
Can I go to the dentist during COVID-19?
Can I go to the dentist during COVID-19?
You can go to the dentist during COVID-19. To keep everyone safe, your dental visit will look a little different. Your dental office may ask if you want to schedule a video appointment. When you go to your dental office for an appointment, you may have your temperature taken. You may be asked to wear a face-covering and to keep six feet between yourself and others in the waiting room.
Learn more about returning to the dentist during COVID-19.
Watch this video to learn about what your next dental appointment may look like.
What Is the Medi-Cal Dental Program?
What Is the Medi‑Cal Dental Program?
The Medi‑Cal Dental Program offers free or low-cost dental benefits for enrolled Medi‑Cal members. If your income is more than the Medi‑Cal limit for your family size, a low-cost monthly premium may be required.
Do I qualify for Medi-Cal Dental?
Do I qualify for Medi‑Cal dental services?
The Medi‑Cal program offers a variety of benefits to members including covered dental services. To receive dental coverage through Medi‑Cal, you must be Medi‑Cal eligible. Your eligibility determines the types of benefits you have access to through Medi‑Cal. You do not need to apply separately for dental coverage because it is a part of the Medi‑Cal program.
How do I apply for Medi‑Cal to get dental services?
For information on how to apply for Medi‑Cal, you can go to www.coveredca.com or you can call 1‑800‑300‑1506.
What am I covered for?
What dental services am I covered for?
View a list of the dental services you qualify for.
Learn more about your covered dental services.
If I am signed up, do I have to pay for dental services?
Medi‑Cal Dental covers dental services for most Medi‑Cal members. Depending on your income and your family size, dental services may be available at no cost to you (or your child). In some cases, you may have to pay a “Share of Cost (SOC)” and/or a co-pay.
What does the Medi‑Cal Dental Program pay for?
Medi‑Cal Dental covers many services to help keep your gums and teeth strong and healthy.
Learn more about services covered by the Medi‑Cal Dental Program.
What is a Share of Cost (SOC)?
In some cases, you may have to pay a Share of Cost (SOC) and/or a co-pay as a Medi‑Cal member. SOC is determined by your monthly income. If you have been told that you have a SOC, this likely means your income is more than the Medi‑Cal limit for your family size, and you have to pay a monthly dollar amount for your medical expenses.
Contact Medi‑Cal at 1‑800‑541‑5555 to find out what your share of the cost is.
What is a Co‑Pay?
Your co‑pay is a fixed amount you pay for a service, usually at the same time you receive the service. The co‑pay usually falls outside your covered dental services. The co-pay amount will vary based on the type of service. For example, a dental visit might have a co-pay of $2. The co‑pay for an emergency room visit will usually cost more. For some services, you may have a co-pay and a SOC. These services may have a co‑pay for adults with the Medi‑Cal dental benefit:
- Non-emergency services provided in an emergency room – Co‑pay $5
- Outpatient services – Co‑pay $1
How do I find a Medi-Cal dentist?
How do I find a Medi-Cal dentist?
You can find a dentist by visiting the Medi‑Cal Dental provider website, or you can call the Telephone Service Center Phone Line at 1‑800‑322‑6384.
What if I want a second opinion?
As Medi‑Cal member, you can ask to see another dentist or specialist before making a decision about your primary dentist’s treatment plan for you. This is also an option for you if you are enrolled in a Dental Managed Care plan.
If I do not have a ride, are there other options to get to the dentist’s office?
Medi‑Cal provides non-emergency and non-medical transportation services to eligible members. You can qualify for transportation if your appointment is medically necessary.
To request transportation assistance, call the Telephone Service Center Phone Line at 1‑800‑322‑6384. The transportation must be used only for necessary health care covered by the Medi-Cal program.
Call your county social services office for help if you need a ride to your appointment, but you do not qualify for medically necessary non-emergency transportation services.
What if I need an interpreter during my dental appointment?
Medi-Cal provides language interpretation assistance and American Sign Language (ASL) translation services to Medi-Cal members at no cost. Language interpreters are available in over 250 languages and dialects.
You, or your dental office can call the Telephone Service Center (TSC) at 1‑800‑322‑6384 Monday through Friday, between 8 a.m. and 5 p.m. to ask for language assistance over the telephone during your dental appointment. Language assistance cannot be scheduled ahead of time.
If you are a member with hearing or speaking limitations, you can call the Teletext Typewriter (TTY) line at 1‑800‑735‑2922, Monday through Friday, 8 a.m. to 5 p.m.; at all other times, you should call the California Relay Service TDD/TTY at 711 for help. For assistance scheduling ASL translation services during your dental appointment, please have the operator call the toll-free member line at 1‑800‑322‑6384.
What do I need to bring to my dental appointment?
Show your Medi‑Cal Benefits Identification Card (BIC) to your dentist’s office at your appointment. Your dentist will match the name and signature on your BIC with another form of identification, such as:
- Your Social Security Number (SSN)
- A valid California driver’s license
- Any identification card issued by the Department of Motor Vehicles (DMV)
- Or any other document which appears to prove your identity
In some cases, you can still be seen for dental services without a BIC. If your dentist does not know you, they must make a good faith effort to verify your identity.
What happens if I miss an appointment?
It is important to show up to your dental appointments, but if you know you will not be able to make it, call your dentist at least 24 hours before to cancel and reschedule.
Missing a dental appointment can have a big impact on the health of your mouth.
It is best to make all arrangements (transportation, babysitting, time off work) when you schedule your appointment to make sure you can keep it.
What should I do if I have a dental emergency?
What is a dental emergency?
The American Dental Association recognizes these examples as dental emergencies:
- Bleeding that doesn’t stop
- Painful swelling in or around your mouth
- Severe pain
- Facial trauma, such as injury to jawbone and face
- Gum infection with pain or swelling
- After surgery treatment (dressing change, stitch removal)
- Broken or knocked-out tooth
- Snipping or adjusting wires in braces that hurt your cheeks or gums
A routine dental visit is not an emergency. This includes:
- Regular visits for exams, cleanings and x-rays
- Regular visit for braces
- Removal of teeth that aren’t painful
- Treatment of cavities that aren’t painful
- Teeth whitening
If you have dental pain or a dental emergency, contact your dental office for treatment. If you do not have a regular dentist or your dental office is closed, call the Medi-Cal Dental Telephone Service Center at 1‑800‑322‑6384, for help finding one. You can also get free transportation if there are no dental offices open in your area.
When should my child have their first dental appointment?
When should my child have their first dental appointment?
You should make an appointment for your child’s first dental visit as soon as their first tooth comes in or by their first birthday, whichever comes first. Many kids get cavities as early as age 2. See the dentist as soon as possible to prevent problems.
How often should I go to the dentist?
How often should I go to the dentist?
If you are under the age of 21, you are covered for free or low-cost check-ups twice a year. If you are 21 or over, you are covered for free or low-cost check-ups once a year.
Regular dental visits are important for your oral health and your overall health.
Is it safe to go to the dentist while I'm pregnant?
Is it safe to go to the dentist while I’m pregnant?
It is safe and important to see the dentist while pregnant. When you are pregnant, your oral health is a big part of making sure your baby is healthy.
Learn more about oral health care and pregnancy.
Watch this video to learn more about visiting the dentist while pregnant.
What if I only have restricted scope Medi-Cal?
What if I only have restricted scope Medi-Cal?
If you have restricted scope Medi-Cal, sometimes called “emergency Medi-Cal” you may qualify for Medi-Cal coverage for emergency and pregnancy-related services.
What If I live in Sacramento or Los Angeles County?
How can I get information about my benefits if I have a dental managed care plan?
If you live in Sacramento County, you will need to enroll in Dental Managed Care (DMC) and will see a dentist through a dental managed care plan. If you live in Los Angeles County, you can choose to stay in Medi‑Cal Dental or you can enroll in DMC. If you enroll in DMC, the plan you choose will send you information about your benefits.
What is EPSDT?
Early and Periodic Screening, Diagnostic and Treatment (EPSDT)
If you or your child are under 21 years old, Medi-Cal covers preventive services, such as regular health check-ups and screenings to check for any problems with your medical, dental, vision, hearing, mental health, and any substance use disorders. You can also get vaccinations to keep you healthy. Medi-Cal covers screening services any time there is a need for them, even if it is not during your regular check-up. Medically necessary services are covered under EPSDT. For more details, view the Information for Medi-Cal Beneficiaries (EPSDT) document.
What is an Authorized Representative?
An Authorized Representative is someone you can name and give access to your Protected Health Information (PHI). An Authorized Representative can be family members, friends, or any other individual you choose. For example, you may want your spouse or adult child to help with billing questions, booking appointments, or to be aware of your health status. See our Member Authorized Representative Frequently Asked Questions for more information.