Dental - Community Health Plan of Washington - Medicare Advantage

Dental Coverage Is Included on All 2020 Plans

Routine, preventive dental services are included on all plans, with no annual limit. Basic dental services include:

  • Cleanings
  • Oral exam
  • Dental x-rays
  • Fluoride treatment.

It does not include services in connection with filling, removal, or replacement of teeth. For other dental services that are not considered routine care, you will pay 20% of the actual cost.

Comprehensive dental services is covered on select plans with a $500 benefit limit per year. Comprehensive dental services include:

  • Non-routine services
  • Diagnostic services
  • Restorative Services
  • Endodontics/Periodontics/Extractions
  • Prosthodontics, other oral/maxillofacial surgery
  • Diagnostic dental X-rays
  • Dentures
  • Other services

Medical Dental services: require prior authorization. Copays and coinsurance amounts depend on the specific services rendered. Medical services can include surgery of the jaw or related structures, setting fractures of the jaw or facial bones, extraction of teeth to prepare jaw for radiation treatment of neoplastic cancer disease, or services that would otherwise be covered when provided by a physician.

Dental Network: Members can choose to see any dentist, with no restrictions. Check with your current dentist if they accept CHPW Medicare Advantage insurance and your provider will work with us directly for billing purposes. If your dentist does not accept our insurance, you may still see them. You will need to pay up front for services and submit a claims form for reimbursement. Call Customer Service for more information about that process.

2019 Dental Benefits by Plan

MA Plan 006

Routine and Supplemental Dental Care: This includes annual cleaning and basic dental services. Maximum benefit allowance of $500. You pay any cost over the $500 allowance.

MA Pharmacy Plan 008

Routine and Supplemental Dental Care: This includes annual cleaning and basic dental services. Maximum benefit allowance of $500. You pay any cost over the $500 allowance.

MA Pharmacy Plan 009

Routine and Supplemental Dental Care: This includes annual cleaning and basic dental services. Maximum benefit allowance of $500. You pay any cost over the $500 allowance.

MA Extra Plan 010
Dental is not a covered benefit on this plan.

MA Special Needs Plan 014
There is a total maximum benefit of up to $1,800 each year for annual routine cleanings, basic dental services and other routine preventive and comprehensive services,  

MA Value Plan 016
Dental is not a covered benefit on this plan. 

2020 Dental Benefits by Plan

MA Plan 006

Routine and Comprehensive Dental Care: This includes cleanings and dental services as listed above. No limit to routine dental services.

Maximum benefit allowance of $500 per year.

You pay any cost over the $500 allowance.

MA Pharmacy Plan 008

Routine and Comprehensive Dental Care: This includes cleanings and dental services as listed above. No limit to routine dental services.

Maximum benefit allowance of $500 per year.

You pay any cost over the $500 allowance.

MA Pharmacy Plan 009

Routine and Comprehensive Dental Care: This includes cleanings and dental services as listed above. No limit to routine dental services.

Maximum benefit allowance of $500 per year.

You pay any cost over the $500 allowance.

MA Extra Plan 010

Routine Dental Care: This includes annual cleaning and dental services as listed above. No limit to routine dental services.

Comprehensive dental services are not covered.

MA Special Needs Plan 014

Routine and Comprehensive Dental Care: This includes cleanings and dental services as listed above. No limit to routine dental services.

Maximum benefit allowance of $2,500 per year.

You pay any cost over the $500 allowance.

MA Value Plan 016

Routine Dental Care: This includes annual cleaning and dental services as listed above, limit one preventive service per year.

Comprehensive dental services are not covered.

 

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Support for the Chronically Homeless

Our health clinic partner, Yakima Neighborhood Health Services (YNHS), has opened a resource center to help the homeless population in Yakima. Read more about the new Rhonda D. Hauff Resource Center in our blog.

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