Age 21 and Older
We pay for covered dental and dental-related services when they are:
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Within the scope of the eligible clients medical care program
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Medically necessary
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Within the standard of care; and
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Within accepted dental or medical practice procedures that are:
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Consistent with a diagnosis of dental disease or condition; and
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Reasonable in amount and duration of care, treatment, or service.
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Subject to the limitations and listings of non-covered procedures.
Eligibility, Fee Schedule, and Billing Instructions for clients age 21 and older.
WAC Program Regulations:
388-535-1050 Dental-related definitions
388-535-1065 Coverage limits for dental services
under GA-U and ADATSA programs
388-535-1247 Dental-related services not covered
for clients through age twenty
388-535-1255 Covered dental-related services -
Adults
388-535-1257 Covered dental-related services for
ages 21 and older - Preventative services
388-535-1259 Covered dental-related services for
ages 21 and older - Restorative services
388-535-1261 Covered dental-related services for
ages 21 and older - Endodontic services
388-535-1263 Covered dental-related services for
ages 21 and older - Periodontic services
388-535-1266 Covered dental-related services for
ages 21 and older - Prosthodontics (removable)
388-535-1267 Covered dental-related services for
ages 21 and older - Oral and maxillofacial surgery
services
388-535-1269 Covered dental-related services for
ages 21 and older - Adjunctive general services
388-535-1271 Dental-related services not covered
for ages 21 and older
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