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Medi-Cal Dental Managed Care

The California Department of Health Services (Department), Medi-Cal Dental Managed Care Program provides a comprehensive approach to dental health care, combining clinical services and administrative procedures that are organized to provide timely access to primary care and other necessary services in a cost effective manner. The Department contracts with three Geographic Managed Care (GMC) Plans and five Prepaid Health Plans (PHP) that provide dental services to Medi-Cal Beneficiaries in Sacramento and Los Angeles counties. All Medi-Cal dental managed care plans are licensed by the State of California, Department of Managed Health Care, pursuant to the Knox-Keene Health Care Service Plan Act of 1975.

Each dental plan receives a negotiated monthly per capita rate from the state for every recipient enrolled in their plan. Medi-Cal Dental Managed Care recipients enrolled in contracting plans are entitled to receive dental benefits from dentists within the plan's provider network. Covered dental services provided by Medi-Cal dental managed care plans are the same dental services provided under the Denti-Cal Fee-for-Service (FFS) Program and defined in Welfare and Institutions Code 14132(h), and in Title 22, California Code of Regulations, Sections 51059 and 51307.

Dentists who wish to provide services to Dental Managed Care enrollees must participate in the Dental Managed Care plan's provider network.

Dental Geographic Managed Care (GMC)

Dental GMC is a mandatory program in Sacramento County. Medi-Cal recipients in Sacramento County who are eligible to receive dental services must select one of the available GMC plans for their dental care.

Dental Prepaid Health Plan (PHP

Dental PHP is a voluntary program in Los Angeles County. This program was established to allow Medi-Cal recipients the option to enroll in Health Maintenance Organizations (HMOs) as an alternative to the Medi-Cal Dental FFS program.

Dental Managed Care Unit (DMCU)

The Dental Managed Care Unit provides contract oversight for the PHP and GMC plans to ensure compliance with all applicable State and Federal statutes, regulations and policies set forth in their contracts. For more information, call the Dental Managed Care Unit at (916) 464-3888 or you may submit your written inquiry to:

California Department of Health Care Services
Medi-Cal Dental Services Branch
Dental Managed Care Unit
P.O. Box 997413
Sacramento, CA 95899-7413
MS 4708

For information or inquires regarding a specific GMC and/or PHP dental plan, please call the Plan's toll-free number listed on the Managed Care Plan Directory page.

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