The recent implementation of the Affordable Care Act (ACA) has many patients wondering how their dental coverage may or may not be affected.  Following is a summary of how the ACA will affect patients seeking insurance for dental health.  Note that the law impacts adults and children under 18 differently.  All information is taken from HealthCare.gov.

 

Is dental coverage required under the ACA?

Dental coverage for children is an essential health benefit. This means it must be available to you as part of a health plan or as a free-standing plan. This is not the case for adults. Insurers don’t have to offer adult dental coverage.

Does everyone have to get dental coverage?

Starting in 2014, you must have health coverage or pay a fee. But this is not true for dental coverage. You do not need to have dental coverage to avoid the penalty.

What is “dental coverage” under the ACA?

Benefits that help pay for the cost of visits to a dentist for basic or preventive services, like teeth cleaning, X-rays, and fillings. In the Marketplace, dental coverage is available either as part of a comprehensive medical plan, or by itself through a “stand-alone” dental plan.

How do I get dental coverage?

Health plans that include dental coverage. In the Marketplace, dental coverage will be included in some health plans. You’ll be able to see which plans include dental coverage when you compare them. You’ll also see what the dental benefits are. If a health plan includes dental coverage, you will pay one premium for everything. The premium shown for the plan includes both health and dental coverage.

Separate, stand-alone dental plans. In some cases separate, stand-alone plans will be offered. You may want to choose this option if the health coverage you plan to enroll in doesn’t include dental coverage, or if you want different dental coverage.  If you choose a separate dental plan, you’ll pay a separate, additional premium for the dental plan.

How much does dental insurance cost?

That depends.  Some health plans include dental coverage and the cost is built in.  Stand-alone plans are priced partly on location so you will need to check plan availability based on your state and county.  This questionnaire may help you find the cost of a stand-alone dental plan: https://www.healthcare.gov/find-premium-estimates/

For more information, check out HealthCare.gov, or talk to your employer’s HR department or a licensed insurance agent.