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What You Need to Know: Restored Dental Benefits for Adults in California

What You Need to Know: Restored Dental Benefits for Adults in California

Updated on January 8, 2018 to include recommendations made by Maternal and Child Health Access

We are excited to announce, in a joint statement with Asian Americans Advancing Justice-Los Angeles and Justice in Aging, that beginning January 1, 2018, adults with full-scope Medi-Cal have many dental benefits restored through Denti-Cal. This includes all pregnant women, regardless of immigration status, who are eligible for pregnancy-related Medi-Cal with full benefits.

The full restoration provides an important opportunity to educate California residents, especially Medi-Cal beneficiaries, about the additional dental benefits to ensure that beneficiaries are able to seek needed dental services.

Here are the major dental services available to adults through Medi-Cal, as of January 1, 2018. However, Denti-Cal continues to have a cap of $1,800 for covered services per year, although some services do not count towards the $1,800 cap and additional services can be covered if shown to be medically necessary. Adults with full-scope Medi-Cal can expect to receive a letter in the mail notifying them of these new benefits.

Major services covered as of January 1st, 2018:

  • Initial Exam
  • Cleaning (prophylaxis)
  • Fluoride Treatment
  • X-Rays
  • Fillings
  • Prefabricated Crowns (resin & stainless steel only)
  • Extractions
  • Root Canals in Front Teeth
  • Full Dentures
  • Full Denture Adjustments & Repairs
  • NEW! Laboratory Processed Crowns
  • NEW! Root Canals in Back Teeth
  • NEW! Partial Dentures
  • NEW! Partial Denture Adjustments, Repairs, and Relines
  • NEW! Periodontics (Scaling and Root Planing)

While the restored dental coverage will now extend to adults with full scope Medi-Cal, beneficiaries can face an array of barriers to accessing these services. It remains critical to provide culturally and linguistically appropriate education to community members about their benefits. Here is a consumer pamphlet, produced by Asian Americans Advancing Justice-Los Angeles, CPEHN, and Justice in Aging in English and Spanish (and soon available in various other languages) with more information about the restored dental benefits and how to access them. 

Advocates and providers who want to learn more about the restored benefits can read more on the Denti-Cal Provder Bulletin found here

To learn more, please visit https://www.denti-cal.ca.gov or call 1-800-322-6384.

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