WILL MEDI-CAL PAY FOR MY TREATMENT?
Medi-Cal gets approved on a case-by-case basis, and not every case gets accepted and paid for by the state. New patients 21 and under are eligible to be screened for coverage.
Patients who score high enough on the HLD and who are in full adult dentition (i.e., lost all their baby teeth) will have their case submitted to the state.
The state will make the final determination as to whether the case is accepted or denied coverage.
Accepted cases receive full coverage for treatment if benefits remain active throughout treatment. For cases that are denied coverage, our Treatment Coordinators will reach out to discuss an affordable payment plan that will work for your family.
Malocclusion Severity Index
Many insurances, Medical/Dentical included, require the patient to have a specific amount of “severity’ for their malocclusion (bad-bite), in order to offer financial assistance and or coverage for orthodontic treatment.
These requirements focus primarily on the severity of the bite and damage to the oral environment. They usually do not take into account smile esthetics or the psycho-social benefits of orthodontic treatment.
Orthodontic treatment can have a significant improvement to a person’s quality of life. This is the reason we offer very affordable payment options, so that we never let finances stand in the way of a confident smile.
Below is the Handicapping Index for the California Denti-Cal Program followed by examples of patients that have qualified for this program.
(*In office scoring by our doctors is not a guarantee of coverage as only the official Reviewers/Adjudicators at the state level can either accept or deny coverage.)