Medi-Cal Older Adult Expansion
About the Medi-Cal Older Adult Expansion
As of May 1, 2022, adults 50 years of age or older who are currently enrolled in restricted scope Medi-Cal (often called Emergency Medi-Cal) are eligible for full scope Medi-Cal benefits. Immigration status does not matter, but all other Medi-Cal eligibility rules still apply. This includes free and low-cost dental services.
What does full scope Medi-Cal mean?
Medi-Cal provides free or low-cost health coverage for eligible people who live in California. Full scope Medi-Cal covers more than just emergency health care. It provides medical, dental, mental health, vision care, substance use treatment services, and long-term care.
With full scope Medi-Cal, you are now eligible to receive all dental treatments covered by the Medi-Cal Dental Program. Eligibility requirements, such as prior authorization or medical necessity, still apply. See the links below for some of the dental services available to you.
For more information about other covered dental services for adults, click here.
For more information about other covered dental services for seniors, click here.
If you are not currently enrolled in Medi-Cal, visit CoveredCA.com to apply or contact your local county office.
FAQ
Frequently Asked Questions About Your Benefits Expanding
Below are some frequently asked questions you may have regarding your benefits expanding.
Why are my Medi-Cal benefits expanding?
Starting May 1, 2022, a new law in California gave full scope Medi-Cal to Californians 50 years of age or older who qualify for Medi-Cal, and immigration status does not matter.
Full scope Medi-Cal includes these benefits: Alcohol and drug use treatment, dental care, emergency care, family planning, foot care, hearing aids, medical care, medications your doctor prescribes, medical supplies, mental health care, personal attendant care and other services that help people stay out of nursing homes, referrals to specialists, if needed, tests your doctor orders, transportation to doctor and dental visits and to get your medications at the pharmacy, and vision care (eyeglasses).
Will I get more health care services with full scope rather than restricted scope Medi-Cal?
Yes. Medi-Cal offers free or low-cost health care for people who live in California. Full scope Medi-Cal is different from the restricted scope Medi-Cal coverage you have now. Restricted scope Medi-Cal only covers some services, but it does not cover things like medications and primary care. With full scope Medi-Cal, you are now eligible to receive all dental treatments covered by the Medi-Cal Dental Program. Eligibility requirements, such as prior authorization or medical necessity, still apply. For more information about medical necessity, please see page 14 of the Member Handbook. Click here to view a list of covered dental services.
Do I need to fill out a new Medi-Cal application?
No. If you have restricted scope Medi-Cal in May 2022, you will be automatically transitioned to full scope Medi-Cal. If you get a packet in the mail to renew your Medi-Cal, fill it out and return it. You can call your county office for help.
What dental services can I get with full scope Medi-Cal?
With full scope Medi-Cal, you can receive medically necessary dental services.
- Exams
- X-Rays
- Teeth cleaning
- Fluoride varnish
- Fillings
- Tooth removal
- Crowns*
- Emergency services
- Sedation
- Root canals
- Partial and full dentures
- Denture relines
- Scaling and root planing
*Crowns on molars or premolars (back teeth) may be covered in some cases.
How can I find a Medi-Cal dental provider who is accepting new patients near me?
If you live in Sacramento, Los Angeles, or San Mateo counties, see information for your county below.
For all other counties, you will get fee-for-service (regular) Medi-Cal dental services through the Medi-Cal Dental Program. Click here to use the “Find A Dentist” tool to find a Medi-Cal dental provider near you. You can also call the Medi-Cal Dental Telephone Services Center at 1(800) 322-6384 (TTY 1(800) 735-2922), Monday through Friday, 8 a.m. to 5 p.m. The call is free.
If you live in Sacramento County, you will get your dental services through a Medi-Cal Dental managed care plan (MCP). To learn more about Medi-Cal Dental MCPs, call Health Care Options at 1(800) 430-4263 (TTY 1(800) 430-7077). The call is free. Or you can fill out the Dental Choice Form in your My Medi-Cal Choice Packet.
If you live in Los Angeles County, you will get fee-for-service Medi-Cal dental services through the Medi-Cal Dental Program, unless you choose to enroll in a Medi-Cal Dental MCP. To learn more about enrolling in a Medi-Cal Dental MCP, call Health Care Options at 1(800) 430-4263 (TTY 1(800) 430-7077). The call is free. Or you can fill out the Dental Choice Form in your My Medi-Cal Choice Packet.
If you live in San Mateo County, you will get dental services through the Health Plan of San Mateo. This is a MCP. To learn more about dental services through Health Plan of San Mateo, call toll-free 1(800) 750-4776 or (650) 616-2133 Monday through Friday, 8 a.m. to 6 p.m. For TTY: Call 1(800) 735-2929 or 7-1-1.
Click here for additional FAQs regarding the Older Adult Expansion.