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. Preventive dental services include:

  • Cleanings
  • Oral exam
  • Dental X-rays
  • Fluoride treatment

Comprehensive dental services are covered on select plans with a $500 benefit limit per year. $2,500 benefit limit per year for Plan 014 (SNP). 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.

2020 Dental Benefits by Plan

MA Plan 006

Routine and Comprehensive Dental Care: This includes cleanings and dental services as listed above.

Maximum benefit allowance of $500 per year. Preventive services have no frequency limit and do not accrue to the $500 allowance.

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.

Maximum benefit allowance of $500 per year. Preventive services have no frequency limit and do not accrue to the $500 allowance.

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.

Maximum benefit allowance of $500 per year. Preventive services have no frequency limit and do not accrue to the $500 allowance.

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.

Maximum benefit allowance of $2,500 per year. Preventive services have no frequency limit and do not accrue to the $2,500 allowance.

You pay any cost over the $2,500 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.

 

DID YOU KNOW...?

Stay on Top of Your Prescriptions

Woman grabbing a prescriptionDid you know that certain prescription medicines are available as a 90-day supply? Medicine that you take on a long-term basis to manage your health is called a “maintenance drug.” A 90-day supply makes it easier to keep taking the medicine you need to feel your best. You may also be eligible to receive your long-term medications through free home delivery.

LEARN MORE

☏ HAVE QUESTIONS ?

Sales Team

Get real answers
from real people

Phone: 1-800-944-1247
Email: Sales@chpw.org

x