Cost of Dental Services

As an HPSM Medi-Cal or CareAdvantage member, you get covered dental benefits at no cost through the HPSM Dental program. Here is information about how to:

Get reimbursed if you paid for HPSM covered dental care 

If you paid for covered dental care on or after January 1, 2022, you can ask HPSM to pay you back.

• To request a refund for paid services, complete the Direct Member Reimbursement (DMR) Claim Form.
• To have a form mailed to you, email a request with your name and address to Customersupport@hpsm.org.
• See the top of the form for instructions on how to submit your completed form to HPSM.

Make sure you don’t pay for covered dental care

You should not be billed by any provider for any services covered by Medi-Cal and HPSM Dental. That includes private insurance cost-sharing amounts such as deductibles, co-insurance or private insurance copayments.

• To make sure you are not billed for covered dental services, please call HPSM before seeing your dental provider. 
• If any dental provider tries to charge you for services, do not pay. Tell them you should not be billed because you get Medi-Cal through HPSM. 
• Non-network dentists may try to perform dental services that are not covered by the HPSM Dental program. Or they may try to charge you more than HPSM will pay. Always call HPSM before you pay for any dental services.

Get dental care from an HPSM network provider

As an HPSM member, you get covered dental benefits at no cost when you see an HPSM network provider. Seeing an HPSM network provider is the best way to make sure you don’t pay for covered dental benefits. 

Get dental care from a non-network provider 

While we recommend that members get dental care from a provider in HSPM’s network, you can go to a non-HPSM dental provider.  

• For example, if you have been to a dentist in the past 12 months who is not in the HPSM network, you can request continuity of care. That means you can see that dentist for up to 12 months from the date of your request.
• Please call HPSM before your next visit with a non-HPSM dental provider. That will help make sure they don’t charge you for covered services. You can also request continuity of care when you call HPSM. 

Contact HPSM with questions about your dental plan