The Oral Health Fund is designed to help people living with HIV/AIDS pay for dental expenses when they are uninsured or underinsured and when there is a co-payment or a share of cost with Medi-Cal or private insurance. Clients may use any dental practitioner, however, if the dentist does not accept Medi-Cal reimbursement the client may be personally responsible for charges not covered through the Oral Health Fund.
Even though in California Medi-Cal Dental Care for Adults was discontinued all procedures which were covered by Medi-Cal will be still be covered at the most recent Medi-Cal rates. If a procedure is not covered by Medi-Cal, actual costs will be paid.
ANNUAL LIMIT: If monthly income is less than $1,354; annual limit is $2500 If monthly income is $1,355 - $3,610; annual limit is $1500
ELIGIBILITY: If eligibility has not been previously established in the County Database by an agency in the CARE system, applicants must provide documentation of the following to the Fund Manager:
HIV/AIDS diagnosis Marin County residency Monthly income less than $3,610
APPLICATION PROCESS: A client or their Case Manager completes a request form and submits it to Leslie Gallen by mail or fax (457-5687). The requests forms should be accompanied by the dentist's proposed treatment plan which includes procedure codes and cost.
TREATMENT PLAN APPROVAL:
The fund will pay at the Medi-Cal rate for an initial visit to obtain a treatment plan. However, no other procedures may be undertaken without approval from the Oral Health Fund Manager.
After the treatment plan has been reviewed, the dental provider and the client will be notified of the amount the fund will cover. PLEASE NOTE: The client may be billed by the dentist for amounts not approved for coverage through the Oral Health Fund.
Oral Health Fund payments are sent directly to the dentist or clinic. Clients are personally responsible for any charges not covered by the Oral Health Fund.
The following Dental Clinics offer the most afforable oral health services:
Marin County Dental Clinic 411-4th Street, San Rafael (415) 473-5450 To utilize the Marin Dental Clinic it is strongly suggested that appointments are obtained through a Case Manager or the Fund Manager.
University of the Pacific - Dental School Clinic 2155 Webster Street San Francisco, CA 94115 (415) 929-6654
UCSF Dental School Clinic 100 Buchanan Street San Francisco, CA 94102 (415) 476-5608
