加州医疗保险牙科福利变更 - 常见问题
Medi-Cal 牙科福利变更的生效日期已推迟至 7 月1 、 2027日。
以下是对部分 Medi-Cal 成年会员牙科福利终止问题的解答：
1. 从 1 月 1 和 2026 开始，Medi-Cal 福利发生了哪些变化？
从1 月1和2026起，一些成年人将无法享受 Medi-Cal 的全面保障，包括牙科、视力和其他服务。这是根据他们的移民身份而定的。该变更适用于 19 岁及以上、未怀孕或产后一年内的成年人（怀孕后）。
如果这种情况适用于您，您将只符合享受限制范围 Medi-Cal 的资格。它涵盖紧急护理，包括牙科急诊和与怀孕有关的服务。如果您未满 26 岁，并且在 18 岁生日时处于寄养状态，您的牙科服务将不会改变。
To find out if the change affects you, go to: Medi-Cal Changes.
2. 7 月 1、2027 日，牙科福利将如何变化？
Starting July 1, 2027, 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.
变化如何影响你
- If you applied for Medi-Cal before January 1, 2026, you can use your full dental benefits until June 30, 2027. Starting on July 1, 2027, 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.
- 如果您在1 年 1 月或之后申请 Medi-Cal，2026 ，您将仅有资格获得限制范围 Medi-Cal。该保险涵盖紧急情况，包括与牙科相关的服务、与怀孕相关的服务以及一些养老院护理。
注意：这一更改不会产生影响：
- 19 岁以下儿童和孕妇。他们将保留全额 Medi-Cal 和牙科保险。
- 年龄在 26 岁以下、18 岁生日时仍在寄养家庭中的寄养青年。他们将保留牙科福利。
3.哪些移民将无法获得有牙科保险的 Medi-Cal？
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. 全面覆盖的 Medi-Cal（不含牙科保险）提供哪些紧急牙科服务？
承保范围内的牙科急诊服务是指为止住剧痛或诊断和治疗突发的严重医疗问题而需要立即进行的治疗。严重问题是指如果不及时治疗可能会造成严重伤害或死亡的问题。牙科急诊服务可用于
- 口腔出血不止
- 口腔内或周围肿胀疼痛
- 牙痛或下颌疼痛
- 脸部或颚骨受伤
- 牙龈或牙齿感染，伴有疼痛或肿胀
- 术后护理（如更换绷带或拆线）
- 牙齿断裂或磕掉
- 剪断或固定牙套上的钢丝，以免伤及脸颊或牙龈
To learn more, go to Smile, California at: Smile, CA – What should I do if I have a dental emergency?.
5.如果我怀孕了，但不确定自己是否有资格享受加州医疗保险的牙科福利，我该怎么办？
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.如果我怀孕了或产后一年（怀孕后），我是否可以继续参加 Medi-Cal 牙科计划（牙科管理性保健计划）？
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.如果我是寄養兒童、寄養青少年或未滿 26 歲的前寄養青少年，且在我 18 歲生日時仍在寄養家庭，我可以留在 Medi-Cal 牙科計劃（牙科管理性護理計劃）中嗎？
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.当我的 Medi-Cal 变为不含牙科的全范围时，我需要做什么吗？
您的保险范围应自动更改。如果您收到 Medi-Cal 续保邮包，请填写。在截止日期前寄回。您可以致电您所在县的 Medi-Cal 办公室寻求帮助。为避免失去 Medi-Cal 福利，请回答县里的所有要求。
9.如果变更发生时我正在接受牙科治疗，该怎么办？
如果你现在正在接受牙科治疗，而你：
- 不符合享受全范围 Medi-Cal 牙科福利的条件，以及
- 未怀孕或怀孕后第一年，或
- 年龄不低于 26 岁，且在 18 岁生日时处于寄养状态：
You can keep getting your dental care until June 30, 2027. Starting July 1, 2027, only emergency dental services will be covered.
10.当我的 Medi-Cal 转为不含牙科的全范围承保时，我是否需要选择新的牙医？
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.
11.19 岁以下且不符合联邦全面 Medi-Cal 资格的 Medi-Cal 新会员或现有会员的承保范围是否会发生变化？
无论移民身份如何，他们都将保留全面的 Medi-Cal。这包括牙科服务。
12. 19 岁及以上的新 Medi-Cal 会员或现有 Medi-Cal 会员，如果不符合联邦全面医疗补助资格，是否可以获得牙科服务？
No. Starting July 1, 2027, 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.从哪里可以获得更多帮助？
如果您需要英语以外的帮助，请致电您所在县的 Medi-Cal 办公室。如果您需要其他格式的 Medi-Cal 書面資訊，Medi-Cal 有布萊葉盲文、大字體、錄音、數據 CD 或其他無障礙格式，可幫助您理解信件或填寫表格。为了得到这个
- Go to Alternative Formats.
- Call (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.
如需其他帮助，请致电
- 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.我可以在哪里了解更多关于我的移民身份如何影响我的加州医疗补助计划（Medi-Cal）的信息？
DHCS 和县 Medi-Cal 办事处无法回答有关移民身份或公共指控的问题。如果您对自己的移民身份和 Medi-Cal 福利有任何疑问，请咨询合格的移民律师。
其他资源包括
- 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.
- 加州卫生与公共服务局公共负担指南。要了解公共负担规则，请访问： CHHS – 公共负担指南。
- California’s immigration resource page. To learn more, go to: Immigration and California families.
15.我可以在哪里了解更多关于加州医疗补助计划（Medi-Cal）资格的信息？
- 为了 一般 questions, 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.
- 为了 帮助 与 管理 关心 计划 questions, 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.
- 称呼 Medi-Cal 健康 关心 选项 (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.
- 为了 问题 关于 您的 牙科 请致电 Medi-Cal 牙科计划。电话号码在您的 Medi-Cal 牙科计划卡背面。通话免费。
- 为了 变化 到 这 范围 的 Medi-Cal 覆盖范围 基于移民身份，请发送电子邮件至ImmigrationPolicy@dhcs.ca.gov。
- 到 学习 more, go to: Medi-Cal Changes.
16.从哪里可以了解更多牙科服务？
- 电话： 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.
- 在线的： Go to the Smile, California website at Smile, California