Apple Health Coverage

Apple Health (Medicaid) pays for covered dental and dental-related services for adults (21 years and older).

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

Dental services for children

Apple Health (Medicaid) includes quality dental and dental-related services for eligible children, age 20 and younger. All children should see a dentist when their first baby tooth appears or by their first birthday.

Some covered dental services include:

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

Access to Baby and Child Dentistry (ABCD)

Children under the age of six who are enrolled in Apple Health (Medicaid) have access to early dental care through the Access to Baby and Child Dentistry (ABCD) Program. This includes no-cost dental care and a path to good oral health.

Division of Developmental Disabilities (DDD)

For adults with this designation, all coverage is the same as adult coverage, along with the following additions:

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

You may be eligible for Apple Health for Adults coverage if you:

  • Are age 19 through 64.
  • Have annual household income at or below the Medicaid standard (see income chart below).
  • Are a U.S. citizen or meet Medicaid immigration requirements.
  • Are not incarcerated.
  • Are not entitled to Medicare.

There are four ways to apply for (Medicaid) Apple Health:

Online: Go to Washington Healthplanfinder – select the “Apply Now” button under Washington Apple Health.

Phone:  Call the Washington Healthplanfinder Customer Support Center at 1-855-923-4633.

Paper:  Submit an Application for Health Care Coverage.

In person: Local resources who, at no additional cost, can help you apply for health coverage.

What you need to apply

  • Your household monthly income.
  • The Social Security numbers and dates of birth for each member of your household.
  • Your immigration information, if that applies to you.

Am I signed up or enrolled in Apple Health?

You can check to see if your coverage has started by visiting the ProviderOne client portal or call our Customer Service Center at 1-800-562-3022. You will need to know your Services Card number or Social Security number.

Enrollment next steps

If you’re accepted, you’ll receive a Services Card in about two weeks. Coverage will begin on the first day of the month in which the application was submitted. You’ll have the option to select a managed care plan online or you’ll be auto-enrolled into a plan. If you’re not eligible for Apple Health, you may qualify for help with your health insurance or for other health services. The Washington Healthplanfinder website will help you with that.

Still have coverage questions?

Call Health Care Authority at 1-800-562-3022 or click links for flyers below.

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For questions about your coverage:

Call Health Care Authority at 1-800-562-3022 or click links for flyers below.

English

Spanish

Chinese

Vietnamese

I you need transportation for your appointment:

Find information about non-emergency transportation for covered medical services for individuals receiving Apple Health coverage.

Medical Assistance Customer Service Center (MACSC):

Phone:1-800-562-3022
Email: askmedicaid@hca.wa.gov
Online: Secure web form
Business hours:

  • Client line: Monday through Friday 7 a.m. to 5 p.m. Pacific Time (PT) (except state holidays)