California Ends Cost Sharing for Pediatric Fluoride Varnish in Health Plans

Edited by Hygienetown staff

California health plans and insurers that cover fluoride varnish as a pediatric oral care benefit must cover medically necessary applications without cost sharing, whether the service is billed as a dental or a medical benefit, under AB 350, which Gov. Gavin Newsom signed Sept. 27.

The requirement applies to health care service plan contracts and health insurance policies issued, amended, or renewed on or after Jan. 1, 2027. Plans may not impose a deductible, coinsurance, copayment, or other cost-sharing requirement for the coverage. Specialized plans and policies, Medicare supplement coverage, and Medi-Cal managed care contracts are excluded.

The law, Chapter 500 of the Statutes of 2026, also changes Medi-Cal. Coverage of fluoride application and other appropriate fluoride treatment extends to beneficiaries under 21, up from children 17 and under. By July 1, 2027, the Department of Health Care Services must issue billing guidance so that Medi-Cal coverage is consistent with the federal Early and Periodic Screening, Diagnostic, and Treatment benefit, subject to utilization management controls.

That policy must allow fluoride varnish without place-of-service restrictions. It may be applied by a Medi-Cal enrolled, licensed medical or dental provider, or by a qualified health care or public health professional working under that provider’s supervision. Those professionals, who include community health workers, must complete training in oral health and fluoride varnish application. The supervising provider bills on their behalf and keeps documentation of the training.

The Legislature’s findings note that current Medi-Cal policy reimburses fluoride varnish in primary care settings only for children 5 and younger. As of April 2025, most Medi-Cal managed care plans fell below the state’s 19.3% minimum performance level for children receiving at least two fluoride varnish applications a year.

Assemblymember Mia Bonta, D-Oakland, authored the bill.

Sources:
California Legislative Information, AB 350, Health care coverage: fluoride treatments, chaptered text, Chapter 500, Statutes of 2026: leginfo.legislature.ca.gov/AB350
Office of the Governor, “Governor Newsom issues legislative update 9.27.2026,” Sept. 27, 2026: gov.ca.gov/2026/09/27/legislative-update-9-27-2026