Please fill out the form below to make a payment for your Covered California dental coverage through LIBERTY Dental Plan. You also have the option to click here to print the form and mail your payment. Please note that checks should be made payable to LIBERTY Dental Plan.
**IMPORTANT: Initial payments are refunded if we are unable to verify your member ID. If you experience this, please review the member ID on your payment receipt and resubmit payment as necessary, or contact us if you have any questions.
For subsequent payments: Please visit https://libertydentalplan.ixt.com to set up an account to view and pay your invoices. You can also make a one-time payment using our IVR payment system at (877) 484-4345.
Click here to print the form and mail your 2017 Special Enrollment Period Late Payment. Checks should be made payable to LIBERTY Dental Plan.
The name and address entered must match the name and address on file with your bank or credit card account.
I authorize LIBERTY Dental Plan to charge the Total Amount Owed to the payment method selected above.
I understand that eligibility will begin on the proposed effective date, pending enrollment confirmation from Covered California and successful payment processing.