Dear Sacramento Medi-Cal Dental Subscribers,

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We understand that the transition from Fee-for-Service (FFS) to Dental Managed Care (DMC) in Sacramento County may cause you significant concern, especially when it comes to maintaining access to high-quality, flexible dental care for your family. We recognize how important it is for you and your loved ones to receive timely and personalized dental services, and we empathize with the challenges that this change may bring.​​

 

Background:

In December 2023, the California Department of Health Care Services (DHCS) allowed Medi-Cal Dental beneficiaries in Sacramento County to switch from their current Dental Managed Care (DMC/GMC) plan back to Fee-for-Service (FFS) due to failures of DMC plans to meet the acceptable standards for delivering timely and quality dental care. Many families, especially children, experienced delays and disruptions in care under DMC plans. This decision was made to ensure that Medi-Cal recipients could maintain access to dental care that met their needs.

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However, DHCS recently announced that it will return to Dental Managed Care plans effective July 1, 2025, forcing beneficiaries to transition back to DMC/GMC. 

 

For many families, children’s dental health is a top priority, and we know that losing access to your current provider can lead to unnecessary delays and disruptions in care. As parents and guardians, you have every right to ensure your children receive the best possible dental care—and we want to support you in advocating for that right.

 

How to Still Switch Out of Your Current DMC Plan: You must submit a Beneficiary Dental Exception (BDE) request form to the Department of Health Care Services (DHCS). For more information visit DHCS website or CLICK HERE.
 

How to Stay in Fee-for-Service Medi-Cal Dental: You can continue seeing your current Fee-for-Service (FFS) dental provider until July 2026. Call your DMC plan at (800) 430-4263 thirty days before July 2025 and ask for Continuity of Care with your current FFS dental provider so you can continue seeing your current FFS dental provider through July 2026. Before July 2026, submit a Beneficiary Dental Exception (BDE) request to DHCS if you wish to continue in the FFS program beyond the transition period.

 

IMPORTANT: If you want to continue seeing your current FFS provider after July 2025, you must contact your DMC plan at least 30 days before July 2025 and request Continuity of Care with your current provider.

 

For More Information on How to Submit a BDE Request or For Assistance, Please Contact:
📞 Medi-Cal Dental Customer Service: 1-800-322-6384
🌐 Visit: www.dental.dhcs.ca.gov

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The Impact on Children:

Children’s dental health is crucial for their overall well-being, impacting their ability to speak, eat, and learn. The return to Dental Managed Care poses a significant risk to children’s access to timely, consistent dental care. Many pediatric dental providers do not accept DMC plans, leading to longer wait times, fewer options, and potential gaps in care.

 

Why It Matters for Children:

Children are particularly vulnerable when it comes to dental care. Oral health plays a critical role in overall health and well-being, affecting everything from nutrition to speech development. Changes to the dental care system can create barriers that put children at risk for delayed or inadequate treatment, leading to future health issues that could have been prevented with the right care.​​

 

​Why Medi-Cal Dental Fee-for-Service (FFS) is a Better Choice Than Dental Managed Care (DMC) plan?

When it comes to accessing quality dental care, Medi-Cal Dental Fee-for-Service (FFS) offers greater flexibility, more provider choices, and fewer restrictions compared to the Dental Managed Care (DMC) model. Here’s why FFS is the better option for Medi-Cal Dental beneficiaries:

 

1. More Freedom to Choose Your Dentist

With FFS, you can visit any Medi-Cal Dental provider who accepts Medi-Cal, without being restricted to a network. In contrast, DMC requires you to choose a dental plan, which may limit your choice of providers and make it harder to find a dentist that meets your needs.

 

2. Easier Access to Specialty Care

FFS allows patients to see specialists without needing referrals from a primary dentist. Under DMC, referrals often require plan approval, leading to potential delays in receiving necessary treatments.

 

3. No Plan Enrollment or Restrictions

FFS: No need to enroll in a managed care plan—simply find a participating provider and receive care.

DMC: Requires enrollment in a specific dental plan, and switching providers within the plan can be difficult.

 

4. Faster Appointment Availability

Many patients under DMC experience longer wait times due to limited provider availability within their plan. FFS offers a larger network of dentists, increasing the likelihood of getting an appointment sooner.

 

5. No Prior Authorizations for Basic Services

DMC plans often require pre-approvals for certain procedures, which can delay necessary treatment. FFS allows dentists to provide services without unnecessary delays, ensuring timely care.

 

6. Statewide Access

FFS is now available for Sacramento County Medi-Cal Dental subscribers, making it a more flexible and widely accessible option for Medi-Cal beneficiaries.

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For more information or to switch to FFS, visit Smilecalifornia.org/Sacramento or call Health Care Options at (800) 430-4263.

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