Dentist that accept apple health for adults

CHPW makes it easy to keep your teeth healthy

As a Community Health Plan of Washington (CHPW) Apple Health member, you have coverage for dental services through the Washington State Health Care Authority.

Use your ProviderOne card with any dentist who accepts Apple Health.

In addition, CHPW covers accidental injury to teeth.

Find a dentist or oral surgeon

Dental care for kids (6 and under)

Kids age 6 and under can get no-cost dental care through the Access to Baby and Child Dentistry program (ABCD). Every child should see a dentist when their first tooth appears, or by their first birthday—whichever comes first.

Find an ABCD dentist near you

Dental care for youth (7-20)

The ProviderOne card covers dental care for youth age 20 and under. Covered dental services include:

  • Routine exams
  • Cleaning
  • X-rays
  • Fillings
  • Fluoride application
  • Extractions (pulling teeth)
  • Limited services are available for children with cleft palate or other serious dental problems (covers medically necessary services with prior authorization)

Dental care for adults (21+)

The ProviderOne Card covers dental care for adults age 21 and over. Covered dental services include:

  • Routine exams
  • Cleaning
  • X-rays
  • Fillings
  • Fluoride application
  • Extractions (pulling teeth)
  • Other limited dental services, including:
  • Periodontal (gum disease)
  • Endodontic (root canal)
  • Dentures/Partials
  • Oral Surgery

Developmental Disabilities Administration (DDA) dental services

Adults with the DDA designation get all the services covered for adults. They also get coverage for:

  • Topical fluoride – three times per year
  • Sealants – covered for posterior teeth
  • Crowns – stainless steel only, covered for posterior teeth with supporting documentation

Services not covered for adults

  • Bridges
  • Implants
  • Crowns

Contact the Health Care Authority for more information about dental benefits at 1-800-562-3022 or visit their site.

Become a CHPW member:

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Dental Coverage
Dental plans can cover just adults, adults and children, or children only. Anyone who is eligible and enrolls in a Qualified Health Plan is eligible to enroll in a dental plan. You’ll get to decide which household members you’d like to cover as you shop.

Households can only sign up for one dental plan. If the household is eligible for tax credits, it will only be applied to the health plan, not the dental plan.

Shopping for Dental
You can shop for dental plans the same way you pick a health plan – sort, filter, and compare options side-by-side. You can also view your total monthly costs for both health and dental before you confirm your coverage.

Pediatric Dental
Dental coverage for children is an essential health benefit, which means any child on your application who is 18 or younger is required to enroll in a dental plan.

Dental plans for children are available through Washington Healthplanfinder as family plans or as pediatric-only plans. Benefits for children don’t differ between family plans or pediatric-only plans. The only difference is that with family dental plans, all members of your household (including adults) can be covered.

Things to consider when enrolling your child in a pediatric-only dental plan:

  • Pediatric-only dental plans are not necessarily cheaper than dental coverage that covers the entire family. Plans and prices are different for each insurance company. Compare your options to make sure you pick the right coverage for your family.
  • If your child is eligible for Washington Apple Health, you don’t need to enroll them in a separate dental plan.
  • Because dental coverage for children 18 or younger is considered an essential health benefit, an annual out-of-pocket maximum applies to any dental plan your child is enrolled in. Dental is not an essential health benefit for adults so the same annual out-of-pocket maximum does not apply.

Adults on Medicaid are now eligible to receive restorative and preventative dental services, complete dentures, resin partials, root canals on anterior teeth, filling cavities and routine checkups and cleanings in addition to emergency services. For a list of non-profit dental care providers in Seattle/King County click here.

Residents of Washington state are generally eligible for Medicaid if they are at 138% of the Federal Poverty Level or below.  Also there is no open enrollment period for Medicaid. For more information about enrolling in Medicaid, click here.

Seattle & King County Public Health’s Access and Outreach additionally maintains a list of King County dental clinics that accept Medicaid, and a list of reduced cost denture providers. Call (800) 756-5437 for the most current information or click on the following links to see their most recent brochures: Dental Providers, Denture Providers, Orthodontists, or Pediatric Dentists.

Below is some information about which King County community dental clinics are newly accepting Medicaid. Clients can also use the “find a provider” link maintained by the Health Care Authority, which includes contact information for private dentists as well. However the dentists may not be currently accepting new clients.

Click on the links for location and contact information about the following clinics:

HealthPoint: Six clinics located in south and east King County provide routine and preventive dental care, extractions, fillings, crowns, bridges and root canals. Will bill Medicaid for dental services.

International Community Health Services: Four clinics located in central and south Seattle, Shoreline and Bellevue provide comprehensive oral exams and x-rays, dentures, emergency care, limited root canals, minor oral surgery, regular and deep cleanings, sealants and fluorides, and fillings and crowns. Will bill Medicaid for dental services.

Neighborcare Health: Six clinics around Seattle provide general dentistry, including exams, x-rays, cleanings, fillings and extractions,  limited oral surgery as well as limited crown, denture and root canal services. Will bill Medicaid for dental services.

Public Health Centers: Five clinics in King County provide general dental care services. Downtown clinic is for people who are homeless. Public Health dental clinics have limited capacity so presently they are adding new adult clients to the following populations ONLY:

  • Current dental client pregnant women transitioning out of pregnancy coverage
  • Current dental client children turning 19
  • Parents of current dental clients
  • Pregnant women
  • Homeless youth

Sea Mar Community Health Centers:Four Clinics in South Seattle, Des Moines, Bellevue and Burien offer primary dental care, including consultation, exams, x-rays, scaling, root canals, prophylaxis, fluoride, fillings and extractions. Will bill Medicaid for dental services.

Seattle Indian Health Board: Central Seattle clinic provides dental exams, fillings, oral surgery and extractions, scaling/polishing, limited crowns, bridge work, root canals and oral hygiene care. Will bill Medicaid for dental services; however at this time this clinic serves Native Americans ONLY.

University of Washington – School of Dentistry: Clinics located on the University of Washington campus provide comprehensive dental care for people who meet the educational needs of the school. Dental services are performed by students under the direct supervision of experienced dentists who are faculty members of the School of Dentistry. Services range from fillings, root canals, crowns, implants, complete and partial dentures and more. Will bill Medicaid for dental services.

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