Dental Benefits - Washington State Local Health Insurance - CHPW

Dental Benefits

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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