Dental Care for Children and the Affordable Care Act: What Parents Need to Know

 

Trying to get one’s arms around the ACA and its impact on dental care is no mean feat. Even attorneys have been struggling to make sense of it all. So, with this in mind, I’ve attempted to simplify things by answering some of our employee’s and member’s most common questions.

 

  1. Suppose I have insurance from my employer? Might I be penalized by not having dental insurance by March 1st?Adult dental care is not required. While children’s dental care IS required, it is required to be OFFERED, not purchased, on most official exchanges. However, a few state-run exchanges may require the purchase of pediatric dental or off-exchange purchases made through brokers or others.
  2. I’m hearing about children’s dental care being an essential health benefit. What does that mean?An Essential Health Benefit (or EHB) is one that, simply, must be offered.Dental care for children (also called Pediatric Dental Care) is one of them. Again, though, they must be offered, not obtained in most cases.
  3. When we’re talking about dental care for children, what age children are we talking about?In most states, a child is considered birth to age 19. In a few states the definition has been expanded to include young adults up to age 26.
  4. Regardless of what is or is not required, what options are available for adults and especially for my children?There are two marketplaces- within and outside our government’s. Let’s start with the former.In the federal government marketplace, you can only obtain dental insurance if you also purchase a health insurance plan. Then you can either purchase a stand-alone policy or one connected to your health policy. There may be an exception to this in your state if your state has its own marketplace, but that is rare.Outside of the government, your options expand. You can buy a plan through an insurance agent, directly from an insurer or from a dental plan provider. Families who qualify for their state’s Medicaid program may also qualify for dental coverage through that agency, so be sure to ask.A dental savings plan is a non-insurance product that allows access to discounts from participating providers. The savings vary by plan, provider, and location, and range from offering between 10 and 60% off a dentist or dental specialist’s usual rates.
  5. What does DentalPlans.com offer?We sell over 30 different dental savings plans… the most and largest variety available.
  6. What about specifics like fillings and orthodontia? Do any plans cover those, or is it mostly check-ups and cleanings that we’re talking about?Most insurance plans include basics like cleanings, x-rays, and at least some fillings. Orthodontic care does not tend to be included unless it’s medically necessary. You can choose a dental plan via DentalPlans.com that offers great discounts on orthodontia if you’d like to.
  7. Since a child is defined as to age 19 or older in some states, how does the one I buy impact my out-of-state college student? As long as there are participating providers in his or her school’s state, and he/she meets the plan’s eligibility requirements, you’re good. If not, you or your student could consider an alternate insurance or non-insurance plan, like one of ours.

 

Parents, the bottom line is this: Regardless what is or is not legally required, having some sort of dental care plan for your children is necessary – for their oral health, overall health, and academic success. Who could concentrate, develop, or learn in pain? And what if your child has an emergency? Please… if you do not have dental coverage for your child, yourself, or any one else in your family, call or visit us at www.dentalplans.com today. The number of fantastic, truly affordable plans we offer will delight you.

To learn more call one of our :DP AtYourService Customer Care Representatives at 1-800-238-5163.

 

 

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