Dental Benefits Through Covered California

Thank you for choosing Dental Health Services through Covered California.

You can submit your payment information and dentist selection here. You can conveniently pay with either a credit card or your bank account information. Your first payment will not be withdrawn from your account until the beginning of your first month of coverage. Your payments will be withdrawn from your account between the 5th and the 15th of each month.

Member Information

Primary Subscriber Name

Birth Date (MM/DD/YYYY)

Address:

City:

State: CA OR WA Zip Code:

Phone:

Email:

Your Selected Dentist Number

Don't know which dentist to select yet? Not to worry! You can always log into your member portal and complete this step later

( search )

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

Payment Information

Payment Frequency Monthly Autopay Annual Monthly Invoice Payment Method Credit Card Checking Withdrawl

Card Type (Visa, MasterCard, or Discover) Visa MasterCard Discover Cardholder Name

Card number

CVV Code

Expiration date

January February March April May June July August September October November December 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035 2036 2037 2038 2039 2040 2041 2042 2043 2044 2045 2046

Bank Routing # Checking Account #

 

By selecting one of the above payment methods, you authorize Dental Health Services to withdraw the applicable premium from your account.

If you have questions about these terms, you are invited to speak with your Member Service Specialist at 800.63.SMILE

• Home
• About Us
• Exchanges
• News
• Resources
• Contact Us

If English is your secondary language, you may obtain this information written in your language. Please call a Member Services Specialist at 866.756.4259 or toll-free at TTY line 711 for the hearing and speech impaired.

IMPORTANTE: Si Ingles es su Segundo idioma, usted podria obtener esta información escrita en su propio idioma. Para ayuda gratuita, llame a su Especialista de Membrecia al 866-756-4259. O a la linea gratuita TTY 711 para personas con necesidades de audicion y habla.