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Beneficiary Dental Exception Reports

For more information on the Beneficiary Dental Exception (BDE) process, which allows a beneficiary to request to opt-out of a Medi-Cal Dental Managed Care Plan (MCP) and move into Fee-For-Service when they are unable to schedule an appointment with a Dental MCP provider, please refer to the Beneficiary Dental Exception – Members page for instructions.

Pursuant to Welfare and Institutions Code (WIC) Section 14089.09, the Department of Health Care Services (DHCS) is responsible for processing and reporting on Beneficiary Dental Exception requests received for Medi-Cal Dental MCP members in Sacramento County.

As part of the California Advancing and Innovating Medi-Cal (CalAIM) 1915(b) waiver Special Terms and Conditions (STC), DHCS conducted a parity evaluation to assess the performance (utilization) of Sacramento County dental managed care plans (MCPs) compared to the statewide dental Fee-For-Service (FFS) delivery system. Based on the evaluations, members enrolled in DMC plans had the option to enroll in FFS from December 2023 through June 2025, until new DMC contracts were implemented on July 1, 2025.

During this period, members were not required to submit a Beneficiary Dental Exception to transition from DMC to FFS. As a result, no BDE reporting occurred until the new Dental MCP contracts were implemented on July 1, 2025.

BDE Reports

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