Medical and Dental Services

All children and adults with disabilities should receive routine or preventive medical and dental care to maintain overall good health. In most cases, the costs for medical and dental services are paid for by private health insurance or generic resources such as county health clinics and community dental clinics, Medi-Cal/CalOptima and Medicare. However, there are some circumstances in which RCOC funds medical or dental services.

Medical

For detailed information about RCOC’s policies for medical care, review RCOC’s Purchase of Service Guidelines.  These Purchase of Service (POS) Guidelines have been adopted by the Board of Directors to ensure that RCOC exercises good stewardship of the tax dollars it spends on behalf of people with disabilities.  RCOC follows these Guidelines when authorizing service requests for consumers and families.

If you need help determining whether you or your family member is eligible for health care through Medi-Cal/CalOptima, contact your RCOC service coordinator.

Dental

As with medical care, RCOC follows Purchase of Service Guidelines when authorizing service requests for consumers’ dental care needs. In addition, when California eliminated funding for most adult dental services in 2009, RCOC assumed some of these costs and developed Dental Services Funding Guidelines that mirror the standards that had been in place for Denti-Cal, the dental component of the state’s Medi-Cal program. If you need dental care services, follow these steps:

1. Consult with your usual dental care provider.  Some services are still covered by Denti-Cal and your dentist may be able to deliver the treatment you need as they always have.  If your provider cannot treat you, he or she may be able to refer you to another dentist or facility that does cover the service.
2. If you find that your regular dental care provider cannot meet your needs, and cannot refer you to another provider, contact your RCOC service coordinator for help.  Your RCOC service coordinator will explore possible insurance and other possible resources, such as Community Dental Clinics, that may be available to meet your needs. If no community resources are available, RCOC will pay for a qualifying and approved dental service.

To learn more about California’s decision to eliminate most adult dental services from Denti-Cal, read the Adult Denti-Cal FAQs. For details on how RCOC determines whether it may pay for adult dental services, review the Dental Services Funding Guidelines.