Dental coverage for kids (also called pediatric dental insurance) up to age 19 is considered an essential health benefit (leg.wa.gov) under health reform. State law (leg.wa.gov) requires individual and small group health plans to cover these services - either as part of the health plan or through a separate stand-alone pediatric dental plan.
Pediatric dental insurance you buy through the Health Benefit Exchange
You can get pediatric dental insurance included in a Qualified Health Plan (QHP) you buy through the Washington Healthplanfinder (also called the Exchange) (www.wahealthplanfinder.org).
However, not all QHPs include pediatric dental insurance. If not, you’ll need to buy a separate stand-alone dental plan to supplement the QHP.
Pediatric dental insurance you buy outside of the Health Benefit Exchange
If you buy a health plan outside of the Exchange that does not include pediatric dental benefits, you must provide written proof (leg.wa.gov) that you also bought a pediatric stand-alone dental insurance plan.
Some of the services the pediatric dental benefit may cover
- Diagnostic services
- Preventive care
- Restorative care
- Oral surgery and reconstruction
- Root canals