Tuesday, March 15, 2011

How can l qualify for Denti Cal?

I don't have dental insurance,and l think l need to see a dentist for gum issues. It may required multiple visits.I am 23,make $1200 a month, and l live w/ my parents. Since l don't have to pay rent,do l qualify for Den ti Cal?
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You would only qualify if you also qualify as for medi-cal. Denti-Cal Beneficiary Eligibility A Medi-Cal beneficiary is eligible for dental services provided under the Denti-Cal Program. However, limitations or restrictions of dental services may apply in certain situations to the following individuals: ? Those enrolled in a prepaid health plan which provides dental services; ? Those enrolled in another pilot program which provides dental services; ? Those who are assigned special aid codes; ? Those with minor consent restricted service cards. According to state law, when a provider elects to verify Medi-Cal eligibility using a BIC, a paper identification card or a photocopy of a paper card and has obtained proof of eligibility, he or she has agreed to accept the beneficiary as a Medi-Cal beneficiary and to be bound by the rules and regulations of the Denti-Cal program. A person is considered a child until the last day of the month in which his/her 18th birthday occurs. After that particular month, he/she is considered an adult. However, a treatment plan authorized for a child is effective until completion if there is both continuing eligibility and dental necessity, regardless of change in age status. Beneficiaries who cannot sign their name and cannot make a mark (X) in lieu of a signature because of a physical or mental handicap will be exempt from this requirement. Beneficiaries who can make a mark (X) in lieu of a signature will not be exempted from this requirement and will be required to make their mark on the Medi-Cal identification card. In addition, the signature requirement does not apply when a beneficiary is receiving emergency services, is 17 years of age or younger, or is a beneficiary residing in a long-term care facility. If Medi-Cal eligibility is verified, the provider may not treat the beneficiary as a private-pay beneficiary to avoid billing the beneficiary's insurance, obtaining prior authorization (when necessary) or complying with any other program requirement. In addition, upon obtaining eligibility verification, the provider cannot bill the beneficiary for all or part of the charge of a Medi-Cal covered service except to collect the Medi-Cal copayment or SOC. Providers cannot bill beneficiaries for private insurance cost-sharing amounts such as deductibles, co-insurance or copayments. Once eligibility verification has been established, a provider can decline to treat a beneficiary only under the following circumstances: ? The beneficiary has refused to pay or obligate to pay the required SOC. ? The beneficiary has limited Medi-Cal benefits and the requested service(s) is not covered by the Denti-Cal program. ? The beneficiary is required to receive the requested service(s) through a designated health plan. This includes cases in which the beneficiary is enrolled in a Medi-Cal managed care plan or has private insurance through a health maintenance organization or exclusive provider network and the provider is not a member provider of that health plan. ? The provider is unable to provide the particular service(s) that the beneficiary requires. ? The beneficiary is not eligible for Denti-Cal services. ? The beneficiary is unable to present corroborating identification with the BIC to verify that he or she is the individual to whom the BIC was issued. A provider who declines to accept a Medi-Cal beneficiary must do so before accessing eligibility information except in the above circumstances. If the provider is unwilling to accept an individual as a Medi-Cal beneficiary, the provider has no authority to access the individual's confidential eligibility information.
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