Medi-Cal Dental Benefit Changes
Back to Medi-Cal Dental Program
*The effective date for the Medi-Cal Dental Benefit Changes has been delayed to July 1, 2027*
Starting on July 1, 2027, Medi-Cal will stop covering dental services for some adult members, except for emergencies. This change is based on immigration status. The change only affects Medi-Cal members who are aged 19 and older and do not qualify for federally funded full-scope Medi-Cal.
To find out if the change applies to you, read the Immigration Status Chart at: DHCS – Immigration Status Categories
You will keep full-scope Medi-Cal with dental benefits regardless of your immigration status if:
- You are designated by the county as pregnant or one year postpartum (after pregnancy ends), or
- You are designated by the county as foster youth or former foster youth under 26 who were in foster care on their 18th birthday, or
- You are under 19
If you are enrolled in a Medi-Cal Dental Plan (Dental Managed Care Plan), you will either:
- Stay enrolled in your Dental Managed Care Plan if you are under 19, or
- Move to the Medi-Cal Dental Program (fee-for-service) for your full dental benefits if you are:
- Designated by the county as pregnant or one year postpartum (after pregnancy ends), and/or
- Designated by the county as foster youth or former foster youth under 26 who were in foster care on your 18th birthday
Emergency Dental Services:
For adults aged 19 and older who do not qualify for federally funded full-scope Medi-Cal, emergency dental services will continue to be covered through the Medi-Cal Dental Program (fee-for-service). Covered emergency dental services are those treatments needed right away to stop severe pain or to diagnose and treat sudden serious medical problems. This includes care for:
- Bleeding 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 (such as bandage changes or stitch removal)
- A broken or knocked-out tooth
- Cutting or fixing wires in braces that hurt your cheeks or gums
The following Current Dental Terminology (CDT) Codes are identified emergency dental procedures:
D0220, D0230, D0250, D0330, D0502, D0999, D2920, D2940, D3220, D3221, D6092, D6093, D6930, D7111, D7140, D7210, D7220, D7230, D7240, D7241, D7250, D7251, D7260, D7261, D7270, D7285, D7286, D7410, D7411, D7412, D7413, D7414, D7415, D7440, D7441, D7450, D7451, D7460, D7461, D7490, D7510, D7511, D7520, D7521, D7530, D7540, D7550, D7560, D7610, D7620, D7630, D7640, D7650, D7660, D7670, D7671, D7710, D7720, D7730, D7740, D7750, D7760, D7770, D7771, D7810, D7820, D7830, D7910, D7911, D7912, D7979, D7980, D7983, D7990, D9110, D9210, D9222, D9223, D9230, D9239, D9243, D9244, D9245, D9246, D9247, D9410, D9420, D9430, D9440, D9610, D9910, D9920, D9930, D9951
To learn more about Dental Emergency services, go to: Smile, California – Dental Emergency Information.
For answers to questions about which immigration statuses the changes affect, read the Frequently Asked Questions (FAQs) found in the resources below.
Provider Information
Approved Methods for Eligibility Verification
Per the Medi-Cal Dental Provider Handbook, Section 4 – Treating Members, providers must use one of the following official methods to verify a member’s eligibility:
Automated Eligibility Verification System (AEVS)
The AEVS is available 24 hours a day, seven days a week. Starting July 1, 2027, the AEVS message for members impacted by this change will be: DENTAL BENEFITS LIMITED TO EMERGENCY SERVICES ONLY. Providers can access AEVS by calling (800) 456-2387. You will need your Provider NPI and the member’s Benefits Identification Card (BIC) ID number or Social Security Number.
Medi-Cal Website (Provider Portal)
Eligibility can also be verified through the Medi-Cal Provider Portal. Please reference Provider Bulletin Volume 41 Number 2 for more information. Once logged in, providers can perform a real-time eligibility search.
Provider Bulletins
The effective date of the dental benefit changes has been delayed to July 1, 2027. Updated provider bulletins regarding this delay are coming soon.
Member Notices
During April 2026, DHCS mailed notices to affected members notifying them of their dental benefit coverage changes and the way they can obtain dental services. DHCS will mail a notice informing members that these changes have been delayed to July 1, 2027.
Updated Member Notice *Coming Soon*
Frequently Asked Questions
Member Bulletins
The effective date of dental benefit changes has been delayed to July 1, 2027. Updated member bulletins regarding this delay is coming soon.
General Resources
Contact Us
For questions about Medi-Cal Dental
Medi-Cal Dental Telephone Service Center
Phone: (800) 322-6384 The call is free.
TTY: (800) 735-2922 or 711
Hours: Monday – Friday, 8 a.m. to 5 p.m.
To find contact information for your Dental Managed Care Plan, go to:
Dental Managed Care Plan Directory
Help with Medi-Cal benefits and understanding your rights and responsibilities.
Medi-Cal Ombudsman Office
Phone: (888) 452-8609 The call is free.
TTY: California State Relay at 711
Hours: Monday – Friday, 8 a.m. to 5 p.m.