Insurance

Medi-Cal Health & Dental Benefits

What does medi cal insurance cover

  1. ambulatory (ambulatory) services
  2. emergency services
  3. hospitalization
  4. maternity and newborn care
  5. mental health and substance use disorder services
  6. prescription drugs
  7. programs such as physical and occupational therapy (known as rehabilitation and habilitation services) and devices
  8. laboratory services
  9. preventive and wellness services & chronic disease management
  10. Children’s (pediatric) services, including oral and vision care.
  11. Take a look at the medi-cal health benefits webpage for more information about the services in each category. For a definition of any of the terms used, see the federal glossary at healthcare.gov.

    full restoration of adult dental benefit effective January 1, 2018

    Medi-Cal offers comprehensive preventive and restorative dental benefits for both children and adults. You can find a Medi-Cal dentist on the Medi-Cal Dental Provider Referral List or by calling 1-800-322-6384.

    Additionally, Senate Bill 97 (Chapter 52, Statutes of 2017) fully restored optional adult dental benefits that were not reinstated in May 2014. This policy became effective January 1, 2018. restored benefits will include, for example: laboratory processing crowns, posterior root canal therapy, periodontal services, and partial dentures, including denture adjustments, repairs, and relines. Full dental benefits are listed in the Dental Provider Manual, Section 5, Criteria Manual, posted on the Medi-Cal Dental website. more information is available on the dhcs medi-cal dental program website.

    Adult dental benefits that will remain and not change as a result of the 2014 or 2018 restorations:

    • pregnancy-related services
    • emergency services
    • Services Furnished to Residents of an Intermediate Care Facility/Skilled Nursing Facility
    • services provided to consumers by the development services department
    • benefits for mental health and substance use disorder services

      For beneficiaries who do not reside in a dmc-ods optional county, the following medical drug benefits are available:

      For more information on the benefits of the dmc-ods waiver, visit the dmc-ods website.

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