Your Dental Benefits Through
Covered California

Payment Form

We are glad you are here.

Thank you for choosing Dental Health Services through Covered California. To complete your enrollment, you must submit your binder payment. You can submit your personal and plan information here and set up your ongoing payment arrangements on the next page. When you click the "Submit" button at the bottom of the page, you will be taken to Instamed, our secure payment website.

It is important to enter the birthdates of all enrollees on the plan below the "Payment Information" section. This will ensure your card is charged the correct amount by Instamed. 

Subscriber Information

* Please DO NOT include the state prefix to the dentist number. This should be a 2-4 digit number only.

Payment Information

Your Premium


If you have questions, you are invited to speak with your Member Service Specialist at 855-495-0905. They are glad to help!