By skyforbes I am helping a very close family friend in California who will need some dental work, specifically may need several extractions, possibly root canal and possibly dentures.
They have Medi-Cal and also Medicare Advantage. They have an HMO dental policy (Delta Dental) through the Advantage plan. My understanding from reading is that the insurance must first be billed and Medi-Cal can then be billed as the last resort. Am I right in understanding that Medi-Cal might cover the out-of-pocket expenses that they incur?
She will be going in to the dentist tomorrow and I will try to call the Medi-Cal line today, but have heard of the long wait times. Essentially, my question is, if the provider is in network for the HMO and also a Medi-Cal dental provider, will Medi-Cal cover the out-of-pocket expenses that our friend incurs? If so, what should she ask the Dental provider to bill (get the allowable charges from Delta Dental and bill Medi-Cal for out of pocket expenses, etc.)?
Thank you all for the help!