The bill adds a new section to chapter 48.43 RCW establishing that, for dental-only plans, the treating dentist must determine which preventive dental services are medically necessary and appropriate in consultation with the covered person, consistent with the established or recognized standard of care. A health carrier offering a dental-only plan is prohibited from restricting or overriding those determinations by imposing age restrictions or frequency limitations. If a carrier conditions reimbursement of a preventive dental service on an adjunctive service, the carrier must reimburse the provider for both services when both are provided. The bill lists preventive dental services to include dental prophylaxis, fluoride varnish, sealants, oral hygiene instruction, silver diamine fluoride, nano-hydroxyapatite, preventive resin restoration, and oral cancer screenings. The bill expands the definition of "health carrier" (in addition to RCW 48.43.005) to expressly include health care service contractors, limited health care service contractors, and disability insurers that offer dental-only coverage. Affected parties identified include health carriers offering dental-only plans, treating dentists, covered persons, and providers who deliver preventive dental services. The bill was read for the first time on 01/16/26 and referred to the House Committee on Health Care & Wellness. The text provided does not include an effective date, enforcement mechanism, penalties, monitoring or implementation details, or whether these rules apply to medical plans that include dental benefits, so those matters are uncertain from the extracted facts.

If enacted, the bill would shift authority over which preventive dental services are "medically necessary" to the treating dentist working with the patient, bar dental-only insurers from using age or visit-frequency rules to override that clinical judgment, and require dental-only carriers to pay for both a preventive service and any adjunctive service when payment for the preventive care is conditioned on providing the adjunctive service. That means dentists bear the responsibility to decide and document needed preventive care within accepted standards, patients are likely to get broader access to services like cleanings, sealants, fluoride, and oral cancer screenings, and dental-only carriers (including health care service contractors and disability insurers offering dental-only plans) may face higher utilization and costs and fewer simple grounds to deny coverage based on age or preset frequency limits. The bill text provided does not state an effective date, enforcement process, penalties, or whether the rules apply to dental benefits outside standalone dental plans, so how quickly carriers must comply, how disputes will be resolved, and how costs are monitored or recovered is unclear.