Though it has been years that the Affordable Care Act (ACA), widely known as the ObamaCare, was constituted, there is still so much to be learned about this health reform law, and people in the US are still throwing many questions about how it works and how it affects them. One of the major topics regarding the law is it is making dental insurance plans cheaper. Well, the truth is, the ObamaCare only has a relatively small impact on dental coverage for adults, but does aim to extend such benefits to children. Now, if you are one of those individuals who want to know how this service really works, take a look at the following ACA dental insurance FAQs.
ACA Dental Insurance FAQs
Q: Will I be able to get cost assistance on dental coverage?
A: Typically, this type of financial assistance will only apply to major health coverage and not to dental plans, but if you were able to take out a marketplace plan that covers insurance for dental services, it will only have one premium to which premium tax credits will be applied. You will not be able to apply tax credits to stand-alone dental plans.
Q: Does the ObamaCare require Americans to buy dental insurance?
A: No. While most Americans were required to purchase health insurance last year or face tax penalties, the ACA does not mandate people to get dental insurance. Adults are not required to purchase it for themselves, and technically neither they are required to do the same for their children. However, since vision and dental coverage for children is one of the law’s 10 EHB categories, it is being embedded into the qualifying health insurance plans, unless it is provided as standalone coverage on insurance exchanges.
However, Americans not being required to purchase dental plans does not entail that they should forego them. Remember that dental insurance is linked to access to preventive care, such as regular exams and cleanings, which is very important to oral and overall health. As you will see, most of the basic dental plans will cover preventive services and visits at 100% and will just cost less than a dollar per day.
Q: Will the ACA dental insurance be sold on the health insurance exchanges?
A: The answer here depends on the state you are living in. take note that some marketplaces are selling standalone dental plans for adults and children, but this does not mean that you have to purchase them on an exchange. You can shop in and out of your state’s exchange to be able to find the best coverage and rate for your needs. Also, you can contact a broker or an agent, or consult a sales specialist at dentalinsurance.org for assistance in searching for a reliable and affordable dental plan. You can even visit the website directly to look for plan options and quotes from a variety of providers.
Q: Will the ObamaCare health plans include dental benefits?
A: The ACA does not cover dental benefit requirements that are outside the pediatric vision and dental EHB. Also, designs of health plans differ, so it can happen that major health insurance policies sold on and off the exchanges will cover dental benefits. Usually, family and individual health plans do not include dental procedures and oral surgery, unless the services are seen as medical in nature. So, before you buy health insurance, you should read the fine print and ask questions first about the benefits carried by the plan you are about to take out. Always check with your insurer to see if hospitals, physicians and treatments are covered before you receive care.
Q: When it comes to the Obamacare pediatric vision and dental essential health benefit (EHB), who is considered a child?
A: Under the ACA, children under 19 years of age are eligible for pediatric services.
Q: Does the ACA allow children to stay on dental insurance plans of their parents through the age of 26?
A: While the ACA does not mandate child eligibility for dental coverage to be through age 26, a lot of dental insurers decided to raise the dependent age limit in their policies. However, this practice is strictly optional, so again, check and work directly with your provider regarding the dental plan you are going to buy.
Q: What is the coverage of the pediatric vision and dental EHB?
A: Remember that benefits would vary, where each state would select a benchmark plan, but most, if not all, plans include similar basic benefits. One plan may offer less and another may offer more. Also, take note that health plans having embedded dental benefits might cover relatively low-cost and common diagnostic, preventive and emergency procedures, while a Children’s Health Insurance Program (CHIP) program might have more robust benefits, which include medically necessary orthodontia.
Q: If the pediatric vision and dental EHB in my state is sold separately, do I have to buy it for my child or children?
A: No, as parents or guardians are not required to take out standalone pediatric vision and dental EHB plans for their children when buying on their individual state’s exchange. And according to how the American Dental Association interprets the ACA, those who are purchasing health plans through their employer and those who are buying off the exchange are mandated to purchase the pediatric vision and dental EHB.
Q: Are there Obamacare subsidies and tax credits for dental insurance premiums?
A: The answer is “no”, as the financial aid only applies specifically to health insurance plans that are bought from federally funded and state-based exchanges. In addition, eligibility is determined by the income a household earns.
Q: Are grandfathered plans required to include the pediatric vision and dental EHB?
A: No, as health plans that are granted grandfathered status are not a constituent to the ACA EHB categories or any other provision.
Q: Can I cancel my dental plan if I want to?
A: In general, you have the freedom to cancel your dental plan anytime by not paying it, especially if it is a standalone plan. However, remember that if you buy a plan that includes dental coverage, you cannot drop the dental part without dropping the entire plan.