Important Changes to Medi-Cal Dental Coverage

If you or a family member uses Denti-Cal (Medi-Cal Dental) to cover your dental care, please read this carefully. Two significant changes are taking effect on July 1, 2026 that may affect your coverage. We want to make sure you understand what’s happening and what your options are.

What’s Changing on July 1, 2026?

Change #1: Some Adults Will Lose Full Dental Benefits Based on Immigration Status

Starting July 1, 2026, Denti-Cal will no longer cover routine dental services for certain adult Medi-Cal members who do not have satisfactory immigration status (SIS). This is being referred to by the state as full-scope Medi-Cal “with no Dental.”

Who is affected:

• Adults age 19 or older who are undocumented or who have an unsatisfactory immigration status (UIS) under current federal rules

What coverage remains for those impacted:

• Emergency dental services only — this includes treatment for severe pain, tooth infections, extractions for acute problems, and other qualifying urgent dental needs. Routine cleanings, fillings, X-rays, and preventive care will no longer be covered.

Change #2: Reimbursement Rate Cuts That May Reduce Provider Access

Separate from the immigration-related changes, Proposition 56 supplemental payments to Denti-Cal providers are being eliminated on July 1, 2026. Prop 56 (passed by California voters in 2016) funded meaningful increases to dentist reimbursement rates — the first significant increase since the 1990s. These payments have made up 40% or more of what Denti-Cal pays dental providers.

What this means for patients:

• Dentist reimbursement rates will drop significantly, potentially by 40–80% for some services
• A CDA survey found that nearly half of dentists currently participating in Denti-Cal may leave the program or see fewer Medi-Cal patients if these cuts take effect
• Patients across all immigration statuses may find it harder to find a Denti-Cal provider, face longer wait times, or be told their provider can no longer accept Denti-Cal

This affects ALL Denti-Cal patients — not just those with immigration status changes.

Did You Receive a Notice in the Mail?

Beginning in April 2026, the California Department of Health Care Services (DHCS) began mailing notices to affected Denti-Cal members. If you received one, it explains whether your benefits are changing. If you’re unsure whether you received a notice or what it means, please contact our office — we’re happy to help you understand it.

What Are Your Options?

If your dental benefits are being eliminated:

1. Schedule an appointment before June 30, 2026. If you currently have full Denti-Cal benefits, you can still use them for routine care — cleanings, exams, X-rays, fillings — through June 30. Don’t wait. Call us now.
2. Ask us about payment plans or in-house options. We understand affordability is a real concern and are committed to working with our patients. Please talk to our front desk about what financial options may be available.  https://heydaydental.com/insurance/
3. Purchase a PPO Dental Plan. PPO Dental Plans are available directly through insurance carries. It can offset the cost of routine and major dental treatment.

If your benefits are staying the same but you’re worried about provider access:

• Don’t delay care. With many providers potentially leaving the Denti-Cal network, staying current with your preventive care now is the best way to avoid costly problems later.
• Keep your annual renewal current. Missing your Medi-Cal renewal deadline could end your coverage. You have a 90-day window to fix a missed renewal, but don’t let it lapse.

We’re Here for You

These changes are complex and we know they can feel overwhelming. Our team is available to answer questions about your coverage, help you confirm your status, and ensure you get the care you need before any benefits change. Please don’t hesitate to call our office 925-217-0299.