메디칼 치과 혜택 변경 사항 - 자주 묻는 질문
Here are answers to questions about the end of dental benefits for some adult Medi-Cal members:
1. How will Medi-Cal benefits change starting on January 1, 2026?
Starting on January 1, 2026, some adults cannot get full-scope Medi-Cal coverage, including dental, vision, and other services. This is based on their immigration status. The change applies to adults aged 19 and older who are not pregnant or within one year postpartum (after pregnancy).
If this applies to you, you will qualify for restricted-scope Medi-Cal only. It covers emergency care, including dental emergencies and pregnancy-related services. If you are under 26 years old and were in foster care on your 18th birthday, your dental services will not change.
To find out if the change affects you, go to: Medi-Cal Changes.
2. How will dental benefits change on July 1, 2026?
Starting July 1, 2026, Medi-Cal will not cover regular dental services for some adults, except emergencies. This is based on their immigration status. The change applies to members ages 19 and older who do not qualify for full-scope Medi-Cal (read question #1) and are not pregnant or within one year postpartum (after pregnancy). If you are under age 26 and were in foster care on your 18th birthday, your dental services will not change.
How change affects you:
- If you applied for Medi-Cal before January 1, 2026 , you can use your full dental benefits until 6월 30, 2026 . Starting on July 1, 2026, your coverage will be called full-scope Medi-Cal with no dental. If you were enrolled in a Medi-Cal Dental Plan (Dental Managed Care Plan), you will be disenrolled.
- If you applied for Medi-Cal on or after January 1, 2026, you will qualify for restricted scope Medi-Cal only. This covers emergencies, including dental-related services, pregnancy-related services, and some nursing home care.
Note: The change does not affect:
- Children under age 19 and pregnant people. They will keep full Medi-Cal with dental.
- Foster youth under age 26 who were in foster care on their 18th birthday. They will keep dental benefits.
3. Which immigrants will not get Medi-Cal with dental coverage?
The change only affects immigrants whose status does not get federally qualified funding for their Medi-Cal. To learn more, go to: Immigration Status and Changes to Medi-Cal Eligibility.
4. What emergency dental services does full-scope Medi-Cal with no dental cover?
Covered emergency dental services are those treatments needed right away to stop severe pain or to diagnose and treat sudden serious medical problems. Serious problems are those that could cause serious harm or death if not treated right away. Emergency dental services can be for:
- Bleeding in your mouth that does not stop
- Painful swelling in or around your mouth
- A toothache or jaw pain
- Injuries to your face or jawbone
- Infection in your gums or teeth with pain or swelling
- After-surgery care (like bandage changes or stitch removal)
- A broken or knocked-out tooth
- Cutting or fixing wires in braces that hurt your cheeks or gums
To learn more, go to Smile, California at: Smile, CA - What should I do if I have a dental emergency?.
5. If I am pregnant and not sure if I qualify for Medi-Cal dental benefits, what should I do?
If you are pregnant, call or go to your local county Medi-Cal office. Speak with a county eligibility worker. Full-scope Medi-Cal covers you during pregnancy and for one year postpartum (after pregnancy). It includes dental services. The county eligibility worker will tell you if they need any information from you.
6. If I am pregnant or one-year postpartum (after pregnancy), can I stay in my Medi-Cal Dental Plan (Dental Managed Care Plan)?
No. You will leave your Medi-Cal Dental Plan (Dental Managed Care Plan) and go to the Medi-Cal Dental Program (fee-for-service). You will still have dental coverage. To learn more and find a dentist, go to Smile, California.
7. If I am a foster child, foster youth, or former foster youth under age 26 who was in foster care on my 18th birthday, can I stay in my Medi-Cal Dental Plan (Dental Managed Care Plan)?
No. You will leave your Medi-Cal Dental Plan (Dental Managed Care Plan) and go to the Medi-Cal Dental Program (fee-for-service). You will still have dental coverage. To learn more and find a dentist, go to: Smile, California.
8. Do I need to do anything when my Medi-Cal changes to full-scope with no dental?
Your coverage should change automatically. If you get a Medi-Cal renewal packet in the mail, fill it out. Send it back by the due date. You can call your county Medi-Cal office for help. To avoid losing Medi-Cal benefits, answer all county requests.
9. What if I am getting dental treatment when the change happens?
If you are getting dental care now and you:
- Do not qualify for full-scope Medi-Cal with dental benefits, and
- Are not pregnant or in the first year after a pregnancy, or
- Are not under age 26 and were in foster care on your 18th birthday:
You can keep getting your dental care until June 30, 2026. Starting July 1, 2026, only emergency dental services will be covered.
10. Do I need to choose a new dentist when my Medi-Cal changes to full-scope coverage with no dental?
If you have a dental emergency, you can go to any Medi-Cal dentist. To find a Medi-Cal dental dentist near you, call Medi-Cal Dental at 1-800-322-6384. Or go to Medi-Cal Provider Directory.
11. Will coverage change for new or current Medi-Cal members who are under age 19 and do not qualify for federal full-scope Medi-Cal?
No. Regardless of immigration status, they will keep full-scope Medi-Cal. This includes dental services.
12. Will new or current Medi-Cal members aged 19 and older who don't qualify for federal full-scope qualify for dental services?
No. Starting July 1, 2026, adults aged 19 and older who don't qualify for federal full-scope Medi-Cal will only get emergency dental services. You will only keep full-scope Medi-Cal with dental services if you are pregnant or in the first year after pregnancy. If you are under 26 and were in foster care on your 18th birthday, your dental services will not change.
13. Where can I get more help?
If you need help in a language other than English, call your county Medi-Cal office. If you need written Medi-Cal information in another format, Medi-Cal has Braille, large print, audio, data CD, or other accessible formats to help you understand your letters or fill out your forms. To get this:
- 다음으로 이동 Alternative Formats.
- Call 1-833-284-0040 (California Relay 711). The call is free.
If you need information about immigration status and Medi-Cal eligibility, go to Immigration Status and Changes to Medi-Cal Eligibility Categories.
For other help, call:
- Dental Services – (800) 322-6384 (TTY (800) 735-2922)
- Mental Health Services – (800) 896-4042 (TTY (800) 896-2512)
- Substance Use Disorder Services – (800) 879-2772 (TTY 711)
- Long-Term Services and Supports – (916) 552-9105 (TTY (800) 430-7077)
- Fee-for-Service or General Member Questions – (800) 541-5555 (TTY (800) 430-7077)
14. Where can I learn more about how my immigration status affects my Medi-Cal coverage?
DHCS and county Medi-Cal offices cannot answer questions about immigration status or public charge. If you have questions about your immigration status and Medi-Cal benefits, talk to a qualified immigration lawyer.
Other resources are:
- California Department of Social Services – Immigration Services Bureau. To get a list of nonprofit organizations that help immigrants in California, go to: CDSS -Immigration Service Contractors.
- Health Consumer Alliance (HCA). To find out if you qualify for free legal help with health-related issues such as problems getting or keeping coverage and problems with a health plan. Call (888) 804-3536.
- California Health and Human Services Agency Public Charge Guide. To learn about public charge rules, go to: CHHS - Public Charge Guide.
- California's immigration resource page. To learn more, go to: Immigration and California families.
15. Where can I learn more about Medi-Cal eligibility?
- For general 질문 , call the Medi-Cal Help Line Monday – Friday, 8 a.m. to 5 p.m. (except on State holidays) at ( 800) 541-5555 . The call is free.
- For help with 관리 케어 계획 질문 , call the Medi-Cal Ombudsman Office. They help members understand their benefits and rights. They are open Monday – Friday, 8 a.m. to 5 p.m. (except on State holidays). Call ( 888) 452-8609 (TTY: 711 for California State Relay). The call is free.
- To find an office near you, go to Medi-Cal County Office Search.
- 통화 Medi-Cal 건강 관리 Options (HCO) Monday – Friday, 8 a.m. to 6 p.m. at (800) 430-4263 (TTY: (800) 430-7077). The call is free. Or go to Medi-Cal HCO at Medi-Cal Managed Care Health Care Options. Medi-Cal HCO can help with Medi-Cal health and dental plan choices.
- For 질문 about 당신의 치과 plan, call your Medi-Cal Dental Plan. The phone number is on the back of your Medi-Cal Dental Plan card. The call is free.
- For 변경 사항 에 의 scope 의 Medi-Cal 적용 범위 based on immigration status, email ImmigrationPolicy@dhcs.ca.gov.
- To 배우기 more, go to: Medi-Cal Changes.
16. Where can I learn more about dental services?
- 전화: Call Medi-Cal dental service center Monday – Friday 8 a.m. to 5 p.m. (except State holidays) at (800) 322-6384 . The call is free.
- 온라인: Go to the 스마일, 캘리포니아 website at Smile, California.
