Apple Health dental managed care
Find information about how to use Apple Health managed care dental.
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Starting July 1, most Apple Health clients will move to a managed care dental plan. This means Apple Health pays a dental plan a monthly premium to manage your dental coverage.
Currently, dental services are paid fee-for-service (also referred to as Apple Health coverage without a managed care plan). That's what we call it when Apple Health pays dental providers directly for each service they do, using the ProviderOne payment system.
If you currently receive Apple Health coverage, you’ll be sent information about dental services in the mail in late March. No action is required at this time.
In early June, you’ll be sent the name of your managed care dental plan, along with contact information for your plan, and how to change dental plans, if you choose.
There are two types of coverage, based on services available in your area:
Coverage with a managed care dental plan
Most Apple Health clients are automatically enrolled into a managed care dental plan. The plan will coordinate your dental care and help you access services. You will receive a dental health plan ID card and information about how to:
- Contact your dental plan
- Find a dental provider*
- Access dental services
*Clients in managed care dental must see only dental providers who are in their dental plan's provider network.
Coverage without a managed care dental plan
If a managed care dental plan is not available in your area, the Health Care Authority (HCA) will continue to cover your dental services. We call this Apple Health dental coverage without a managed care plan (also known as fee-for-service).
If you have Apple Health dental coverage without a managed care plan, you may contact your current dental provider directly to ask if they accept Apple Health. To find a provider that accepts Apple Health dental coverage without a managed care plan, use the Find a Provider search tool.
All Apple Health dental plans cover the same basic dental services. Some managed care dental plans may offer additional services.
Each dental plan has its own network of providers. Please verify with the dental plan that the providers you prefer are in the dental plan’s network. Your dental health plan will help you find these benefits and coordinate your care, when necessary.
If you have a preferred dental provider, contact them directly to ask if they accept Apple Health managed care dental.
You must be eligible for Apple Health coverage to get dental services. Find out if you’re eligible for coverage online.
You will be automatically enrolled into an Apple Health managed care dental plan. Health Care Authority will offer three managed care dental plans to our Apple Health clients. You will have the option to change your dental plan at any time.
Managed care dental plans coming July 1