Health care coverage: fluoride treatments.

Assembly Member Bonta's fluoride treatment legislation mandates coverage of fluoride varnish applications in primary care settings for California children under age 21, expanding access through both private insurance and Medi-Cal programs starting in 2026.

The bill requires health care service plans and insurance policies to cover fluoride varnish treatments without imposing deductibles, copayments, or other cost-sharing requirements. These provisions exclude specialized health plans and Medicare supplement policies. Under the Medi-Cal program, the legislation extends coverage for fluoride and other appropriate fluoride treatments to beneficiaries under 21 years old, directing the Department of Health Care Services to establish billing and reimbursement protocols for providers.

The measure builds upon existing Medi-Cal coverage, which currently provides silver diamine fluoride treatments for children ages 0-6 and fluoride applications for those 17 and under. The new requirements apply to health plans and insurance policies issued, amended, or renewed after January 1, 2026. For Medi-Cal providers, the bill outlines specific billing allowances when fluoride varnish is applied by qualified staff working under the provider's supervision.