automatically eligible for SSI-Linked Medi-Cal.)

If you need additional help applying or have additional questions, you can contact a trained Certified Enrollment Counselor (CEC) for free by calling 1-800-300-1506.