California Medi-Cal Dental (Denti-Cal) Benefits
About Medi-Cal Dental Benefits
The Medi-Cal dental program is part of the many benefits offered under the California Medi-Cal umbrella. Medi-Cal is California’s version of Medicaid and helps low-income and struggling families find access to affordable health care. Dental benefits are available for all eligible adults and children. People will find out if they are eligible for Medi-Cal when they apply for healthcare through Covered California, the state’s health insurance marketplace.
Freeway’s licensed and bilingual agents can help families navigate through California’s healthcare options, including dental benefits.
What is Included in Medi-Cal Dental?
For adults and children meeting eligibility requirements, dental benefits are available through Denti-Cal and include the following:
- Exams and X-rays
- Cleanings
- Fluoride treatments
- Fillings
- Anterior root canals (front teeth)
- Prefabricated crowns
- Full dentures
- Other medically necessary dental services
Does Medi-Cal or Denti-Cal Cover Braces?
Yes. But, not everyone with Medi-Cal/Denti-Cal qualifies for these benefits. A patient must first be evaluated to rate the degree of the malocclusion, which is a problem in the way the upper and lower teeth fit together in biting or chewing, such as an overbite or under bite. The way this is determined is by using measurable units known as a Labio-Lingual Deviations (HLD) index score.
Depending on the physically handicapping orthodontic defects and HLD score, Medi-Cal/Denti-Cal will either approve or disapprove the corrective action.
For example:
- Patients covered by a basic Denti-Cal program will be eligible for orthodontic coverage if they have a Handicapping Labio-Lingual Deviation (HLD) index score of 26 points or more.
- Patients covered by a managed care plan through the Denti-Cal program, in certain cases, will not have orthodontic benefits.
- Children with severe health problems who qualify under the California Children’s Services (CCS) will have orthodontic coverage. But, they can’t qualify further without an HLD score of 26 points or more.
- Healthy Families dental coverage through CCS may provide orthodontic benefits with an HLD index score of at least 26 points or more.
Some of the HLD qualifications include:
- Patients must have lost all primary (baby) teeth or be at least 13 years old and not more than 21 years of age.
- HLD index score must be 26 points or more.
- Damage to soft tissue should be the result of severe deep impinging overbite.
- Overbite (overjet) must be greater than 9 mm.
You can learn more about available dental benefits by contacting your nearest Freeway Insurance agent.
How Do I Apply for Denti-Cal?
In order to receive Denti-Cal dental benefits you must first apply and qualify for Medi-Cal health insurance. Enrollment for Medi-Cal is open throughout the year so there is no waiting until next year if you miss the Covered California open enrollment. Applying is just a matter of meeting Medi-Cal income and California residency status requirements to qualify for no-cost health insurance or low-cost health insurance.
Find Affordable Dental Care in California!
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Freeway has partnered with Covered California and some of the nation’s most trusted carriers to help its health insurance customers find affordable, quality health plans at low-cost or no-cost. And, as always, Freeway’s services and your free health care quotes are 100% free.