Dental Health Info Article

Denti-Cal Insurance

When it comes to dental insurance in the state of California, Denti-Cal is one of the most commonly used options. We’ll explore the coverage provided by Denti-Cal, including what’s covered under the plan, who’s eligible and how you can find a Denti-Cal provider, helping you to decide whether it’s an option that’s right for you.

What is Denti-Cal?

Medi-Cal is California’s Medicaid program, a social healthcare plan aimed at assisting low-income households in the state gain healthcare cover. Denti-Cal is the dental side of the program. It offers basic dental care that’s perfect if other dental insurance plans are too costly. Before you receive treatment on this plan, your dentist will check that you’re eligible to receive Denti-Cal based on your financial situation.

What does Denti-Cal cover?

So, what can you receive coverage for under Denti-Cal? A wide variety of services are included:

  • Diagnostic and preventative treatment, including x-rays, fluoride treatments, prefabricated crowns, cleaning, and dental examinations
  • Tooth extractions
  • Root canals (front teeth)
  • Full dentures, as well as repairs and adjustments as needed
  • Emergency services
  • Orthodontics (for children who qualify)
  • Prosthetic appliances

What isn’t covered by Denti-Cal?

It’s also important to know which dental procedures aren’t covered by Denti-Cal. In general, this includes the more extensive forms of dental treatment or those that may be deemed more cosmetic:

  • Root canals (back teeth)
  • Partial dentures, implants, and bridges
  • Gum treatment
  • Orthodontic treatment (for adults)

What about braces?

Denti-Cal does provide coverage for braces, although not everybody will be able to file a claim for the fitting of orthodontics dependent on the issues and the age of the patient. The extent of the malocclusion (misalignment of teeth and bite) is evaluated first. Depending on how much of a physical handicap the malocclusion poses, Denti-Cal will either approve or disapprove coverage for braces. Bites are scored according to the California Modified HLD Index, while children with cleft lips or palates are automatically eligible for braces. In addition, you must be between the ages of 13 and 21 to qualify for braces under Denti-Cal.

How much can I claim for?

Denti-Cal has an annual cap of $1800. However, some services don’t count towards the cap, so it’s important to check the specifics of your plan before you go in to receive treatment.

How can I find out about my local Denti-Cal providers?

Not all dentists in the state will provide services under Denti-Cal. However, there are still plenty of options. You can find out which dentists accept Denti-Cal patients on the Denti-Cal website, be prepared for a waiting list or needing to shop about before finding a dentist who can provide your treatment.

Who is eligible to receive Denti-Cal?

To be eligible for Denti-Cal, you first need to be receiving Medi-Cal. People qualify for Medi-Cal in various different ways. You could qualify if:

  • Your income is at or less than 138% of the Federal Poverty Level.
  • You qualify for Supplemental Security Income.
  • You are elderly, blind, or disabled.
  • You are disabled and working.

Some non-citizens with legal residency in the United States may be unable to receive Medi-Cal. If you have been a legal resident of the US for five years or more, you can qualify for the same Medi-Cal programs as any other permanent citizen. Once you’re a recipient of Medi-Cal, it’s easy to enroll in Denti-Cal, for coverage of dental health.

Is Denti-Cal right for me?

Denti-Cal, as with any healthcare coverage option, has its pros and cons. It’s an affordable way to provide yourself and your family with a basic level of dental care, making it a very sensible option, however, you may also find there to be relatively few Denti-Cal participating dentists in your area, leading to waiting lists for your treatment. Despite this, it remains an inexpensive option for dental care for those on a low income.

Looking for a Denti-Cal dentist? Get in touch with 1-800-DENTIST and book your next appointment!