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Restoration of Adult Dental Services

  • Listed: December 13, 2018 4:40 am
  • Expires: 997790 days, 18 hours

Description

Restoration of Adult Dental Services

Senate Bill 97 (Chapter 52, Statutes of 2017) fully restored adult optional dental benefits that were not restored in May 2014.  This policy is effective January 1, 2018. DHCS is notifying beneficiaries and providers via the notices posted below.

DHCS submitted a State Plan Amendment (SPA 17-027) to the Centers for Medicare and Medicaid Services (CMS) to restore adult optional dental benefits for beneficiaries ages 21 and older with full-scope coverage. Restored benefits will include, for example, laboratory processed crowns, posterior root canal therapy, periodontal services, and partial dentures, including denture adjustments, repairs, and relines. The full dental benefits are listed in the Dental Provider Handbook, Section 5, Manual of Criteria, posted on the Denti-Cal website. These benefits will be available for beneficiaries in both Dental Fee-for-Service and Dental Managed Care delivery systems.

Adult optional dental benefits were eliminated from the Medi-Cal state plan in 2009. In May 2014, pursuant to Assembly Bill 82 (Chapter 23, Statutes of 2013), DHCS partially restored Medi-Cal adult optional dental benefits. The 2014 restored benefits included basic preventive, diagnostic, restorative, anterior tooth endodontic treatment, complete dentures and complete denture reline/repair services.

Adult dental benefits that remain in place and do not change as a result of either the 2014 or 2018 restorations:
  • Pregnancy-related services
  • Emergency services
  • Services provided to residents of an Intermediate Care Facility/Skilled Nursing Facility
  • Services provided to consumers of the Department of Developmental Services

Medi-Cal Adult Dental Benefits

Upon federal approval, adult dental benefits will change on January 1, 2018. Dental
benefits will not change for pregnant women or adults in a skilled nursing or
intermediate care facility. Children’s dental benefits will not change.

You have these services now:
• Exams and x-rays
• Cleanings (prophylaxis)
• Fluoride treatments
• Fillings
• Root canals in front teeth
• Prefabricated crowns
• Full dentures
• Other medically necessary dental services

Services to be added include:
• More types of exams
• Deep cleanings (scaling and root planing)
• Laboratory crowns
• Partial dentures
• Root canals in back teeth

If shown to be medically necessary, dental services can go over the yearly $1800 limit.
For questions or to find a dentist

• Call Denti-Cal at 1-800-322-6384. Or go to www.dentical.ca.gov.
• In Sacramento, call your plan:
o Access Dental: 1-877-821-3234
o Health Net Dental: 1-877-550-3868
o Liberty Dental: 1-877-550-3875
• In Los Angeles county, you can also call these numbers:
o Access Dental: 1-888-414-4110
o Health Net Dental: 1-800-977-7307
o Liberty Dental: 1-888-703-6999

Disclaimer: The community resource directory information is deemed accurate and up-to-date, however, you should always contact the agency or provider to confirm this information and make an appointment. Be sure to confirm payment information with the provider, if payment is required. We are not affiliated to any of the organizations listed in this app/website. The information provided in this app/site is for the benefit of the community and and we are not liable for any information changed from the date we published this information. Please contact us if you like to make any changes in the information by emailing beracahsites@gmail.com

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